The Growing Shortage of Neurologists and What It Means for Stroke Survivors

Across the US, stroke survivors are facing a growing problem: there are not enough neurologists to meet the demand for care, and the situation is worsening. For people recovering from stroke, this shortage can mean long wait times for appointments, delayed diagnosis of new symptoms, inconsistent follow-up care, and limited access to specialists who understand complex neurological recovery. The neurologist shortage is a reality affecting millions of people today, especially in rural areas and regions with limited medical resources. Stroke is already a leading cause of long-term disability, and recovery depends on timely access to neurological expertise. When neurologists are overbooked or unavailable, stroke survivors often fall through the cracks during the times when they most need support.

Why is there a shortage of neurologists?

The growing shortage of neurologists in the United States is the result of several overlapping trends in the healthcare system. First, the demand for neurological care has increased sharply over the last two decades. More people are living longer with chronic neurological conditions such as stroke, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and migraine. At the same time, new cases continue to rise as the population ages. This expanding patient population has outpaced growth in the neurology workforce, and studies predict that by 2025 the United States will face a neurologist shortfall of nearly 19 percent.

The problem is made worse by the uneven distribution of neurologists across the country. Most specialists practice in large metropolitan areas or at academic medical centers, leaving rural and underserved communities with little or no access. Data show that rural regions may have up to 80 percent less access to neurological care compared to urban areas. Many stroke survivors living outside major healthcare hubs must travel long distances or rely on overstretched local hospitals that may not have neurology services at all.

Another driver of the shortage is burnout. Neurology requires extensive training, often more than a decade from college through residency and fellowship, and the clinical workload can be overwhelming. Many neurologists carry heavy caseloads because there are too few specialists to share the demand. As a result, growing numbers of neurologists reduce their hours, limit new patients or retire early, shrinking the workforce further.

Finally, financial pressures contribute to the lack of growth in the field. Neurology is a cognitive specialty that depends on thinking, diagnosis and long patient visits rather than procedures. In the current reimbursement system, procedure-based specialties are often paid more, even when they require fewer years of training. This imbalance makes neurology less financially attractive to medical students choosing a specialty, which slows the entry of new physicians into the field.

Together, these forces have created a workforce crisis in neurology that directly affects stroke survivors who rely on specialist care during recovery.

How the shortage affects stroke survivors

For stroke survivors, the neurologist shortage is not simply a problem within the healthcare system but a direct barrier to recovery. One of the most immediate consequences is delayed follow-up after hospital discharge. Many survivors never see a neurologist once they return home, even though post-stroke complications often begin to emerge in the weeks and months after a stroke. It is common for patients to wait three to six months for a clinic appointment, and during that time spasticity can worsen, seizures may go unchecked, and medications for stroke prevention may go unadjusted. Emotional and cognitive challenges such as anxiety, depression, and memory problems are also frequently overlooked without neurological oversight.

Even when survivors are able to see a general neurologist, access to sub-specialists in stroke recovery remains limited. Vascular neurologists, who focus specifically on blood vessel disorders of the brain, are essential for long-term stroke management, yet they are concentrated at major medical centers. Neuro-rehabilitation neurologists, who specialize in brain recovery and functional improvement, are even harder to find. As a result, many survivors are never referred to proven treatments such as botulinum toxin injections for spasticity, medications for central post-stroke pain, cognitive rehabilitation, or advanced imaging to investigate neurological decline.

The shortage also disrupts continuity of care. Stroke survivors often describe being passed between emergency departments, primary care providers, and therapists without a neurologist guiding their treatment plan. This creates confusion and leads to gaps in care where serious neurological symptoms go unrecognized. Fatigue, movement disorders, neuropathic pain, and post-stroke seizures can be mistaken for unrelated problems or dismissed entirely when a neurologist is not involved.

The burden of this shortage falls hardest on rural communities and underserved populations. Many small towns do not have a single neurologist within driving distance, forcing survivors to rely on general practitioners who may not be trained in stroke recovery. Telehealth has begun to bridge that gap in some regions, but it is far from universal. Internet access remains limited in rural areas, and many neurology clinics still do not offer virtual appointments. Geographic disparities are so severe that some states, including Wyoming, North Dakota, South Carolina, South Dakota, and Oklahoma, have some of the largest projected gaps between the number of neurologists available and the number of residents who need neurological care. Stroke survivors in these areas often face the greatest risk of delayed diagnosis, complications, and preventable disability.

Statistics to keep in mind

• The United States could use approximately 11 percent more neurologists to meet current needs, and by 2025 the gap could grow to about 19 percent. American Academy of Neurology

  
  

• Among U.S. emergency departments, only about 44 percent are located in a facility with a confirmed stroke center (covering Primary, Comprehensive, Thrombectomy-capable, or Acute Stroke Ready designations). 

  
  

• Rural areas have about 80 percent reduced access to neurologists compared to metro areas, and micropolitan regions around 60 percent less access.

  
  

• The number of neurologists treating patients in the U.S. grew by only 598 over a decade (from ~12,761 to ~13,359) in one dataset, illustrating slow workforce growth. The Hospitalist Community

  
  

A list of national stroke-centers and tele-neurology services

Below we have curated a list of well-recognized stroke-centers and tele-neurology networks across the US. This is not an exhaustive list, but offers options and referral paths for survivors and their families.

Stroke Center Sites

• UCLA Stroke Center (Los Angeles, CA) — Their “Telestroke Network Partner Program” enables community hospitals to consult via video with stroke-neurology experts 24/7. UCLA Health

  
  

• NYC Health + Hospitals / Bellevue (New York, NY) — A certified Comprehensive Stroke Center and part of a multi-site system of stroke treatment centers. NYC Health + Hospitals

  
  

• University of Chicago Medicine (Chicago, IL) — Their Telestroke Network enables remote stroke expert consultation with affiliated hospitals in the region. UChicago Medicine

  
  

• Maryland Institute for Emergency Medical Services Systems (Maryland’s state oversight of stroke center designations) — Example: Maryland currently has 32 Primary Stroke Centers and three Comprehensive Stroke Centers. MIEMSS

  
  

• Texas Department of State Health Services (Texas) — As of recent data: 48 Comprehensive (Level I), 4 Advanced (Level II/Thrombectomy-capable), 113 Primary (Level III), 26 Acute Stroke Ready (Level IV) centers. Texas Health Services

  
  

Tele-Neurology / Telestroke Networks

• Hartford HealthCare (Connecticut) — Their teleneurology/tele-stroke network provides 24/7 consultative services across their hospitals, typically responding within minutes of the initial call. Hartford HealthCare

• Dartmouth Hitchcock Medical Center (Lebanon, NH) — Their TeleNeurology service offers 24/7 access to board-certified neurologists for emergencies and routine neurology consults. DHMC and Clinics

• Access TeleCare — A national tele-neurology provider network offering stroke and non-stroke neurology consults for hospitals, with emergent coverage across hundreds of hospitals. Access TeleCare

• Mayo Clinic Telestroke program — Provides remote video-consultation and stroke-expert review of imaging for partner hospitals. Mayo Clinic

  
  

What stroke survivors can do to get neurological care

The shortage is serious, but there are strategies survivors and caregivers can use to improve access:

• Use outpatient stroke clinics when available. Many hospitals now run stroke follow-up clinics that connect survivors to a team that includes neurologists, rehab specialists and nurse practitioners. Ask your hospital discharge planner or primary-care doctor for a referral.

  
  

• Ask for tele-neurology options. If there is a long wait to see a neurologist in person, ask if there is a virtual appointment via a telestroke or tele-neurology network. This is especially helpful for medication management, recovery planning and follow-up discussions.

  
  

• Work with a primary care doctor who understands stroke recovery. In the absence of specialist access, a strong primary care physician can manage risk factors (blood pressure, diabetes, cholesterol) and coordinate referrals to rehab specialists and escalate care to neurology when needed.

  
  

• Use academic medical centers as a resource. Teaching hospitals often have greater capacity, more specialists and tele-medicine infrastructure. Survivors willing to travel may have faster access to neurologists via these systems.

  
  

• Advocate for early referral at discharge. Ask for your neurology referral before leaving the hospital. Many survivors are discharged without one, which delays care that is essential in the first months after stroke.

  
  

What needs to change

The neurologist shortage is a structural problem within the healthcare system and will require coordinated, practical solutions. Improving reimbursement for neurological care is a necessary starting point, because current payment models undervalue complex diagnostic work compared to procedural specialties. Better financial incentives would also encourage neurologists to practice in rural and underserved areas where access is currently limited. Expanding tele-neurology capacity is another essential step, but meaningful progress will depend on policy changes that support cross-state licensure and reimbursement parity for virtual care.

Long-term workforce planning is critical as well. Neurology training programs need to grow to meet rising demand, and the field must adopt team-based models that safely extend capacity by incorporating nurse practitioners and physician assistants who are trained in stroke and neurological care. At the hospital level, stroke systems of care must be strengthened so that every community has access to neurologists through organized networks. Each acute care hospital should be connected to a stroke center or neurology hub through telemedicine, with clear pathways for rapid consultation and transfer when necessary.

Access to neurological care should not depend on geography or insurance coverage. Stroke is not a one-time medical event but a chronic brain condition that requires long-term specialist oversight. Establishing consistent access to neurology is not an enhancement to stroke recovery, it is a requirement.