I just wanted to share what a PD pal of mine is facing in Texas. She is a Physician who hopes to return to practicing Pediatrics after she delivers her child. I was appalled to learn that she is being "recruited" for the Texas Physician's Health Program based on her PD diagnosis. Mind you this program exists to track physicians and physician assistants who have substance abuse issues and mental health disorders. So, now apparently,
in addition to having a neurological condition, state licensing boards may confer upon us a mental health disorder label?!?!

I understand the need for patient safety, but it is insulting beyond words that not one researcher, not one doctor can point to any definitive standard or definition of what comprises the scale toward PD dementia, especially in Young Onset PWP. Not one can even adequately explain it to us, yet they are going to hold a cogent medical professional who still has much to contribute to some standard that no one can yet define? Please correct me if I am wrong; is there some clear brochure or standard that is used beyond the MMTE to measure our capacity to continue working or that gives clear criteria to establish us as having mental health issues?

I am really upset by this because she is actively being discouraged from practicing medicine. She has supplied a letter of support from her neurologist and it is deemed not good enough. This week they want to interview her, and then in order to even be granted a medical license she has to be party to some sort of monitoring program while in practice. What is really unsettling is that the law was just set into motion this year. Obviously, there is no legal precedent set for ushering her unwillingly into such a program. If Texas is allowed to do this what does it mean for the ADA and PWP in other states? I encouraged her to consult with a lawyer right away before she communicated further with this oversight board. It seems to me that they wish to use her as a means to establish precedent, and I don't think that any one of us would wish to be used as an example like this.

Has anyone heard of this program? I know we have some practicing medical professionals out here and others who used to practice...what do you make of all this?

Laura

Laura,
I am saddened and angered to hear of your friend's dilemma. How insulting! I am sure she is completely capable of returning to her practice and providing the same level of care for her patients as she was previously. Her patients deserve to have the benefits of her expertise without any restrictions and monitoring - again even the suggestion of the need to have her judgement second guessed is so insulting! And what possible justification do they have?
As a family physician in Canada, currently on medical leave from my practice, I still have full opportunity to return to whatever level of practice that I choose - thankfully! But I will be keeping a close eye on what is happening in the US...
Soania

Laura,

Absolutely appalling! And now if she takes action, who will present the mental health issues with Parkinsons? Doctors who don't know what pd dementia is ? Or how medicines work or conflict?

paula

Laura,
This is when I really start to get steamy around the ears..... the disinformation is just too much. There is nothing at all to suggest that dementia even occurs until late stage, if ever, and ALL humans have mental health changes, no matter how well they handle them. Do they bar mothers from being doctors because some women get post natal depression, or diabetics because their lifestyle changes can knock them off course enough to make them depressed ? There is a word for it - discrimination.

Over here people who have real CFS with full blown depression are often seen as malingers, and efforts are made to push them into work even when they clearly are unwell - there are such double standards and misconceptions about illness.

I do hope that there is some body that protects peoples rights that can work with her, and help her maintain her right to be able to work with no stigma.

Face the facts. Parkinson's disease affects every aspect of a person's health. Tremors, ridgidity, cogwheeling, are only the primary symptoms of this insidious disease. The disease is not a disease per se, but a collection of symptoms diagnosed by an experienced movement disorder physician. Movement disorders are the only symptoms used to diagnose the disease but they are just the tip of the iceburg.

Please check out the following site:

http://www.clognition.org/

The person who created this site has received awards for her honest, forthright, analysis of other mental health affects of our illness. She also has suffered the illness herself for many years.

Many of us must give up our dreams if they conflict with the safety of the public. Perhaps your friend would consider using her degree in a non public career such as research. I emphasize for your friend and the many others who worked so hard to obtain the credentials to help society, but are now prevented by any disability. Your friend also would enjoy her job, but her health is important. The stress of being a pediatrician is tremendous.

Life just is not fair!!!!!

Vicky,

I do not deny the pervasiveness of pd. But a satisfactory definition of pd dementia does not exist yet and patients need to say loudly how we need to provide input on the new definitions. Things can change - quickly- and the time has come to speak up. Actions like this will simply make pwp hide.

Depression and Parkinson's have been known to have a connection for some time. Medications we take to control our physical symptoms also have caused mental health disorders. Dementia is only a small part of PD.

Carey knows of what she posts on her site. I would be interested in taking a poll of how many diagnosed Parkinson's patients have been told to have mental health counceling. I am sorry to sound argumentative and heartless. Will not post anymore on this topic. Sorry to have posted in the first place.

Vicky,

we agree so post away. i just don't accept any definitions that have to do with my mental health being thought up by nonpwp-which means they will stall and make money. i have no problem with your statements and sorry if i sounded like i was taking it out on you.

There really is nothing in the original post that states that this individual is not competent or that her condition is in "conflict with the safety of the public". She has PD. I was diagnosed with YOPD after having completed my residency and therefore had this diagnosis since the beginning of my career. I had a busy, essentially full time, successful practice for 12 years through all the daily trials that PD presented. I, myself decided to take a break due to the stress of balancing family, home, career and health. And some aspects were becoming more difficult for me, not my patients. If someone had told me a decade ago that I could no longer practice or that I would have had to be monitored by another physician, it would have been ludicrous! PD in and of itself should not be a diagnosis that precludes this or any similar career.

I think we are confusing "mental health or illness" with "dementia"

Dr. Laura Marsh (formerly at Johns Hopkins; now at the Houston VA), a well-known and respected psychiatrist who specializes in PD and traumatic brain injury thinks that PD should be categorized as a "neuropsychiatric" disorder. In general, this means that most cases of PD are not only defined by motor symptoms, but also usually by some sort of mental component such as depression and anxiety (among many others).

Neuropsychiatric Aspects of Parkinson's Disease, by Laura Marsh.

I don't think this precludes continuing to work - even as a physician. It just means we need to pay attention to ALL potential symptoms. Dr. Marsh is always saying that if depression or anxiety is identified, then there is real help to recover from those conditions - a much better opportunity than there is to recover from other symptoms. And she knows that if you can get your mental health together, your physical health will benefit as well.

I can't comment on what is happening with the woman with Texas, but I do think it can be said that Parkinson's affects your mental health - in different ways in different people - just like all of the other symptoms. No two of us are alike!