The Johns Hopkins University Swallowing Center in Baltimore was formally established five years ago (Arch Intern Med [PRIMARY CARE MEDICINE] 1981; 141:1571-1575) and was believed at the time to be the first—and perhaps largest—of its kind in this country. It has a staff of about 15 physicians from specialties including radiology, neurology, gastroenterology, otolaryngology, and rehabilitation.
There are perhaps eight other US and three European centers for dysphagia that are making efforts to expand in size and diversity. The number of smaller centers in this country is not known. Director Martin W. Donner, MD, says it usually requires a multidisciplinary approach to pinpoint the patient's particular swallowing problem.
According to William J. Ravich, MD, clinical director, about 400 patients are seen each year and about 90% of those with previously unexplained swallowing difficulties can be diagnosed.
However, Ravich adds, that figure "doesn't necessarily translate into treatment." Some causes of dysphagia