Establishing a TOS-Focused Practice

  • Karl A. Illig
  • Robert W. Thompson
  • Julie Ann Freischlag
  • Dean M. Donahue
  • Peter I. Edgelow


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.


Educational Material Thoracic Outlet Syndrome Exam Room Physician Extender Provider Satisfaction 
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  1. 1.
    Lee JT, Dua MM, Chandra V, Hernandez-Boussard TM, Illig KA. RR18. Surgery for thoracic outlet syndrome: a nationwide perspective. J Vasc Surg. 2011;53(6):100S–101S.Google Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Karl A. Illig
    • 1
  • Robert W. Thompson
    • 2
  • Julie Ann Freischlag
    • 3
  • Dean M. Donahue
    • 4
  • Peter I. Edgelow
    • 5
  1. 1.Department of Surgery, Division of Vascular SurgeryUniversity of South FloridaTampaUSA
  2. 2.Department of Surgery, Section of Vascular Surgery, Center for Thoracic Outlet SyndromeWashington University, Barnes-Jewish HospitalSt. LouisUSA
  3. 3.Department of SurgeryJohns Hopkins Medical InstitutionsBaltimoreUSA
  4. 4.Department of Thoracic SurgeryMassachusetts General HospitalBostonUSA
  5. 5.Graduate Program in Physical TherapyUCSF/SFSUUnion CityUSA

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