Physician Requirements in Neurology-Reply

Dr Menken makes several points concerning the determination of requirements for the specialty of neurology by the extension of the GMENAC methodology. He believes that the earlier GMENAC estimates were more accurate than the revised numbers in our article. Of note, the original estimates for all of the six specialties discussed were just that —estimates—which were based on a review of the literature and not derived by application of the GMENAC methodology. Thus, the numbers in our article are more accurate in terms of the GMENAC methodology, although not perhaps in Dr Menken's opinion.The methodology did consider referral rates, which Dr Menken believes would be the determining factor of actual requirements for neurologists. Referral rates were one of the variables estimated by the Delphi panelists. Three of the Delphi panelists were primary care physicians, two were general internists, and one was a family physician.