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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. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn