Dawn Buse, PhD: Patient Referrals From Primary Care for Migraine


The clinical professor of neurology at Albert Einstein College of Medicine discussed the referral process for patients with migraine and which patients may be too complex for the limited time primary care physicians have.

“There are several points where it does seem that a referral may be warranted. It may be comorbidities which make treatment more complicated, it may be someone who is quite refractory to a range of treatments they’ve tried in the acute or preventive space…Certainly, if someone is having a very high degree of disability or their treatment is not optimized, that may also be the right person to refer.”

With more than 40 million estimated individuals with migraine in the United States alone and a small number of migraine specialists to handle their treatment, the need for primary care physicians to take up the reigns is quite apparent. Although, the majority of patients with migraine are more than treatable for primary care providers, thanks in part due to the recent influx of efficacious therapies into the market.

However, as Dawn Buse, PhD, clinical professor of neurology, Albert Einstein College of Medicine, would point out, there are still several instances in which a referral to a specialist is necessary. At the 2019 American Headache Society (AHS) Annual Meeting, July 11-14, 2019, in Philadelphia, Pennsylvania, Buse told NeurologyLive about the specific instances when patients should be referred, as well as provided some insight into why a referral can be best for the patient.

Buse noted that while primary care providers are, of course, capable of handling these patients, with the limited time they tend to have on their hands, a referral to a headache specialist who may be seeing fewer patients and have the ability to conduct a more thorough review could be helpful.

For more coverage of AHS 2019, click here.


Buse D. Migraine Care Across the Healthcare Landscape in the United States Among Those with ≥4 Migraine Headache Days Per Month: Results of the OVERCOME Study. Presented at: 2019 American Headache Society Annual Meeting; July 11-14, 2019; Philadelphia, PA. Poster P60.

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