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The Headache Clinics: The Headache Care Center in Springfield, Missouri

The Headache Care Center was founded in January, 1996, by Roger K. Cady, MD and Kathleen Farmer, PsyD. The following is based on an interview with Doctor Kathleen Farmer.

Doctor Cady attended medical school at the Mayo Medical School in Rochester, MN. He completed a Family Practice residency at Mayo Clinic-St. Francis in LaCrosse, WI, and continued his work in Family Practice in Hillsboro, WI. In 1986, Dr. Cady assumed the role of Medical Director at the Shealy Institute in Springfield, MO, where he remained until 1995, and where he began his work in headache medicine.

Doctor Cady is Board Certified by the American Board of Family Practice, and has received subspecialty certification in Headache Medicine from the United Council for Neurologic Subspecialties. He holds a Certificate of Added Qualification from the National Headache Foundation. In 2000, Dr. Cady was the co-recipient of the prestigious Harold G. Wolff Award from the American Headache Society for his research entitled “The Spectrum of Headache.” He was elected to the Board of Directors of the National Headache Foundation in 1998, and has served as its Associate Executive Chairman since 2010. Dr. Roger Cady received the Lifetime Achievement Award from the National Headache Foundation in 2012.

Doctor Farmer is a psychologist specializing in Health Psychology at the Headache Care Center. She received her PsyD degree from the Forest Institute of Professional Psychology in Springfield, MO, and is a Diplomat of the American Academy of Pain Management. Prior to founding the Headache Care Center with Dr. Roger Cady, she served as the chair of the Psychology Department of the Shealy Institute for the Comprehensive Management of Pain from 1988 to 1995.


Dr. Roger Cady (left) and Dr. J. Kent Dexter stand in front of the “Wall of Champions” at the Headache Care Center in Springfield, Missouri.

J. Kent Dexter, MD, is a graduate of the University of Missouri Medical School at Columbia, MO, where he completed a residency in Internal Medicine. Dr. Dexter is Board Certified in Internal Medicine, and was awarded the subspecialty certification in Headache Medicine from the United Council for Neurologic Subspecialties. He is a Fellow of the American College of Physicians. Dr. Dexter previously served in the Department of Medicine of St. Johns Regional Health Center, Springfield, MO, and was Chairman of Primary Care, Monroe Clinic, Monroe, WI. He returned to Springfield in 2003 to serve as the Medical Director of the Headache Care Center.

The other staff members of the Headache Care Center include Heather Manley, LPC; Danielle Gilmore, RN; Dani Hurt, RN; Sarah Woolford, RN; Angela Wall; and, Blair McClelland.

The typical patient at the Headache Care Center is an individual with debilitating headaches – most commonly chronic migraine. However, a wide range of other headache disorders are treated at the Center. Also, most patients have headache-related co-morbidities, including sleep disruption, irritable bowel syndrome, weight gain, and often depression. Adults as well as children are evaluated at the Center. A referral from another health care provider is not required.

At the first appointment at the center, the patient should expect to spend about 30 minutes with one of the nurses and describe their headaches as well as review other medical issues and medication history. The patient will then be seen by one of the Center’s physicians for a 60-minute period which is comprised of a comprehensive diagnostic evaluation, as well as a physical and neurological examination. At this initial visit, an individualized treatment plan will be developed, including lifestyle, pharmacological, and non-pharmacological interventions, and follow-up. The patient will also meet with a psychologist to determine the limbic contribution to the disability of headaches and development of a behavioral plan with the use of biofeedback and cognitive restructuring and follow-up.

A typical day at the Center is busy with new patient and follow-up visits. The schedule is highlighted by collaboration among the health care professionals and patients in order to implement the best treatment strategy for a patient. The Center does not specialize in any particular headache condition or treatment.

At the Center, the treatment philosophy is patient-centered, comprehensive, individualized care for the patient experiencing headache. They strive to assist patients to become successful managers of their headache disorders with compassion, education, and collaboration. Patients are guided to become collaborators with the health care professionals in order to make effective therapeutic and lifestyle decisions. Patients are provided with a “care-kit” of a variety of effective treatment tools.

The Center does not offer inpatient care but provides a comprehensive, intensive outpatient program for patients with intractable headaches. A wide-range of acute treatment options are available as well as a full-range of alternative therapies. Thermal biofeedback is central. Other important therapies include massage, nutritional interventions, acupuncture, nerve blocks, and transcutaneous stimulation. During the next few years, they would like to expand the complimentary services provided at the Center.

When asked about why they elected to practice Headache Medicine, Doctors Cady, Farmer, and Dexter noted that historically, most primary headaches (migraine, tension-type, and cluster) have been minimized as legitimate medical diseases. Headache patients have often been misdiagnosed and inadequately treated. These health care professionals have devoted over 25 years to the care and management of headache patients, conducting extensive research on pharmacological and non-pharmacological headache therapies, and have been pioneers in patient-centered headache management. They chose to go into headache medicine because they realized that headache is a manageable disease and that with appropriate care, patients can get their lives back. They concurred that headache is, without a doubt, one of the most rewarding medical conditions to treat.

When asked what they enjoy most about working in Headache Medicine, Doctors Cady, Farmer, and Dexter concurred that it is the patients. It is rewarding to see how patients can change their lives when provided with education and quality treatment. They each enjoy conducting research and being able to explore the new frontiers of headache medicine. And, it is rewarding to be part of their patients’ success.

Do they have any general advice for the patient experiencing headache? They suggested that the patient record, in a diary, headache days, treatment, and the effects of treatment. The diaries should be shared with their health care provider at the initial visit and at follow-up visits. Patients should seek to learn about their headaches, and become involved in the management of the disorder.


Headache Care Center
3805 South Kansas Expressway
Springfield, Missouri 65807
(417) 890-7888

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