BOSTON—There is a widespread shortage of specialists certified in the diagnosis and treatment of migraine, according to a study presented at the International Headache Congress 2013 meeting.
Researchers Emily D. Mauser and Noah L. Rosen, MD, from Hofstra North Shore–Long Island Jewish Health System in New York, geographically located all of the headache specialists certified by the United Council for Neurologic Subspecialites (UCNS) and cross-referenced those data with population data obtained from the US Census. The expected migraine and chronic migraine populations were calculated for each state, based on epidemiologic data published in 2012. Ratios of UCNS-certified physicians to expected migraine and chronic migraine populations were then compared for each state.
According to the analyses, 416 UCNS-certified headache specialists currently practice in the US, and there are an estimated 36 million patients older than 12 with migraine.
The shortages are not evenly distributed across states. New York has the highest number of specialists (56), followed by California with 29, Ohio with 29, Texas with 25, Florida with 24, and Pennsylvania with 23. Six states—Alaska, Delaware, Montana, North Dakota, South Carolina, and Wyoming—have no headache specialists. States with the worst ratios of provider to migraine patients include Oregon, Mississippi, Arkansas, and Kansas. The District of Columbia has the best ratio, followed by New Hampshire, New York, and Nebraska.
“This is a troubling picture,” said Dr. Rosen, who led the study. “Migraine is a highly disabling disorder—the seventh most disabling in the world and the fourth most disabling among women. It’s clear that many more specialists need to be trained and certified to meet the need,” he said.
He noted that migraine costs the United States more than $29 billion each year in direct medical expenses, such as doctor visits and medications, and indirect expenses such as missed work and lost productivity.