Balance Clinic Staffing – Part I

This series on staffing was co-authored by Shanna Thompson, M.S.

When a patient is diagnosed with cancer, all related physicians meet at what is known as “tumor board.” The radiation oncologist, medical oncologist, surgeon and attending physician discuss all aspects of the patients’s care. A treatment plan is devised based on the best clinical evidence. This type of multidisciplinary cooperation reduces the chances that a patient’s care will be influenced by the bias or limitations of a single physician.

While vestibular disorders are rarely life threatening (although frequently quality of life threatening), shouldn’t we aspire to the same type of comprehensive, evidence based, unbiased approach when dealing with patients complaining of dizziness and balance disorders? There is no one specialty that in isolation can competently evaluate and treat all possible causes of dizziness. No single medical or allied health professional can provide an “expert opinion” for all of these patients, and there are no formal training programs that offer a degree of “Vestibular Specialist.”

Comprehensive evaluation and treatment of the dizzy patient require a multidisciplinary team approach. The team should minimally consist of a medical director (typically ENT or Neurology), Audiology and Physical Therapy. Occupational therapists, psychologists, physiatrists and nurses also participate on the “balance team.” Historically, all of the above specialists receive some training in vestibular disorders, but it requires substantial post-graduate training to function as a competent vestibular team member. Contrary to what some equipment sales representatives may claim, purchasing a piece of equipment, taking a two day course and following a flow sheet does not make one a competent vestibular specialist.

Next week, we will review the roles of each member of the vestibular team.


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.