Where do you think the neuromonitoring profession is going?

I recently published a few questions on Survey Monkey and then contacted folks on LinkedIn and Facebook, asking them to complete the survey. Because I got so many responses, I decided to publish answers to each question separately. This is just the first of several surveys that I have planned to address different topics.

My survey began with the following instructions:

You have been invited to participate in this survey because you are a neurophysiologist, neurologist or technologist practicing intraoperative neurophysiological monitoring (IONM). Please answer as many of the following questions as you’d like. You can choose to maintain anonymity, or you may elect to identify yourself by writing your name at the end of each answer. Once the survey is closed, the answers will be published in a blog post on NeurologicLabs.com. Thanks for your participation!

Note: All responses are presented below as submitted though Survey Monkey. The only responses that I eliminated are the ones that were racist, sexist or otherwise egregiously unprofessional and/or inappropriate. If you didn’t have an opportunity to participate in the survey, it is still open. Responses truly are anonymous. To participate, just click here.

Where do you think the neuromonitoring profession is going?

  1. We need to band together similarly to what the nurses have and demand more respect from the doctors. Our field is crucial and highly specialized, yet we are mostly seen as “reps”. I see us finally legitimizing ourselves as an establish healthcare field. ~Anonymous
  2. Who cares? I am out once I can find a better job at near the same pay. ~Anonymous
  3. The way of the buggy whip. ~Anonymous
  4. Who cares besides underemployed 3rd world “doctors” and PhDs? ~Anonymous
  5. Down the sewer. Successful folks have sold out, already! ~Anonymous
  6. Away from simple lumbar fusions and more towards stroke and aneurysm coiling and hopefully for greater participation in cranis for eloquent cortex mapping and monitoring. ~Anonymous
  7. It has a self-imposed shelf life. The fact that the founders of modern IONM, the only real experts out there, have been reduced to the level of “tech” and pushed out of the field by the AAN, ACNS and AMA has left us in the tragic circumstance that we’re in. Online docs are clueless, the standard of care that we deliver is low, surgeons are demanding kickbacks, everyone is carving out CMS reimbursements to avoid prosecution. Automated systems are taking over IONM, driven by metal companies who offer IONM to hospitals for free. In the eyes of surgeons, most of whom don’t know any better, the expert neurophysiologist is no different than a small black box. Hospitals go with whoever is cheap, or free, and no one even cares about quality – probability because everyone assumes that it doesn’t matter, or it doesn’t exist. ~Anonymous
  8. Down hill fast as the no of requests for monitoring quickly outpaces the availability of well trained specialist staff. ~Anonymous
  9. Increase in the number of cases. ~Anonymous
  10. The profession is thriving. I think we need to be careful about not overselling and sticking to things were we can really make a difference. ~Anonymous
  11. Wandering. Good non-MDs are prevented from contributing while incompetent/unscupulous MD destroy IONM credibility. ~Anonymous
  12. UP! ~Anonymous
  13. Seems to be moving in a purely technical model direction. Higher education and training no longer be prioritized in our for-profit models. ~Anonymous
  14. My view changes depending on what I hear weekly. I think there is going to always be a need, but will the pay make it worthwhile? ~Anonymous
  15. Becoming limited due to insurance. ~Anonymous
  16. As the profession increased in utilization, the quality is driven down, as demand far exceeds the supply. The remote model is now the standard in the industry, which is bad for patient care. W/ no formal vetting/display of knowledge and competency, it’s a race to the bottom to pump of sub par care at the cheapest price. It’s funny to think that as the profession has matured, it’s actually turned out worse than where it was 10 years ago. ~Anonymous
  17. Continued growth is licensing occurs. ~Anonymous
  18. Away from patient care. ~Anonymous
  19. The need for neuromonitoring is increasing and its our job to go with the trend by improving the quality of our service to the surgeon and patient. ~Anonymous
  20. I think the profession is moving forward slowly, gradually raising the bar for professional standards, but we are not doing enough in the realm of politics to better define our scope of practice. ~Anonymous
  21. Still needed but transitioning into more guiding the surgeon than strictly “monitoring” since there is a considerable amount of un-necessary monitoring going on that will need to decline. ~Anonymous
  22. I can only say in relation to outside of US: it will continue to progress, looking forward for innovations for better /easier recording techniques for spine and nerve stimulation….. ~Anonymous
  23. Downward spiral. ~Anonymous
  24. If we don’t get away from venture capital firms taking over small agencies and bleeding them dry, and just putting any old person in the OR, IOM will tank. ~Anonymous
  25. If providers of neurophysiology services do not soon stake their claim to a legal scope of practice through state licensure, then IOM will become a watered down, devalued, automated service … with the foremost negative consequence being an increase in iatrogenic injury and decreased functional outcomes. ~Anonymous

That’s what I have so far. I’m sure more answers will come in over time. Feel free to comment below.

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