(BPT) - While the country faces an ongoing physician shortage, the nationwide neurologist shortage is even greater. Given the needs of an aging population facing conditions, including Alzheimer's, dementia and other cognitive disorders, patients often wait as long as six, nine or even 12 months to see a neurologist.
In South Carolina, which has a higher incidence of Alzheimer's and related dementias than many other states, 11.5% of those over 65 (about 112,000 people) live with the disease. South Carolina has the eighth-highest mortality rate from Alzheimer's in the nation and is considered a neurology care desert, with one of the nation's lowest ratios of neurologists to patients with Alzheimer's disease.
Innovation that improves access to care
Addressing the state's critical need for diagnosis and treatment, the Medical University of South Carolina (MUSC) has spearheaded a groundbreaking program, the South Carolina Alzheimer's Network (SCAN), to help those with Alzheimer's disease and other cognitive disorders. SCAN educates primary care physicians about cognitive disorders while providing direct access for physicians to consult with neurologists through their online eConsult platform. The first of its kind in the state and one of just a few similar programs in the nation, SCAN aims to improve patient care, reduce wait times to see a neurologist and make more timely and accurate diagnoses for people with cognitive disorders.
"SCAN brings together a multidisciplinary team of specialists in cognitive neurology, neuropsychology, psychiatry, neuroradiology and infusion therapy to provide accurate diagnoses and personalized care plans," said Nicholas Milano, M.D., director of the division of Cognitive and Behavioral Neurology at MUSC. "Equally important, it expands access to care with our innovative eConsult system, through which primary care providers begin evaluation and forward patient records to our team for expert review so we can offer testing and treatment recommendations or schedule patients at a treatment center when needed."
Through SCAN, MUSC became the only health system in South Carolina selected to participate in Medicare's GUIDE model (Guiding an Improved Dementia Experience), making it clear that this is a model other states can learn from. SCAN is committed to ensuring patients have access to:
Early, accurate diagnosis.
Coordinated lifelong care plans reflecting co-management by primary care and cognitive specialists.
New anti-amyloid medications prescribed safely to appropriate patients.
Clinical trials and research protocols through the proposed South Carolina Alzheimer's Disease Research Center (SC-ADRC).
SCAN uses a system of advanced care coordination and telemedicine to reach people throughout the state, supporting and educating primary care providers and expanding access for more patients.
Why early, correct diagnosis is key
For anyone experiencing memory issues or other cognitive problems — or witnessing these symptoms in a loved one — it's essential to know that these issues are not just a sign of aging but could indicate a more serious medical condition.
SCAN helps primary care physicians to determine the root cause of these symptoms, offering recommendations and resources to treat neurological disorders.
At a time when Alzheimer's diagnosis and treatment have experienced major improvements, including new medications to slow disease progression and testing that helps to diagnose the disease, Milano said it's more vital than ever to use these breakthroughs correctly.
"Alzheimer's disease biomarkers, detected through brain scans or blood tests, can appear years before symptoms. That opens the door to earlier diagnosis but also increases the risk of misdiagnosis," he explained. "Not everyone with these biomarkers will go on to develop cognitive impairment or dementia. With overreliance on biomarkers, symptoms from treatable conditions like sleep apnea or medication side effects could be mistaken for Alzheimer's, leading to missed opportunities for proper treatment."
Milano also advised caution when prescribing the newest drugs. "Anti-amyloid meds can cause severe side effects. While most patients tolerate them well, safe use requires expert coordination across clinical teams," he said. "These drugs are only approved for individuals with early, symptomatic Alzheimer's, not those with normal cognition, regardless of test results. Unfortunately, I've seen patients harmed when tests were misused as routine screening tools, or treatment was prescribed too soon."
Correctly diagnosing patients is the key to finding the right treatment at the right time, which is why physician access to neurologists through eConsult makes such a difference. Months before patients can typically schedule an appointment with a neurologist, physicians can share information with a neurology team to determine if an appointment is even necessary and begin recommended tests or treatments right away.
Treatment for a range of cognitive disorders
Symptoms of many cognitive disorders can be similar or overlap, making diagnosis challenging. Thanks to the team of experts at SCAN within MUSC's neurology department, cognitive neurologists can determine the appropriate treatment for each patient.
Alzheimer's treatment at MUSC Health offers the region's best care for people with Alzheimer's disease and other cognitive disorders. MUSC Health has been recognized as High Performing in Neurology & Neurosurgery in the 2025-2026 U.S. News & World Report rankings, and its expert team provides comprehensive evaluation and treatment for adults facing all types of memory and cognitive challenges.
Patients and loved ones interested in learning more should speak with their doctors about requesting an eConsult with SCAN. Additional information is available at MUSCHealth.org.
