In practice the two share the work rather than compete. Your primary care physician manages day-to-day health, medication review and the reversible-cause screen; the neurologist establishes the diagnosis, sets the treatment plan and reassesses at intervals. Most patients continue seeing both.
In practice the two share the work rather than compete. Your primary care physician manages day-to-day health, medication review and the reversible-cause screen; the neurologist establishes the diagnosis, sets the treatment plan and reassesses at intervals. Most patients continue seeing both.
Primary care generally handles the initial screening, the medication review, management of blood pressure, diabetes and cholesterol that affect cognition, and the practical business of ongoing health. Neurology establishes and revises the diagnosis, sets and adjusts specific treatment, and monitors the trajectory. Neither replaces the other and the handover in both directions matters.
Cognitive conditions unfold over years. A diagnosis is a starting point, and what matters afterwards is periodic reassessment, adjusting for new symptoms, and supporting the family as needs change. That is why a referral that ends with a diagnosis and no follow-up plan is of limited value to anyone.
The referral should say what has already been screened, so it is not repeated. The neurology letter back should say what the diagnosis is, what changed, what to watch for and when to re-refer. Bringing your medication list to every appointment matters more here than almost anywhere else, because polypharmacy is a common and reversible contributor. Bring the same medication list to both. Duplication between prescribers is a recurring and entirely avoidable contributor to confusion in older adults, and it is found by someone reading the whole list rather than by any test. Anticholinergic medications in particular are worth reviewing explicitly.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: National Institute on Aging; MedlinePlus: memory; American Academy of Neurology.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.