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As ESPOSITO says, it requires a diagnostic and treatment approach that looks beyond borders of medical specialties and The optimal clinical management of PA requires continuous crosstalk and a practical translationality between several medical specialties, so as to not lose the global sight of this complex disease and to guarantee the best possible care and outcome to the patient. But this is impossible in the USA HealthCare system as the Health Insurance Companies offer no billing code for the sub-specialty doctors to talk to each other so if they can not bill the cross-departmental conversation and get paid for their time, they refuse to spend the time to talk to another sub-specialty on the phone or email or at all

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