Why are Vestibular Specialists so Hard to Find? Part I


As I have mentioned in earlier blogs, I practice in a rural area in southern West Virginia. We operate a comprehensive balance clinic offering Rotational Chair, Active Head Rotation, Platform Posturography as well as standard Videonystagmography. The funny thing is, many local referring physicians and patients have no idea that this is unusual. I suspect they may think there is a comprehensive balance clinic in every small town, just like there are usually several options for patients with hearing loss.

The reality is that the closest options with comparable diagnostic capabilities are hours away in every direction. Why are there so few vestibular specialty clinics when the statistics show that more people suffer from dizziness than hearing loss? Why are vestibular specialists so hard to find? Obviously, the answer to this question is a matter of opinion and perspective, but here are my thoughts on the subject:

There are several factors at work that affect the health care we receive –some good, some bad. As it relates to the diagnosis and treatment of dizziness and vertigo, the good factors are primarily advances in the testing and treatment of vestibular (inner ear) disorders. Tests such as Rotational Chair, Platform Posturography and Vestibular Evoked Potentials, and treatments such as Canalith Repositioning and Gentamicin Injections (you can Google these terms for a description) have greatly improved our ability to manage debilitating dizziness and imbalance. There are very few patients that can not be diagnosed and managed effectively when the above services are made available.

Unfortunately, these types of services are rarely available and rarely utilized. This is where the “bad factors” come into play. I will lump the “bad factors” into two broad categories: 1. Lack of awareness, and 2. Economics. Next week we discuss “Lack of Awareness.”


About Alan Desmond

Dr. Alan Desmond is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. In 2015, he received the Presidents Award from the American Academy of Audiology.

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