Being initially diagnosed with Parkinson’s Disease can be overwhelming for most. There are a lot of various symptoms or conditions that these patients might have. Therefore it’s in the patient’s best interest to cover all the bases concerning their care. This can be achieved by consulting with one or more healthcare professionals to ensure every aspect of their health is addressed.

In this article, we’re going to discuss the types of doctors that can be involved in the care of PD patients and the symptoms and conditions that these physicians address.

Primary Care Physician

The primary care physician is the first point of contact in patient care. Outside the patient’s PD diagnosis, they would be responsible for providing general healthcare for the patient. PCPs or family doctors are the first line in detecting any symptoms related to movement disorders and help address these as soon as possible.

A patient may come in for a normal clinic office visit, maybe complaining of early symptoms related to movement disorders or PD. Once they find telltale signs of the patient having movement disorders, it's up to the PCP to refer them to specialists more versed in these to confirm the diagnosis.

After confirming the diagnosis of PD and during the duration of the disease, a primary care physician needs to make sure that the patient’s kidneys, liver, heart, lungs, lipids, bone density, vitamin levels, and thyroid condition are all in check. They would be the ones taking care of these common issues, while the specialists deal with more specific concerns.

Neurologist/Movement Disorder Specialist

Generally, a neurologist focuses on the disorders of the brain and the nervous system, while movement disorder specialists are focused more on diseases such as Parkinson’s and specialize more in its care. Movement disorder specialists are trained to identify and differentiate between Parkinson’s and other Parkinsonian disorders. Patients would be receiving a more accurate diagnosis and in turn, personalized medication and therapies.

A movement disorder specialist would likely be the one managing the treatment plans and supportive care related to managing PD for these patients. It’s also highly likely that neurologists/movement disorder specialists already work with other healthcare professionals who address Parkinson’s Disease. Patients might benefit from a healthcare team who’s more familiar with each other and care can be coordinated more effectively.

Physical Therapist

Not all physical therapists have an M.D., but the care they provide to patients with PD has been invaluable in improving their quality of life and overall wellness. 

Physical therapy exercises can greatly improve the general strength and mobility of PD patients. These include general stretching and strengthening, balance and gait training, and reciprocal movement exercises to name a few. Physical therapists will strive to keep the patient in tip-top shape to mitigate the effects of PD symptoms.

Starting physical therapy early in the diagnosis of PD has been recommended to counteract the movement disorder symptoms that are associated with PD.

Physical therapists can also use other treatment modalities such as massage therapy or neuromuscular therapy to help with tremors, rigidity, and pain. While the effects of NMT or massage therapy on PD patients still require further study, early results show promising outcomes. The addition of pain relief alone already is a significant improvement in the quality of life of these patients.

Occupational Therapist

The goal of an occupational therapist is to improve the strength and mobility of PD patients as it relates to their usual daily activities. As in the word itself, occupational therapy will try to help the patient to keep their jobs, keep doing their hobbies, or make their homes. Occupational therapists identify specifically which exercises will help the patient be able to keep doing these activities and maintain their independence in the performance of these.

An occupational therapist only differs from a physical therapist where they give exercises that are more targeted to specific actions and movements, as opposed to PT which is general. But you’ll find that most of the time, you’ll find therapists in your community who practice both physical and occupational therapy anyway, but your mileage may vary.

Speech-Language Pathologist

Almost 90% of PD patients will develop speech problems or dysarthria sometime after diagnosis, and having a speech-language pathologist in your care team could be vital. While speech problems may not be a huge deal for some PD patients, swallowing problems or dysphagia can manifest in 40 to 95% of PD patients and can result in serious health issues. It could result in choking or accidental aspiration of food particles, leading to aspiration pneumonia. It could also lead to malnutrition and dehydration. Early detection and treatment of swallowing problems is critical to patient safety. They can also recommend softer food recipes that are easier to swallow and less of a choking hazard.

SLPs use behavioral and myofunctional therapies in the management of dysarthria (difficulty of speech) and dysphagia. These include targeted shouting and swallowing exercises that enhance the muscles in your airways. These exercises can be intense and loud! It can involve a lot of shouting and requires a lot of effort.

A speech-language therapist can also employ cognitive therapies, this time to address the communication and comprehension deficits associated with speech problems. These would include memory exercises and strategies that would allow the patient to gather their thoughts efficiently.

Palliative Care Physician

Palliative care focuses more on chronic symptoms the patient is having. In the context of Parkinson’s disease, this would include the management of symptoms that largely affect the patient’s quality of life.

Pain or chronic pain is one of the most debilitating chronic symptoms that a patient with PD could have. Over 70-95% of PD patients get some form of chronic pain within the duration of their disease. The origin of this pain varies from patient to patient, from age-related orthopedic issues to musculoskeletal pain associated with the symptoms of PD such as rigidity. It could also be just central pain that impairs the patient’s quality of life. Finding the causes of this pain is central to keeping the patient comfortable and able to participate in the various PD-related therapies and rehabilitation.

Addressing non-movement symptoms such as fatigue, both physical and mental, is also important. Besides the patient getting fatigued, it’s also the care partners and family members who become tired simply because of the long-term aspect of care.

Palliative care physicians provide both emotional and spiritual support to both parties. They ensure that the needs of the patient are attended to and chronic symptoms associated with PD are well managed. They ensure that the patient and their loved ones are well-equipped to handle the chronic issues that PD causes.

Conclusion 

Caring for persons living with Parkinson’s disease can be a challenge, but getting proper healthcare can ease their symptoms and allow them to live healthier, more meaningful lives. There’s tons of support available for these patients, from early detection and management of PD to occupational therapies and supportive care. Prioritizing care is also key, especially if patients can’t afford to pay out of pocket.

The above is just a short list of doctors or specialists that may be involved in your PD patient’s care team. Watch for the continuation of this article which will list other medical needs of your PD patient and their respective doctors or specialists.