Abstract Details

Title Delivering a Diagnosis of Functional Neurological Disorder without Formal Training? A Cross-sectional Study on the Experience of Neurology Faculty

Topic ��ɫ��, Research, and Methodology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 15-007

Objective The aim of this study was to determine the degree of educational exposure to and clinical experience in delivering a diagnosis of functional neurological disorder (FND).

Background The prevalence of FND within the United States is estimated to be 250,000-300,000 with healthcare costs totaling over $1 billion annually. FND is important to diagnose accurately and timely as it is a treatable condition with otherwise heavy burden in terms of disability, and negative impact on quality of life, career and family.

Design/Methods An anonymous 38-question survey constructed through Qualtrics, inquiring about training in and delivering a diagnosis of FND was emailed to neurology faculty at Mayo Clinic Minnesota, Arizona, and Florida.

Results A total of 235 neurology providers were surveyed and 76 (32%) completed the survey. Of these, only 22% (n=17) reported receiving structured education on how to deliver a diagnosis of FND during training, mostly (88%, n=15 of 17) as didactic lectures. Unstructured training reported by 93% (n=53) included watching another provider deliver the diagnosis of FND. In clinical practice, 97% (n=72) had delivered a diagnosis of FND and 55% (n=40) reported feeling apprehensive when doing so, with 97% (n=67) having experienced a negative patient reaction. The most common reasons for concern included worrying the patient may be dissatisfied with their care (88%, n=35) or may be disappointed in their clinician (63%, n=25), about the potential of receiving patient complaints (63%, n=25), or offending the patient (58%, n=23).

Conclusions While the vast majority of neurology providers in this survey have delivered the diagnosis of FND in clinical practice, a minority have received formal instruction on how to do so during their neurology training. Most had experienced a negative patient response, and more than half felt apprehensive giving this diagnosis. Patient dissatisfaction is the most common reason for apprehension regarding delivering this diagnosis.

Authors/Disclosures
Aimen Vanood, MD (Mayo Clinic Arizona) PRESENTER	Dr. Vanood has nothing to disclose.
Jacob Farris, MD	Dr. Farris has nothing to disclose.
Matthew T. Hoerth, MD, FAAN (Mayo Clinic Arizona)	Dr. Hoerth has a non-compensated relationship as a Epilepsy.com Editorial Board member with the Epilepsy Foundation of America that is relevant to AAN interests or activities.
Cornelia Drees, MD (Mayo Clinic Arizona)	Dr. Drees has nothing to disclose.

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