From Our 2011 Archives
Parkinson's Patients Do Best if Treated by Neurologist
Study Shows Parkinson's Patients Cared for by Neurologists Are Less Likely to Be Put in Nursing Homes
By Victoria Rodgers
Reviewed by Laura J. Martin, MD
Aug. 10, 2011 -- People with Parkinson's disease may live longer if treated by a neurologist, a new study suggests.
The study also found that Parkinson's patients who see a neurologist are less likely to be placed in a nursing home and less likely to break a hip.
The study is published in Neurology.
"This is a very interesting and unique investigation," Washington University researcher Allison Wright Willis, MD, tells WebMD. "There are ways that we can help improve the lives of people with Parkinson's disease beyond discovering a cure and beyond discovering the cause."
Researchers analyzed the records of nearly 138,000 newly diagnosed Parkinson's disease patients receiving Medicare seen in outpatient clinics during 2002. Between 2002 and 2005, 58% of them were treated by neurologists.
The fact that more than half of Parkinson's patients are already seeing a neurologist for treatment is reassuring to James C. Beck, PhD, director of research programs at the Parkinson's Disease Foundation.
"But that still leaves a large number, over 40%, who are not seeing a neurologist for their care," Beck tells WebMD. Beck was not involved in the study.
The study revealed that women are 22% less likely than men to see a neurologist, and minorities are 17% less likely than whites to see a neurologist.
The study does not reach any definite conclusions accounting for these numbers.
"It's hard to know exactly if there is a problem with the finding that women or non-whites are less likely to see a neurologist without really investigating some of the reasons why, on an individual level," Willis says.
Seeking a Specialist's Care
"You can't look at this and say, 'we found the answer -- here is what we need to do differently now,'" says James F. Burke, MD, of the University of Michigan and member of the American Academy of Neurology.
"You can look at this and say this is a suggestive practice pattern and we need to dig into it further and do more research. I think that is very, very hard to take that 20% mortality value at face value at this point."
The study still reinstates the belief that neurologists may provide the best care for Parkinson's disease patients. Willis says this is a reasonable idea because neurologists may be more comfortable treating Parkinson's disease. They may also be more aware and more knowledgeable about possible side effects and complications.
"People with Parkinson's disease should be seeing a specialist for their care," Beck says.
Although the study does not provide definite answers concerning the treatment of Parkinson's disease and whether seeing a neurologist is a key to treatment, it does provide more information for further studies.
"Hopefully future studies will allow us to answer that question, but it isn't quite clear at this time, and it isn't quite clear with this study who the ideal person to see a neurologist is or when along the course of Parkinson's disease one can benefit most from seeing a neurologist," Willis says.
Future studies may suggest which Parkinson's disease related complications can be prevented by a neurologist. These studies may also suggest which patients with Parkinson's disease may benefit most from a neurologist's care.
SOURCES: Allison Wright Willis, MD, Washington University.James C. Beck, PhD, director of research programs, Parkinson's Disease Foundation.James F. Burke, MD, University of Michigan; member, American Academy of Neurology.News release, American Academy of Neurology.Willis, A.W. Neurology, August 2011. ©2011 WebMD, LLC. All Rights Reserved.