Diagnostic Error Survey
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Several types of health care professionals may become involved in the diagnosis, treatment, and management of dizziness and balance disorders. Below are brief descriptions of some of these specialties.
If you decide to use our online directory of vestibular disorder specialists to find a doctor for a second opinion, you might find it helpful to know that some doctors have more specialized training than others, and therefore might be better able to help you. Below is a brief description of some of the specialists involved with treating vestibular disorders.
An Otolaryngologist (also known as an ENT, or ear, nose, and throat doctor) are physicians and surgeons who diagnose and treat diseases and disorders of the ear, nose, throat, and related structures.
Otologists/Neurotologists are otolaryngologists who have completed 1-2 years of additional training. They specialize in the ear and its connections to the brain. Evaluation by an otologist/neurotologist is appropriate when a person has been seen by a primary care physician or otolaryngologist/ENT, but needs a further opinion or a more specific diagnosis.
A Neurologist diagnoses and treats disorders of the brain and nervous system. They do not perform surgery, but they can recommend surgical treatment by an otolaryngologist, neurotologist, or neurosurgeon. Neurologists have at least three years of specialized training following medical school and a one-year internship.
An Otoneurologist is a neurologist with additional years of specialized training. They approach dizziness and balance disorders from the brain outward instead of from the ear in toward the brain (as in neurotologists). Like neurologists, they do not perform surgery but can recommend surgical treatment by other specialists.
Physical therapists (PTs/DPTs) and physical therapist assistants (PTAs) are licensed healthcare providers who optimize physical function, movement, performance, health, quality of life, and well-being across the lifespan. PTs who practice vestibular rehabilitation have undergone advanced training to address the care of patients with dizziness. Patient treatments for vestibular concerns are varied and individualized once specific causes dizziness have been established. Possible treatments and interventions may include, but are not limited to, canalith repositioning maneuvers, reflex and balance exercises, stretching & strengthening, and falls prevention. PTs may also incorporate additional treatments and patient education in order to take a holistic approach to each patient’s condition and needs. Degrees: PT, MPT, DPT, tDPT, DPTSc, MSPT, NCS among others. Professional Associations: American Physical Therapy Association.
An occupational therapist (OT) is a health-care professional responsible for helping patients develop, recover, and improve the skills needed for daily living and working. Occupational therapists work one-on-one with patients, developing a customized therapy program whose goal is improved quality of life and independence by ameliorating the physical, mental, emotional and social sources of a patient’s disability. The word “occupation” comes from the belief that we all have occupational roles that contribute to who we are (e.g mother, son, spouse, employee). Occupational therapy gives patients the skills that are needed to live independent and satisfying lives.
Ophthalmologists are medical doctors who specialize in eye and vision care. They are trained to provide all elements of eye care including prescribing glasses and contact lenses, treating diseases of the eye, and performing eye surgery. Degrees: MD, DO.
An optometrist is a doctor who examines the eyes to determine visual acuity and eye health. Optometrists are specifically educated and trained by an accredited optometry college in a four year course, but have not attended medical school. They are state licensed to examine the eyes and to determine the presence of vision problems. They prescribe spectacles and contact lenses to improve visual acuity, medications to treat eye diseases and in some cases perform specific surgeries. Degrees: OD.
Neuro-ophthalmologists are ophthalmologists with a subspecialty that focuses on vision problems that are related to the nervous system, including the optic nerve and visual pathways. Neuro-ophthalmology is typically a nonsurgical subspecialty; it can, however, include surgery of the eye and orbit. Degrees: MD, DO.
Psychiatrists are medical doctors specializes in diagnosing and treating mental illness. Their training focuses on the relationship between emotional illness and other medical illnesses; their training qualifies them to distinguish between physical and psychological causes of symptoms. They can order medical and neurological psychological testing, and can dispense medication and provide counseling therapy. Degrees: MD, DO.
Psychologists have a doctoral degree in psychology in the study of the mind and behavior. They can order neurological psychological testing and perform counseling therapy and behavior modification therapy. They cannot dispense medication but often coordinate with psychiatrists for such medical intervention. Degrees: PhD or PsyD.
Audiology is the science related to the sense of hearing and balance. An Audiologist is a highly trained professional whose scope of practice includes identification, assessment and diagnosis of people with hearing and vestibular (balance) disorders. Audiologists can hold the title of Master’s degree, Au.D, EdD or PhD. They must hold a license to practice in the state they provide services. They should be certified by either the American Academy of Audiology, the American Speech, Language and Hearing Association or both. Audiologists specialize in testing and treatment of many problems associated with hearing and balance disorders that cannot be medically or surgically treated such as hearing aid evaluations and treatment of some balance disorders. They work closely with the medical profession and can provide services in private practice, hospitals, schools and other settings that might require these services.
A chiropractor treats disorders related to the nervous system by manipulating the musculoskeletal system, primarily by making adjustments to the spine, but also through exercise, lifestyle counseling, and dietary recommendations. Chiropractic neurology is a specialty field within the chiropractic profession, with a subspecialty focus in vestibular rehabilitation. Chiropractic neurology deals with dysfunction of the nervous system by specific activation of parts of the nervous system depending on one’s individual loss of neurological function. Becoming a doctor of Chiropractic (DC) requires a minimum of 2 years of college and 4 years in a school of chiropractic medicine.