Establishing a TOS-focused practice

Patients with thoracic outlet syndrome, especially neurologic, typically require many more resources than the typical vascular, thoracic, or neurologic patient. As such, a dedicated TOS clinic pays major dividends, in terms of time, resources, and patient and provider satisfaction. Such a clinic should include, at a minimum, a provider, physician extender, and physical or occupational therapist truly interested in the problem, along with logistical support for the documentation and paperwork required. If local resources permit, a neurodiagnostician with interest in modern, objective diagnostic and therapeutic block techniques is valuable, as are a psychologist or even a psychiatrist. Educational materials can be made available to patients ahead of time, streamlining the visit itself. Such a clinic does not need to be free-standing or full-time, but can exist "virtually" within a conventional clinic simply by designating a time when patients and providers can all assemble. Such a clinic vastly improves the care of patients with VTOS, and acts as a surprisingly effective marketing tool in most communities.