Prescriptions Renewals

All prescription renewals are completed in person. We do not respond to faxes from pharmacies requesting renewal of medications. When a medication requires renewal, we ask that you book an appointment to see us and review the need for this medication and ensure that all proper monitoring that is required to safely prescribe this medication on a long-term basis is occurring. You can contact our office by telephone, or book a visit online when your prescription renewal is required.

Test Results

We review all test results in person. We will only contact you regarding a result of one of your tests if the result indicates that urgent or emergent action needs to be taken. In all other circumstances it is the responsibility of you as a patient to book an appointment to review results once you have completed the test. We believe that this is crucial for your safety, as over many years we have noticed that not all tests results, and other medical communications reach their end destination. In fact, this failure in communication has become rather commonplace in medicine unfortunately. There is no single medical record keeping system in Ontario. Every time you go to a new medical clinic or facility, it is likely that their system is entirely disconnected from ours!

Ensuring that you follow up to review all tests helps us to ensure that we never miss any results for you, which is critical in ensuring your safety and optimal medical outcomes.

Referrals

All referrals are made at the end of your visit. During the visit we will discuss the rationale for referral and come to an agreement with you on the type and nature of the referral. The referral is sent before you leave the office. It is important to understand that once we send the referral, in most instances, we have little to no control over what happens from there. Specialists’ offices are extremely busy, and our specialty colleagues work very hard to accommodate visits in a timely fashion, but many are unfortunately overwhelmed. For this reason, it may take up to 6 weeks to be given an appointment for the visit. According to the new regulations, it is the role of the specialist’s office to communicate the visit date and time directly to you.

Walk-In Clinics

We do not prohibit the use of walk-in clinics. We encourage to seek health care in a way that is most convenient and appropriate for you. It is certainly our preference to see you for all or as many of your concerns as possible, to ensure that we are aware of all aspects of your care. We recognize and appreciate that this may not always be possible. If you seek care at a walk-in clinic it may be helpful to request that the record of the encounter be sent to us so that we are aware of what occurred and can follow up with you on any outstanding issues arising from that encounter. I some instances, it can be challenging to do this properly without a record of the encounter.

Opiates

We recognize that there are many patients who suffer from chronic pain who have benefited substantially from opiate pain medications. These medications may provide significant quality of life to certain individuals. Without them, not only do these individuals experience enhanced pain, but this can be worsened by the presence of withdrawal symptoms that occur when they are not taken regularly. It is important to us to ensure that patients who benefit from these medications, receive them without interruption. This of course must be balanced with the need to ensure the safety of you as a patient, but also to society more broadly, as we are all aware of the harms that can occur when medications are not taken as prescribed or end up in the hands of someone that the medication was not intended for. For these reasons we must monitor the prescription of these medications closely. All renewals are done in person only, we do not renew opioid medications by fax or telephone. We require that a treatment agreement governing appropriate use of the medication be completed. Additionally, urine drug screening is used to ensure that the medication is being taken as expected, and that no other medications that are not expected are being used.

There are a couple of key things that are commonly misunderstood by patients, that we think it appropriate to address:

1. A new prescriber is not required to continue a previous prescription simply because another prescriber wrote that prescription. In fact, it is expected that each prescriber conduct their own individual assessment prior to prescribing a controlled substance.

2. Normal recommended doses of opiate medications are much lower than they used to be. For this reason, a new prescriber may not be able to prescribe the medication at the exact same dose as the previous prescriber.

3. Each case is unique. We often find ourselves in a discussion about what another doctor has done for another patient. This is not a productive discussion. We do not engage in these discussions. Your case is unique, as is each case. What another prescriber has done for another patient is irrelevant and will not be part of the discussion or the decision as to whether to prescribe you an opiate or other controlled substance.

4. Overdoses and harms related to opiate medications occur commonly in patients who are taking the medications as prescribed. These medications are potentially harmful even when taken as prescribed. Especially when taken with other sedating medications such as benzodiazepines, sleeping aids or alcohol.

5. Side effects to opiates occur over time in many instances. The potential for harm is greater the longer the medication is taken. All patients should be aware of this reality.

For clarity, the process involved in receiving an opiate prescription, and renewing that prescription is as follows: