At 04:05 PM 7/31/02 , Donald Diswinka wrote:
>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
>
Don, this article appeared in the London Free Press today, 31 July.  I too
apologize for its length.  This article appeared on the first page of the
second section of the paper, along with a 14 x 25 cm color picture of Judith in
her garden.
<<
Not enough specialists
A new study shows patients with Parkinson's disease are not getting the quality
of life or treatment they deserve because of Ontario's short supply of
neurologists.

by David Dauphinee
Free Press Health Reporter

Londoners Judith and Al Richards had planned to retire to Peterborough near
family and roots.

"Not any more," says Al.  "We're sticking in London."

Judith learned in 1993 that she had Parkinson's disease.

"It's a miserable disorder, a cruel disorder," Judith said, savouring a few
good moments as a complex regimen of drugs keeps her ever-changing symptoms at
bay.

The diagnosis interrupted what had been an active and independent life.

"You coast along with medication and then something changes," Judith said.

"Suddenly you can't do things in life you used to do, things other people take
for granted, like turning a tap, putting a key in a door."

Asked if she could conjure up just one change, Judith considers the
proposition.

"If I could change something, it would be more specialists, more movement
disorder specialists."

But there's no neurologist in Peterborough to offer guidance as her disease
progresses, let alone the sub-specialty of movement disorder specialist.


Nine years with the creeping, evolving disorder have taught the couple they
need to be near medical specialists.  London has the only movement disorder
program from London to Winnipeg.

A new study says huge numbers of Parkinson's sufferers aren't getting the
quality of life they could - they aren't seeing the right doctor, if they can
even find one skilled to diagnose and handle their condition.

"We have a major manpower issue here - it is not a good picture," said Dr. Mark
Guttman, lead author in a study highlighting the impoverished state of
services.

"A significant proportion of people with Parkinson's are not receiving the
appropriate care by the relevant specialist," said Mary Jardine, executive
director for Parkinson Society Canada.

The Institute for Clinical Evaluative Sciences followed groups between 1993 and
1999,  It found:

        Fewer than half of patients saw a neurologist at least once a year.

        Only 59 per cent saw a neurologist during the entire six-year study
period.

        Annually, almost every patient saw a family physician, half saw an
internist.

        Patients 65 years and older were half as likely to see a neurologist
annually as those who were younger.

The most likely culprit is a shortage of neurologists.

"That's why I'm sitting in Thunder Bay today," said University of Western
Ontario  professor Dr. Mandar Jog, head of the Movement Disorders Program at
London Health Sciences Centre.

Yesterday, Jog held an outreach clinic - one of three or four this year, the
cost covered from fundraising by himself and the Parkinson's Foundation - to
serve patients who can't get to London or Toronto.

The problem is not only a shortage of Jog's subspecialty - there are about 16
in Canada.  In Ontario, there's only one neurologist north of Barrie, leaving a
huge population in the hands of general practitioners.

That's not good enough, say Jog and Guttman.

With more than a dozen drugs to treat Parkinson's symptoms, finding the right
drug, dosage, and mix for the stage of the disease is a complex process beyond
the skill of most family doctors.

A typical physician has fewer than 10 Parkinson's patients.  Guttman has 120.

"There are other conditions that can mimic Parkinson's, that are treated
differently, so they may be getting the wrong diagnosis," he says.

Jog said his London office gets patients driving long distances.

"I have people driving from Owen Sound, Sudbury, Timmins, eight to ten hours.
Are we in Canada, or where are we?"
>>

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