AAN 2026 | A multi-disciplinary clinic for the comprehensive care of patients with chronic headaches

Absolutely. So we created this advanced headache care clinic, multidisciplinary headache care clinic in Virginia Tech Carilion School of Medicine, Carilion Clinic. The idea of this is to give patients an opportunity to come and seek help from different providers at the same time, which are of different specialties. What we have known from different literature pieces is that multidisciplinary clinics work better for patients who have chronic headaches. So our clinic works in an interesting model that we have neurology headache with me, Dr Wepner as physical medicine rehab and TBI specialist, and then physical therapy and pain psychology at the same time working in one big session so it’s a four-hour long appointment in which one by one they go through each provider and then a converging plan is made. So far the results have been very promising; we have multiple patients that have gone through the follow-ups and then pain psychology sessions continue throughout the weeks and so do the physical therapy sessions. In between, they see us as individual providers with me and Dr Wepner, and then we have a converging follow-up at the same time. Lessons are multifold. The most important thing is that accessibility to care is a right for every patient, especially chronic headache patients. People want to get better. And that’s our job to give them the toolbox to get them better. Importantly, due to the volume and how long the wait lines are and how accessible we can make things for them, it’s important that at the same time, everybody comes in and works together. For example, for my wait line, it could be three to four months. PM&R could be another three to four months. The physical therapy could be another three months. It could be a one-year prolonged wait line. But when we are working at the same time, we are working for you for four hours. That’s number two: compliance with the medications. When we have one converging plan, we don’t have to go back and forth with other specialties. They are more compliant with medications, and they know what the expectations are at a converging point as well, that is, where we all want to make sure that we find the point and our maximal improvement threshold that we are looking at.

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