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That Patient with Neck Pain in Exam Rm 2 May not Need a Neurology Referral Today

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The patient with neck pain might be better off referred to a physiatrist for additional evaluation and possibly treatment, according to PM&R physician Atul Patel, MD.


Physiatrist Atul Patel, MD, practices physical medicine and rehabilitation at the Kansas City Bone & Joint Clinic where his role and referrals to him are always evolving, he says. The number of community neurologists who rely on him to help manage spasticity in their patients with multiple sclerosis is rising steadily, for example.

When it comes to seeing patients referred by primary care, Patel points out that the frontline clinicians are typically so busy that referring a patient to a specialist, eg, a neurosurgeon or orthopedic surgeon, for a painful condition, may be the first next step that comes to mind. And often, it's the right move at the right time. In other instances, an intermediate step might be more profitable, at least in terms of time, for the patient, the specialist, and the referring primary clinician. He explains more in this conversation with Patient Care senior editor Grace Halsey.


Atul Patel, MD, is a physiatrist and current treasurer of the Board of Governors of the American Academy of Physical Medicine and Rehabilitation. Before joining the Kansas City Bone and Joint Clinic, he was an associate professor in the department of rehabilitation medicine at the University of Kansas School of Medicine. Patel's clinical areas of interest include musculoskeletal medicine, neuropathic pain, spasticity, Parkinson’s disease and dystonias, stroke rehabilitation, multiple sclerosis, nerve and muscle diseases, geriatrics, electrodiagnostic medicine and general rehabilitation medicine.


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