Treating neurodegenerative diseases

What patients want is not what doctors focus on

Parkinson's disease is an excellent example of the challenges of caring posed by people with neurodegenerative disorders. It is insidious in onset, inexorably progressive, of unknown cause, incurable, yet amenable to management with pharmacological and other interventions. With the ageing of the population the prevalence of Parkinson's disease and other such disorders is projected to increase in the years ahead.1 Thus all doctors must be prepared to provide diagnostic and management strategies for this growing population of patients. Medical practitioners must understand the expectations of patients and their families and introduce these perspectives within the framework of scientific understanding and evidence based practice. Conventional medical education has set a tradition of practice based on science, basic and clinical, cemented by a period of postgraduate training in the conventional apprenticeship mode. This has ensured that practices are generally competent and safe and grounded in the best available information. But is this approach consistent with the mission of …