Vestibular Disorders: Teaching and Learning

I had a different kind of week last week. I took the week off from seeing vestibular patients to teach a couple of courses. On Tuesday, I spoke to a small group of Otolaryngologists and Audiologists about the differences between primary care and specialty clinic management of the dizzy patient. On Friday and Saturday, I spent all day (and I mean ALL day) co-teaching a course with Dr. Joel Goebel for Micromedical Technologies, an equipment manufacturer. Dr. Goebel is a neuro-otologist at Washington University in Saint Louis. We spoke to a larger group that consisted mostly of AuD audiologists, some neurologists and physical therapists. We covered as much as possible in a two-day course, and could have kept going for a third.

I came away from this week with two main observations: 1. I am more hopeful about the future of the dizzy patient than I was a week earlier, and, 2. I still have plenty to learn.

I have been fearful over the last few years that, because there has been such a drastic reduction in reimbursement for vestibular procedures, practitioners would lose interest or be forced to focus their energies elsewhere. I found two groups of smart, enthusiastic people very focused on providing good care for these patients. It reminded me that I love being a vestibular specialist. The changes in reimbursement have not changed that. It’s the practice owner part that has become less fun, because I have to make sure our income exceeds our expenses to some degree.

Teaching a course, and spending two days with someone like Dr. Goebel is a great opportunity to learn some new tricks, discuss theories about things that are still controversial, and confirm and enhance ones comfort level when your conclusions are the same. Dr. Goebel and I estimated that between the two of us, we had probably done about 30,000 Canalith Repositioning procedures over our careers.

Next week, I will share with you one of these tricks I learned.


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.