I would just like my experience to add to tis disma story.  The only MDS
in our province refused to see me for the simple reason that I went ahead
and got a second opinion of my diagnosis!
    Raj
    [log in to unmask]

----- Original Message -----
From: "Donald Diswinka" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, July 31, 2002 5:05 PM
Subject: Poor health care for Parkies in Canada--long


> The following is quite a SCARY snapshot on the state of Health Care in
> Canada in respect to Parkinson's
> My apologies for the lenght of the article.
> I just met a fellow parkie over the age of 65  here in Manitoba at my
> last support group  meeting who in 8 years of having PD had yet to see
> any neurologist, never mind  an MDS neurologist!! His GP Doctor had
> never referred him to one. If you don't get referred here by your
> regular doctor you will never get an appointment with any type of
> neurologist  directly.
>
> Don 53/5
>
>
> Parkinson's patients may not be getting best available care     Jul. 31,
2002
> Provided by: Canadian Press
> Written by: HELEN BRANSWELL
>
> TORONTO (CP) - Many people with Parkinson's disease may not be getting
> the optimum care that's available, a new study suggests. Analysis of six
> years of Ontario medical data shows that fewer than half of Parkinson's
> patients in the province saw a neurologist annually and 41 per cent
> never saw a neurologist during that period.
>
> Among older patients - those over age 65 - only 37 per cent saw a
> neurologist every year, a figure lead author Dr. Mark Guttman termed
> "disastrous." Many appeared to be simply under the care of a family
> physician, who would not have the training to give Parkinson's patients
> the best possible medical attention.
>
> "I think it's a sad state of affairs," said Mary Jardine, national
> executive director of the Parkinson's Society Canada.
>
> Jardine insisted that while the study looked only at Ontario data, the
> problem is a national one.
>
> It's also a worrisome one. Parkinson's is a neurological disease that is
> hard to diagnose and treat. Symptoms and severity vary from person to
> person. Drugs that work for one patient may not work for another.
>
> "It really takes someone who knows about Parkinson's to truly recognize
> the symptoms and to be able to treat accordingly," said Jardine.
>
> "That's why the optimum treatment is not going to be given until they
> see someone who does specialize in Parkinson's."
>
> But many patients never get to see such a specialist, according to the
> study, published in the Canadian Journal of Neurological Sciences.
>
> The authors cross-referenced three Ontario government databases to
> identify a pool of 15,304 Parkinsonian patients. (Parkinson's disease is
> one of a cluster of conditions that appear similar, especially in the
> early stages, and which are treated with the same types of drugs.) They
> compared that group's use of medical services to that of a control group
> of 30,608 non-Parkinson's patients.
>
> While nearly three-quarters of Parkinson's patients under age 65 saw a
> neurologist at least once during the period studied, most older people
> with the disease did not.
>
> This left the authors wondering if there was an age bias at work -
> whether family doctors, who are responsible for referring patients to
> specialists, were simply deciding that for their older Parkinson's
> patients, it wasn't worth the wait to see a neurologist.
>
> "It begs the question: What's going on in our system? Why are people not
> getting access to care? And is there some kind of bias or
> differentiation by age?" Guttman asked in an interview.
>
> About half of the people in the Parkinson's group saw an internal
> medicine specialist during the study period. Neurology is a
> sub-specialty of internal medicine, so some family doctors may have been
> referring their Parkinson's patients in that direction because of long
> waiting lists to see neurologists. (The authors couldn't be sure: the
> Parkinson's patients may actually have seen the internal medicine
> specialists for heart disease or other problems.)
>
> But given that some neurologists lack the specialized training to truly
> treat Parkinson's patients effectively, internal medicine specialists
> probably aren't the answer, said Guttman, a professor of medicine at the
> University of Toronto and a neurologist with a sub-speciality in
> Parkinson's disease.
>
> "If you just had a heart attack, would you be satisfied seeing your
> family doctor and not seeing a cardiologist?"
>
> While he acknowledged that part of the problem is a shortage of
> neurologists and further a shortage of neurologists who specialize in
> Parkinson's disease, the statistics show that isn't the only factor at
> play.
>
> By following the patients for six years, the researchers could determine
> that it wasn't simply a matter of long waits to see neurologists. In
> some cases, family doctors "are not even requesting the consultations is
> the bottom line," he said.
>
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