Patients with amyotrophic lateral sclerosis (ALS) may be seen in the ALS Clinics. These meet monthly and are staffed by Drs. P.E. Barkhaus, Chamindra Konersman, Jorge Marquez de Leon and W. Peltier. Patients receive individualized care by staff in the management of this disorder. The philosophical approach in management is one of optimal use of the patient's abilities and pro-active care that anticipates problems in this progressive disease. Emphasis is also placed on extensive counseling of patients and their families. Patients also have ready access to other specialty care including, but limited to, pulmonary medicine, nutritionist, gastrostomy tube placement/management, rehabilitation, and physical/occupational therapy. Some patients are co-managed with hospice groups.