The most effective balance programs are evidence-based and implement a Multidisciplinary Team Approach, drawing as needed on specialists from Otolaryngology, Audiology, Neurology, Physiatry, etc., as well as Rehabilitation Specialists such as Physical and Occupational Therapists.
The balance team is the core of a balance program, but the program itself can take many forms:
- The “Balance Center” is a comprehensive balance program with two or more disciplines working cooperatively in a “one-stop shop” approach. Balance Centers have been successfully established by physicians, hospitals or medical centers, and rehabilitation facilities. In Balance Centers, all diagnostic tests and assessments are typically conducted at the center, as well as subsequent treatment and/or physical therapy.
- A network of independent services and specialties working together can also comprise a balance program. For example, a rehabilitation professional may serve as a point of entry for patients, with the support of a Balance Center for diagnostic tests and a referring physician for ongoing medical management. Using the information from a comprehensive assessment, therapy direction and goals are determined with a team of professional disciplines, although the individuals are not part of the same group or located at the same site. Similarly, a physician may develop a referral relationship with a specialized physical therapist so that a patient is evaluated both medically and functionally, albeit in separate appointments at separate facilities.
- A balance program may also take the form of an integrated “hub-and-spoke center”with multiple services and specialties at various locations – for example, a medical facility with satellite offices in outlying communities. In this scenario, one central facility (hub) offers comprehensive balance assessment and treatment services, while the satellite offices (spokes) may be rehabilitation clinics with balance screening capabilities. The initial evaluation may be conducted at the satellite location and, when further testing is warranted, patients are referred to the comprehensive center. Satellite offices allow greater access for both patients and referring physicians who may not be within close proximity to the facility offering the comprehensive services. Since comprehensive assessments may only be needed initially, or at most periodically, those services can be offered in one central location. The “spoke” facilities have the advantage of treatment targeted at known, measured impairments, while maintaining their local access for the convenience of their patients.
Whatever form a balance program manifests, the key to success is a comprehensive and integrated approach to patient management, with access to the appropriate and necessary specialties and technologies, followed by a cooperative exchange of patient information.