Neurology
Neurologist visit delays tied to referral, triage
Clinical takeaway: Streamlining referral workflows and standardizing triage may have greater impact on neurology access than expanding workforce alone.
Delays in neurology care are often attributed to workforce shortages, yet patients frequently face long waits even in areas with relatively high specialist availability. This study examined whether workforce supply explains delays or whether other factors shape how quickly patients are seen.
New neurology visits occurred a median of 25 days after an initial primary care or emergency department encounter, with an average wait of about 50 days. Wait times varied meaningfully by clinical and demographic factors, but neurologists per capita was not associated with faster access.
Patients with more urgent neurologic conditions were seen sooner. Stroke visits occurred about 8 days earlier than average, with similar patterns for dizziness or vertigo and traumatic brain injury. In contrast, multiple sclerosis visits were delayed by about 4 days.
Geographic and population-level differences also emerged. Patients in the Northeast waited about 5 days longer than those in other regions, and areas with a higher proportion of non-Hispanic white residents had shorter wait times. Women were evaluated about 7 days sooner than men, and those with consumer-driven health plans had the shortest delays. These patterns suggest that clinical urgency and referral prioritization, rather than overall specialist supply, largely determine access.
This retrospective analysis used 2019-2023 commercial insurance claims data from 114,034 patients, measuring time from an initial healthcare encounter to a first neurology visit.
Together, these findings shift the focus from workforce expansion alone to how patients are routed through the system. Those with higher-acuity symptoms appear to move more quickly through the system, while variation by sex, geography, and insurance suggest that referral pathways, scheduling practices, and how patients enter and move through the system also shape when they get seen. Expanding neurologist supply alone may have limited impact if these processes remain unchanged.
“Our study found that when looking at wait times to see neurologists, it is not a simple supply and demand issue,” said study author John P. Ney, MD, MPH, of Yale University in New Haven, Connecticut, and Fellow of the American Academy of Neurology. “We found that how long you wait to see a neurologist depends on things like how serious your condition is, your sex, where you live, and what kind of insurance you have.”
Source: Laffargue EK. Neurology. 2026 Apr 29. Neurology wait times after primary care or emergency department visits among the commercially insured population in the United States 2019-2023