At the University of Manitoba, Dr. Anish Kanungo is attempting to change the minds of legislators who have been reluctant to use public dollars to finance dedicated clinics for the care of people with Parkinson’s disease.
“The hard thing is that we don’t have a cure for this disease … but symptom management and quality of life – that’s an important goal,” says Kanungo, a neurologist who is spending a year as a clinical movement disorders fellow.
Maintaining a good quality-of-life in people with Parkinson’s disease has moved beyond simply prescribing levodopa. Today, caring for these patients requires experienced neurologists with specialized training in movement disorders who are knowledgeable about the explosion of growth in therapies available now and in the near future.
“There are a lot of approaches to the treatment of Parkinson’s disease that you don’t master in five years of neurology training,” Kanungo says. “You need the extra year of fellowship to develop the competency needed to manage the subtle aspects of the disease.”
In addition to treating patients, Kanungo is also analyzing Manitoba’s population health database to compare outcomes for people with Parkinson’s who are being treated at the clinic, to outcomes of people with Parkinson’s being treated by family doctors and general neurologists in the community.
“Having (specialized care) on one site and under one banner is, we think, the most efficient way to do this – but nobody has really evaluated it,” he says. “As a result, there has been a reluctance to publically fund such clinics, despite the growing population of patients with Parkinson’s across Canada.”
Although such clinics have been established in Centres of Excellence, waiting lists are extensive. Frequently, patients with Parkinson’s must travel great distances from their home communities to reach such centres. That’s why Kanungo hopes to practice in a smaller community outside Manitoba when he finishes his fellowship at the Movement Disorder Clinic at Winnipeg’s Deer Lodge Centre.
While undertaking his fellowship, funded by Parkinson Society British Columbia through the Parkinson Canada Research Program, Kanungo will be uniquely situated to perform this analysis.
“Having only one such clinic in Manitoba allows for a more direct comparison of health outcomes and costs between these models of health provision in Parkinson’s disease – as opposed to other regions, where two or more movement disorder clinics have been established.”