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I read Dr. Orly Avitzur's excellent column on reimbursement and other professional pressures (January, page 54). The article has generated discussion on several listservs, comparing the salaries of neurologists with plumbers and truck drivers.

I appreciate Dr. Tom Swift's comments [citing the reimbursement issue as a top priority for the AAN]. I also know Drs. John Lossing [who no longer sees patients but teaches at George Washington University] and Jim Anthony [whose group practice renegotiated a new contract with another insurer for 160 percent of Medicare], and can vouch for their dedication and professionalism. I appreciate their honesty and leadership in facing these problems.

In order to attract and retain dedicated and excellent neurologists, we must offer them a chance to make a fair living so they can raise and educate their children, and so they don't all decide to become businessmen, plumbers, or truck drivers instead. As distasteful as it is, we must pay attention to our survival or become extinct.