Carolyn, it's a good gosh darn thing we have you around to wake us up once in a while. Thank you.

I'm with you, Paula. I'm so mad I'm spitting nails, and just barely articulate.

WHAT neurologists manage total care for PD patients?? I'd rather have a psychiatrist as my primary, since they are right there with us where the rubber meets the road, and notice how things affect us. Our disorder falls squarely into the chasm between neurology and psychiatry, IMHO, so why deprive us of a GP or internist to referee the proceedings?

Who would you like managing YOUR care, PAN? A neurologist who won't even give you a referral for severe hip pain, or one who tells you on the phone to stop taking your PD meds because you don't look sick enough, or one who tells you not to talk about your other symptoms because only motor symptoms are wanted, who treats you like a case of psychogenic parkinsonism because he can't get into the psychiatrist's files to find out what you're doing with those crazy doctors?

Did that cover it? No? Well, what about the generalist neuro who says you can pick your own meds because he doesn't know anything about them? Or feast your eyes on the one who slips a piece of paper out of their pocket for prescription doses--the piece of paper apparently giving better information about what you need than the painstaking notes you brought with you outlining usual dosage times, meds taken, and any reactions or shortfalls?

Now, the rare good ones--it does happen, for short periods of time--what about their time? It takes 20 years to learn to ge a neurologist, and you want him managing care??? Toenail fungus? Flu? Emotional overreaction? And what, find specialists for you?? Hoo ha.

It seems to me, in fact, that few neurological visits are of any use or benefit to the patient, anyway, except as a source of medications, else why do people PM and email ME to ask what they should take? (I don't attempt to tell them, of course.)

Hel-LO, PAN, with all due respect, "Currently, neurology is not listed as a specialty eligible for primary care incentives in section 5501 of the Senate Health Reform Bill, even though family practice, internal medicine, pediatrics, and geriatrics are included"--this iis how you justify your alarm? Those "specialties" comprise what we used to call "General Practice." Where is the outcry for otorhinolaryngologists or nuclear medcine specialists, or OB-GYNs to be rewarded for managing care? Study the organization of any large hospital!

Yikes, let's not just jump at everything related to neurology and push it forward. We have too much real stuff to fight for, and burdening highly educated and trained individuals with the minutiae of our messy lives is not my idea of something that promises success. And I don't know a neurolgist who would disagree with me on this point.

Now ask me how I really feel about the issue LOL. Oh, and all the incidents mentioned above have really happened, somewhere, to someone.

Jaye