← Risk register SOC 29-1217 · reviewed 2026-08-11

Neurologists

10,590 US workers · median $248,560/yr · Healthcare

SAFE

Neurology's diagnostic core rests on the hands-on neurological exam — reflexes, gait, tone, cranial nerves, subtle asymmetries — which no current system can perform, plus procedures like EMG/nerve conduction, lumbar puncture, botulinum injections, and EEG supervision. AI is genuinely strong on the pattern layer: MRI lesion detection, EEG spike flagging, differential generation, and note drafting, so documentation and first-pass image reads will compress. What persists is owning ambiguous calls — is this MS or an atypical mimic, do we thrombolyse, do we escalate immunotherapy in a deteriorating encephalitis patient — under personal license and liability, and delivering diagnoses like ALS or dementia to families over years of care.

10-year outlook: By 2035 AI handles most neurology documentation and first-pass imaging/EEG screening, letting neurologists see more patients — the exam, procedures, and acute decision-making stay firmly human, and the persistent US shortage keeps demand well above supply.

US employment, 2021–2025+48.7%
7,12010,590 workers

Headcount grew steadily across the period.

The job count is not the verdict

This line is counted by the Bureau of Labor Statistics — the one figure on this page that isn't a judgement of ours. Headcount moves on demand, offshoring, demographics and the business cycle, and automation is one term among several, often not the loudest.

So a falling line is not evidence that AI did it, and a rising one is not evidence that it won't. Both happen in this register: some occupations resist automation and shrink anyway, others are highly automatable and keep growing.

BLS projection, 2024–2034

+5.4%

Percentage only. The projection counts a different population from the 10,590 above — it includes self-employed workers, which for this occupation is most of them, so the two headcounts are not comparable.

Hard to automate, and growing

The work resists current AI and the BLS projects +5.4% more of these jobs by 2034. Note that safe does not mean well paid — several of the fastest-growing resistant occupations are among the lowest paid on the register.

Different clocks. The score is what current AI could do to this work today. The projection is how many of these jobs will exist in 2034. Everything between the two — how fast employers actually adopt, whether demand grows in the meantime — is why they can point opposite ways without either being wrong.

~300 openings a year on average, including replacing people who leave.

One email if this score changes. Watch as many occupations as you like from the same address — no account, and nothing is sent on a schedule, only when a verdict actually moves.

Also known as — 19 job titles this covers

Titles reported by people doing this work, from the US Department of Labor's O*NET survey. If your job title is here, this page is about your work even though the name doesn't match.

PhysicianNeurologistEpileptologistNeurohospitalistAdult NeurologistChild NeurologistNeurophysiologistGeneral NeurologistHeadache SpecialistMD (Medical Doctor)Neurology PhysicianVascular NeurologistPediatric NeurologistNeurosurgery PhysicianOsteopathic NeurologistChiropractic NeurologistPediatric Neurology PhysicianAdult and Pediatric NeurologistDO Physician (Doctor of Osteopathic Medicine Physician)

Score — 80/100 resistance

Holding it up: liability shield (19/20). Weakest point: task resistance (12/20).

Five dimensions, 0–20 each, summed. Higher means more protected. The arithmetic is shown so you can check it: 12 + 14 + 19 + 17 + 18 = 80. · Scored 2026-08-11, and re-examined when evidence accumulates rather than on a schedule.

Task resistance 12/20

Mixed — a routine tier and a judgment tier A 12 reflects that a real share of the neurologist's day — dictating H&Ps, generating differentials from a symptom list, first-pass reads of MRI for white-matter lesions, screening 24-hour EEG for spikes, titrating antiepileptics by protocol — is already being absorbed by ambient scribes and FDA-cleared triage software, while localizing a lesion from an inconsistent exam or distinguishing psychogenic nonepileptic seizures from frontal-lobe events at the bedside stays out of reach.

Embodiment 14/20

Hands-on in uncontrolled environments A 14 rather than 18 recognizes that the hands are essential but the environment is mostly controlled: percussing reflexes, testing tone and pronator drift, needle EMG through muscle, LP into the L3-L4 space, EMG-guided botulinum into cervical dystonia — all in clinic or on the ward, not roadside or in a patient's kitchen, and a meaningful fraction of stroke-call decisions now happen over telestroke video.

Liability shield 19/20

Licensed human required and personally liable A 19 is set by the fact that tPA and thrombectomy decisions, DEA-scheduled prescribing of antiepileptics and stimulants, and EMG interpretation are signed under an individual state medical license backed by board certification in neurology, and a door-to-needle miss or a missed cord compression names the neurologist personally in the malpractice complaint, not the hospital's algorithm vendor.

Trust premium 17/20

The human relationship is the product A 17 comes from the disease timelines: epilepsy, MS, Parkinson's and ALS patients stay with the same neurologist for a decade, and the willingness to accept a DMT change, a driving restriction, a PEG tube conversation, or hospice referral rests on that specific accumulated relationship rather than the recommendation's content.

Judgment & accountability 18/20

Exists to be accountable for ambiguous calls An 18 tracks the calls with no clean rule: thrombolysis in a 79-year-old on apixaban with an unclear last-known-well, immunosuppression escalation in seronegative autoimmune encephalitis that is deteriorating, brain-death determination and apnea testing, and whether an atypical MRI is MS, NMOSD, or sarcoid — each made on incomplete data with irreversible consequences.

Confidence: high · reviewed 2026-08-11 · how scoring works

What this job involves — and which parts are yours

The verdict above describes this occupation as a whole. Almost nobody does the typical version of a job — tick what's actually in your week and see how your own mix sits.

AI already does these at usable quality

These still need a person

Active moats on the surviving side: embodiment, licensure, liability, trust, judgment

How to future-proof this job

Where to go deeper on what this job runs on: Coursera — active listening and communication skills free to audit · Khan Academy — reading and vocabulary, all levels, free free · Toastmasters — public speaking practice at local clubs worldwide low · Coursera — critical thinking and logic, audit free free to audit · Coursera — communication and interpersonal skills free to audit · MIT OpenCourseWare — problem-solving and analytical method courses free

All 35 skills ranked by how many jobs they open →

What would move this back up — beyond any one person

The moves above are yours to make. This is the other half: what would have to change in the world for the occupation itself to score higher. None of it is in any one person's gift, but it is where the floor actually comes from. Scores here are not a one-way ratchet. Only two of the five dimensions — task resistance and embodiment — track what machines can do. The other three track law, what buyers will pay for, and who is answerable, and those move in both directions, often in response to the same pressure AI creates. If every lever below landed, this occupation would score around 89/100, still SAFE.

5 specific changes that would raise this score
  • already happening task resistance +3

    As AI absorbs first-pass MRI reads, EEG spike flagging, and note drafting, the residual day concentrates on the ambiguous tier: atypical demyelinating vs mimic, immunotherapy escalation in autoimmune encephalitis, thrombolysis/thrombectomy calls under time pressure, and multi-year disease-modifying therapy sequencing. This is a genuine two-tier occupation and the judgment tier is not currently automatable.

  • already happening trust premium +2

    Payer and health-system telestroke contracts that specify a board-certified vascular neurologist must be on the video call for thrombolysis decisions, plus Joint Commission Comprehensive Stroke Center certification standards naming neurologist availability, convert trust into a purchased requirement rather than a preference.

  • plausible task resistance +2

    Growth in procedure-anchored subspecialty work — EMG/NCS, botulinum chemodenervation for dystonia/spasticity, DBS programming, intrathecal nusinersen, epilepsy surgery mapping — shifts the case mix toward tasks requiring hands and real-time interpretation. Watch RVU mix and fellowship match data in neuromuscular and epilepsy.

  • plausible liability shield +1

    FDA moving toward requiring autonomous-mode neuro imaging/EEG triage devices (e.g. Viz.ai LVO, Persyst) to be labeled adjunctive-only with a named physician-of-record interpretation, plus CMS conditioning the AI add-on payment (NTAP-style) on documented physician concurrence, would harden the countersignature requirement.

  • plausible judgment accountability +1

    State board and malpractice-carrier positions that AI output does not transfer the standard of care — mirroring recent AMA policy on 'augmented intelligence' physician oversight — plus court rulings holding the interpreting neurologist liable for a missed AI-flagged lesion, keep the consequential call personally owned.

The limit. Already 80/100; the institutional dimensions are near saturation, so realistic headroom is a few points, mostly from task-mix concentration in the judgment and procedural tier. The downward pressure on routine imaging/EEG reads is real and may offset.

These are conditions, not forecasts — what would have to happen, not what will. Specific rules, cases and bills are named so you can go and check whether they exist and where they stand; verify before relying on any of them. Nothing here is legal or financial advice.

Where this work is, and what it pays there

BLS metro figures for 30 areas. The verdict above does not change by city — the rubric judges what the work involves, not where it happens — but pay and headcount do, and the national median hides a very wide range.

Most of these jobs

Dallas-Fort Worth-Arlington, TX 300 $360,640 +45%
Washington-Arlington-Alexandria, DC-VA-MD-WV 190 $161,560 -35%
Cincinnati, OH-KY-IN 180 $101,210 -59%
Chicago-Naperville-Elgin, IL-IN 170 $136,030 -45%
Seattle-Tacoma-Bellevue, WA 130 $331,080 +33%
Houston-Pasadena-The Woodlands, TX 120 $277,960 +12%
Minneapolis-St. Paul-Bloomington, MN-WI 120 $335,420 +35%
Charlotte-Concord-Gastonia, NC-SC 90 $337,600 +36%

Best paid

Memphis, TN-MS-AR 30 $535,950 +116%
Buffalo-Cheektowaga, NY 80 $451,510 +82%
Phoenix-Mesa-Chandler, AZ 70 $409,610 +65%

Percentages are against this occupation's national median of $248,560. Counts are jobs in that metro, not vacancies. Metros where the BLS suppressed the cell are absent rather than shown as zero.

Who is actually doing this — nobody, on the record

We have no reported case of a named organisation automating this occupation. Not one deployment, not one announcement.

That is worth saying out loud next to a score of 80. The verdict above is about what the work exposes — what current AI could do to these tasks. It is not a claim that anyone has done it. For this occupation those two things have come apart completely: the capability argument is on this page, and the evidence column is empty.

Read that as a gap in the reporting we can see, not proof of absence — the dispatch runs on English-language feeds and misses plenty. If you know of a case, tell us, or add a field report from inside the job.

Quick take — do you do this job?

Has AI actually changed your work? One tap, anonymous, and the running tally is public. Nothing else is asked of you.

Self-reported and unverified — a sentiment signal, not a survey. One response per person per occupation; you can change your answer.

Field reports — what people say has changed

No field reports yet. A written account takes a paragraph rather than a tap, goes to an editor before it appears, and is the one thing on this page the rubric cannot produce on its own.

File a field report

Concrete beats general: a tool that arrived, a task that moved, a headcount decision you watched happen. Don't include anything that identifies you or your employer if that would put you at risk.

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