Choosing Your Healthcare Team: Who Needs to be Involved?

A person with Parkinson’s disease (PD) may have several doctors and other professionals on their healthcare team to help them manage their disease as well as its effects on quality of life. Healthcare professionals may be generalists or specialists. Generalists are those who consider the patient as a whole, while specialists are focused and specially trained in one particular system or area. For example, some physicians are trained as neurologists who study disorders in the brain. They can then go on to become a movement disorders specialist, in which they receive special training in recognizing, diagnosing, treating symptoms, distinguishing among different movement disorders that cause similar symptoms, and understanding important drug interactions that may cause symptoms. Regardless, depending on the patients’ needs, both generalists and specialists can play an important role.¹

Primary care physician

A primary care physician (PCP) is generally the one who coordinates all of the patient’s care. PCP is a term that includes family medicine physicians, internal medicine physicians, and pediatricians. The PCP is often the first point of contact for the patient and provides comprehensive care for chronic, preventive and acute conditions. They regularly handle vaccinations, address urgent needs such as respiratory infections, and handle routine screening tests. For patients with chronic conditions like PD, having a PCP instead of utilizing an urgent care facility for acute needs means that the patient’s entire history and background will be taken into consideration.²

Internal medicine doctor

Internal medicine physicians apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Also known as internists, these doctors have training in learning how to prevent, diagnose, and treat diseases that affect adults. They can be the primary care physicians, coordinating a patient’s care with other specialists.³

Neurologist/Movement disorders specialists

A neurologist is a specialist that has special training to diagnose and treat neurological conditions. Some neurologists are also movement disorders specialists, having received additional training on diseases that affect physical movement, such as PD.⁴

Mental health professionals

Many people with PD experience mood disorders, including depression and anxiety, as a result of their condition. Mental health professionals that can provide treatment and support for mood symptoms include:

• Psychiatrists – A psychiatrist is a medical doctor who focuses on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. A psychiatrist can assess the physical and mental aspects of a psychological problem.⁵ A psychiatrist can also prescribe medication to help with these conditions. Because psychiatric drugs can influence motor symptoms and drugs for motor symptoms can alter behavior, it is critical that both the psychiatrist and neurologist are well informed of all treatments.
• Psychologists – A psychologist is a licensed professional that has training and clinical skills to help people cope more effectively with life issues and mental health problems. Most often, they use talk therapy to help their patients.⁶
• Neuropsychologists – A neuropsychologist is a specialist of psychology who specializes in the assessment and treatment of patients with brain disease or injury. They may use standardized tests to assess cognitive deficits and can help the management, treatment, and rehabilitation of cognitively impaired patients.⁷

Physical therapist

Physical therapists are licensed health care professionals who help patients reduce pain and improve or restore mobility. They help patients with PD prevent or manage their condition using treatment techniques that promote the ability to move, return function, and prevent disability.⁸

Occupational therapist

Occupational therapists are licensed health care professionals who work with people who need specialized assistance due to physical, developmental, social, or emotional problems. Occupational therapists often work with people with PD and other illnesses or disabilities to help them do everyday tasks that are important to them, such as eating, dressing, and work activities. They may make changes to the environment, the task, or the person’s skills needed for the task. Occupational therapists also have the knowledge and training to work with people with mental illness or emotional problems, such as depression or stress.⁹

Speech language pathologist

Speech language pathologists are healthcare professionals that diagnose, assess, and treat speech, language, cognitive-communication, and swallowing disorders. They may also be referred to as speech therapists. People with PD who experience difficulty swallowing or changes to their speech may benefit from seeing a speech language pathologist.¹⁰

Registered dietitian

A registered dietitian is a food and nutrition expert. Also called nutritionists, they work with people with PD to educate them on nutrition. They also provide helpful advice and suggestions to cope with some of PD’s symptoms, such as weight gain, weight loss, or difficulty swallowing.¹¹

Social worker

A social worker is a trained professional that helps individuals and families restore or enhance their capacity for social functioning. Social workers can play a role in an integrated, multidisciplinary healthcare team. Their focus on the psychological, emotional, and logistical coping challenges faced by people with PD provides important information to other healthcare providers.^12,13