{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T14:42:10Z","timestamp":1786632130748,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100018748","name":"Argenx","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018748","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>There is a mismatch between clinical need and access to neurologists across the US. Myasthenia gravis (MG) incidence and prevalence are increasing, particularly in US patients older than 65\u2009years, raising concern for access to neuromuscular specialists that represent only 4% of neurologists. We sought to compare the prevalence of MG patients over 65\u2009years of age to the number of board\u2010certified neuromuscular physicians (BCNMP) across the US.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilizing Medicare fee\u2010for\u2010service Parts A\/B coverage non\u2010HMO claims data, MG cases were ascertained using a validated algorithm. Number of BCNMP per state was determined using American Board of Psychiatry and Neurology and American Board of Physical Medicine and Rehabilitation resources. MG prevalence, BCNMP number, and ratios of cases per BCNMP were calculated by state, census division and region for 2012\u20132013 and 2018\u20132019. Ratios between periods were tested using Poisson regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The number of MG cases increased from 29,038 in 2012\u20132013 to 35,691 in 2018\u20132019. BCNMP increased from 585 in 2012\u20132013 to 806 in 2018\u20132019. At the national level, the ratio of Medicare MG cases per BCNMP improved from 49.5 in 2012\u20132013 to 44.3 in 2018\u20132019. The south region had highest ratios at both timeframes, while the northeast had the lowest ratios. Six states had no BCNMP at both timeframes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>While the number of BCNMP has increased nationally, supply and demand may be unequally distributed. Regions across the US demonstrate disparate ratios of MG cases per BCNMP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70345","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T12:26:29Z","timestamp":1785155189000},"page":"714-719","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mismatch Between the Distribution of Neuromuscular Specialists and Myasthenia Gravis Patients in the\n                    <scp>US<\/scp>\n                    Medicare Fee\u2010for\u2010Service Population"],"prefix":"10.1002","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0025-6055","authenticated-orcid":false,"given":"Lauren","family":"Herrera","sequence":"first","affiliation":[{"name":"Department of Neurology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bruckman","sequence":"additional","affiliation":[{"name":"Center for Populations Health Research, Division of Quantitative Health Sciences Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0537-9622","authenticated-orcid":false,"given":"Ikjae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse D.","family":"Schold","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Colorado School of Public Health  Aurora Colorad USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Claytor","sequence":"additional","affiliation":[{"name":"Department of Neurology Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Department of Neurology University at Buffalo Jacobs School of Medicine &amp; Biomedical Sciences  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4248-8927","authenticated-orcid":false,"given":"Yuebing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K.","family":"Hehir","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences University of Vermont  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318294b1cf"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011276"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000210005"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27526"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28006"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S105613"},{"key":"e_1_2_12_8_1","unstructured":"Bureau USDoCEaSAUSC \u201cCensus Regions and Divisions of the United States \u201dhttps:\/\/www.census.gov\/programs\u2010surveys\/economic\u2010census\/guidance\u2010geographies\/levels.html."},{"key":"e_1_2_12_9_1","unstructured":"Bureau USDoCEaSAUSC \u201cGeography Boundaries by Year \u201dhttps:\/\/www.census.gov\/programs\u2010surveys\/acs\/geography\u2010acs\/geography\u2010boundaries\u2010by\u2010year.2019.html#list\u2010tab\u2010626530102."},{"key":"e_1_2_12_10_1","unstructured":"\u201cMapChart \u201dhttps:\/\/www.mapchart.net\/."},{"key":"e_1_2_12_11_1","unstructured":"Bureau USC \u201cTable\u00a01: Annual Estimates of the Resident Population: April 1 2010 to July 1 2019 \u201d(2019) US Census Bureau Population Division."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1339167"},{"key":"e_1_2_12_13_1","unstructured":"Colleges AAoM \u201cUS Physician Workforce Data Dashboard2024 \u201d."},{"key":"e_1_2_12_14_1","unstructured":"Colleges AAoM \u201cERAS Specialty Specific Data Reports (2021\u20132025 Seasons) \u201d(2026)."},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27525"},{"key":"e_1_2_12_16_1","unstructured":"National Resident Matching Program \u201cResults and Data: 2020 Main Residency Match \u201d(2020)."},{"key":"e_1_2_12_17_1","unstructured":"National Resident Matching Program \u201cResults and Data: 2019 Main Residency Match \u201d(2019)."},{"key":"e_1_2_12_18_1","unstructured":"National Resident Matching Program \u201cResults and Data: 2018 Main Residency Match \u201d(2018)."},{"key":"e_1_2_12_19_1","unstructured":"Neurology ABoPa \u201cCertificates\u2014Total and Active (as of December 31 2023) \u201d(2023)."},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-025-12922-7"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5318-9"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.17226\/24624"},{"key":"e_1_2_12_23_1","first-page":"51","article-title":"Disparities in Health Care: Minority Elders at Risk","volume":"18","author":"Byrd L.","year":"2007","journal-title":"ABNF Journal"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.70022"},{"key":"e_1_2_12_25_1","first-page":"791","article-title":"Possible Sex and Racial Disparities in Myasthenia Gravis Care","volume":"70","author":"Suresh S.","year":"2024","journal-title":"Muscle and Nerve"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200503"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.70125"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.27260"}],"container-title":["Muscle &amp; 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