PMD Alliance Ecosystem©
The Medical Network is one of the five unique networks that make up our Movement Disorder Care & Support Ecosystem and doesn’t just include movement disorder specialists. These medical experts who run the gamut in areas of expertise – from the primary care physician to the psychiatrist, from the nurse practitioner to the dermatologist. Having a well-coordinated, comprehensive team of professionals in this domain is an essential part of maximizing care and quality of life!
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Movement Disorder Patient Ecosystem©
Parkinson & Movement Disorder Alliance, 2020
Do not use or reproduce without approval from PMD Alliance
A physician specialty that focuses on the health care of elderly people. Geriatricians aim to promote health by preventing and treating diseases and disabilities in older adults and tend to approach care from a holistic, multidisciplinary stance.
A physician who addresses and treats certain dermatological disorders found in PD such as seborrheic dermatitis and melanoma (PD patients do have an increased risk of melanoma-Qing Ye, et al. 2020). The person with Parkinson’s should be evaluated by their dermatologist annually.
Specializes in the treatment of disorders in the gastrointestinal tract. GI’s can diagnose and address problems related to digestive issues in PD including delayed emptying of the stomach called gastroparesis.
A neurologist who has completed 1-2 years of additional fellowship training in movement disorders, such as Parkinson’s. The benefit of seeing a MDS is the expertise and knowledge of complex symptoms, treatment options, and can help develop a personalized treatment plan. Many people see a general neurologist initially, however, general neurologists may treat a number of other neurological disorders, as well as PD.
Note: If a person with PD requires at least five doses of medications every day and they experience symptoms for at least 1-2 hours that are not improved with medications, they should be referred to a movement disorder specialist, whenever possible, for assessment (WPC, 2019).
A specialist in the anatomy, functions, and organic disorders of nerves and the nervous system. Although not a movement disorder specialist, some neurologists treat patients with Parkinson disease.
Integrative medicine practitioners use a healing-oriented approach that takes into account the whole person and all factors that influence health including mind, body, spirit, and community. Using both conventional and alternative methods to facilitate the body’s healing, the patient and practitioner are partners.
A physician who has completed a neurology or ophthalmology residency followed by a neuro-ophthalmology fellowship. These specialists treat visual symptoms resulting from brain diseases such as Parkinson’s. Vision problems can include dry eyes, double vision, visual field deficits, eyelid apraxia (inability to initiate voluntary opening of the eyelid) and blepharospasm (involuntary contraction of the muscles of the eyelids that cause the eyelids to close).
Generally, the physician who coordinates all the patient’s care. A PCP can include family medicine physicians or internal medicine physicians They manage the patient’s care that is not Parkinson’s related, such as acute illness, vaccinations, and routine screenings.
APP’s include APRN (nurse practitioner) or a PA (physician assistant) An APRN is a nurse who has obtained advanced training and certification at a master’s or doctorate level. A PA has a master’s degree and must complete 2,000 hours of supervised practice before graduation. Many movement disorder and PCP practices employ APP’s who work beside them and you may see them at times in place of your doctor. APP’s can assess and treat symptoms and are an invaluable resource for education, support, referrals for therapies and services, and assistance with things such as insurance authorization for medications, medical equipment, etc.
Neuropsychology is a branch of psychology that focuses on how injury or illness affects the brain and the nervous system influence on a person’s cognition and behaviors. Neuropsychologists can perform testing that can detect cognitive changes in PD/MD which is important for the comprehensive management of patients as well as provide insight to the patient and family members.
Physicians who diagnose and treat mental health issues such as depression, anxiety, and other mental/behavioral health concerns that can occur in Parkinson’s.
Physical Medicine and Rehabilitation (PM&R), also known as physiatry is a medical specialty that emphasizes the diagnoses, treatment and rehabilitation of people disabled by disease, disorder, or injury focusing on function, independence, and quality of life. Physiatrists use a variety of techniques including medications, injections, modalities, exercise, adaptive devices, and cognitive therapy to treat disabling conditions.
Pharmacists are an essential part of medication management and an often-underutilized member of your team. Pharmacists educate on side-effects, they make sure other medications do not worsen PD symptoms, and they evaluate medications prescribed by various doctors to assure there are no contraindications (when multiple medications don’t interact well together).
Good oral health is an important part of Parkinson’s treatment. Many medications given to treat Parkinson’s can cause dry mouth, which can increase tooth decay. Motor symptoms such as tremors and rigidity can decrease the ability to maintain adequate dental hygiene. Regular dental care can help reduce cavities and gum disease.