Crowfoot Village Family Practice - Paragon Publishingparagonpublish.com/pdfs/cvfp.pdf · and innovative group that uses a comprehensive care model to deliver primary health care in

Providing comprehensive family medicine services

www.cvfp.com

Crowfoot Village Family Practice

2 Crowfoot Village Family Practice

Crowfoot Village Family Practice 3

Crowfoot Village Family Practice is a progressive

and innovative group that uses a comprehensive care

model to deliver primary health care in northwest

Calgary. Our staff of family physicians, nurses and

support staff care for newborn to geriatric patients.

Crowfoot Village Family Practice is committed to

striving for excellence in family medicine. We are

proud to be the only clinic of our kind in Calgary.

MISSION STATEMENTAt Crowfoot Village Family Practice our mission

is to provide high quality, comprehensive, and

compassionate family practice care to our patient

population and to facilitate timely access to health

services.

Suite 201, 60 Crowfoot Crescent NWCalgary, Alberta T3G 3J9

Phone: (403) 239-9733 (24 hours)

www.cvfp.com

CONTENTSWelcome ....................................... 3

CVFP Doctors ................................ 4

Comprehensive Care Model ...... 5

Blood Pressure Reading ............... 6

Meet the Staff ............................... 7

Injury Recovery ............................. 8

Diabetes ........................................ 9

Public Health Nurse .................... 10

Balance Problems ...................... 11

Lung Health Clinic ...................... 12

Chronic Disease Team ............... 12

Travel Clinic ................................. 13

Providing comprehensive family medicine services

Did you know you can request appointments through our website: www.cvfp.com?

PROJECT MANAGER Denis Marson Tel: (250) 550-3086 [email protected]

ART DIRECTOR Richart Bocxe

PUBLISHER Jim Thornton

Published for CVFP by:PARAGON PUBLISHING INC.Calgary, AlbertaTel: (403) [email protected]

All rights reserved ©2007. Printed in Canada.

Cover Photo:Four generations are healthy patients of Crowfoot Village Family Practice.Clockwise from bottom left: John and Mary Kaminsky, David and Candace Cook, Steven and Susanne Hoefling, and Emma Hoefling.


Dr. Peggy AufrichtDr. Aufricht completed her medical degree at the University of Calgary in 1984 and her family medicine residency at the Foothills Hospital in 1986. She is a Fellow of the College of Family Physicians and is the project lead for the Crowfoot primary care reform pilot project. Dr. Aufricht enjoys running, skiing, cycling and hiking with her husband and three children.

Dr. Stephanie KubikDr. Kubik achieved her Bachelor of Science with Great Distinction in 1987 before going on to complete her doctorate in medicine at the University of Calgary in 1990. The year 1992 marked her completion of residency and subsequent partnership in CVFP. Dr. Kubik and her hubby are happily enjoying their roles as parents to their beautiful daughter and new son. Together with their dog Emmet, they enjoy hiking.

CVFP Physician Profiles

Dr. Kathy JohnsDr. Kathy Johns graduated from the U of A in 1992. She completed

her Family Medicine Residency at the U of A in 1994 and her Emergency Medicine Certificate in 1995 as Chief Resident. She has

been practicing Emergency Medicine at the Foothills and Peter Lougheed Centres from 1995 to 2006, with active participation in the

STARS Air Ambulance Service, The PARTY Program, the EMS liaison committee and the teaching of medical students and residents.Dr. Johns enjoys spending time with her husband and new baby.

Dr. Janet ReynoldsDr. Reynolds completed her medical degree at the University of Saskatchewan in 1997. She then moved to Ottawa to complete

her Family Medicine training at the University of Ottawa in 1999. She worked in a rural setting in Ontario for two years prior to moving to

Calgary. Aside from practicing family medicine, she does regular shifts at the

Alberta Children’s Hospital on the oncology ward.

Did you know that CVFP has a travel clinic?


Dr. Rick WardRick Ward has been a partner at CVFP since 1988. His professional

interests include preventative cardiology, chronic disease management, psychiatry and sexual medicine.

Besides his activities with CVFP, Rick has a clinical appointment with the Faculty of Medicine at the University of Calgary where he is a

Clinical Assistant Professor. He is actively involved through the U of C with teaching at CVFP and developing educational programs for

family physicians across Canada.He is married to Cindy, whom he met while an undergraduate at the

University of Guelph. They have 2 teenage boys, Evan and Austin.His hobbies include travel, fishing, reading and spending time at his

recreational property on Vancouver Island.

Dr. Wendy StefanekAfter completing her Bachelor of Science degrees at the University of Calgary, Dr. Stefanek obtained her MD from the University of Alberta in 1998. She made the move back to Calgary to complete her Family Medicine residency here at the University of Calgary. She began at CVFP as a locum physician during the fall of 2004.In addition to enjoying the diversity and flexibility of family medicine, Dr. Stefanek enjoys spending time with her family, running and reading for her book club.

The Crowfoot Village Family Practice Comprehensive Care Model

The comprehensive care model was developed in 1999 as a special initiative led by the Crowfoot

Village Family Practice doctors. Working with the Calgary Health Region, the Alberta Medical Association and Alberta Health and Wellness, the Crowfoot practice has moved to a model which includes all major components of primary care reform recommended by the Romanow and Mazankowski reports. These include:

• An electronic medical record • A multidisciplinary health team with a strong role

for nursing staff • 24/7 access to health services • Measurement of health outcomes • An alternate payment method

In this model, our practice receives a monthly fee from Alberta Health and Wellness to provide all primary health care services. Health premiums and coverage from Alberta Health and Wellness remain the same.

To be a part of the practice, patients enroll by

filling out the New Patient Enrollment Form. This is forwarded to Alberta Health and Wellness to attach your health care number to our clinic. Enrolling with CVFP does not change your access to specialists or to any other health services available in Calgary. The Crowfoot practice has a close partnership with the Calgary Health Region, and many regional services are provided at CVFP.

Under this model, we ask that you call us first before seeking medical attention or advice outside of CVFP. We have a registered nurse and doctor available after hours to provide access to services. In case of a medical emergency, patients should call 911 or proceed to the nearest emergency department.

We are also pleased to be a part of the Calgary Foothills Primary Care Network, which is a joint initiative in primary care reform with Alberta Health and Wellness, and the Calgary Health Region. As the various components of the network proceed, we will educate our patients on the benefits they will receive.


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Who takes the best blood pressure reading?If you are over 40 and have come into CVFP for an

appointment in the past several years, chances are the nurse has taken your blood pressure. Most of the time people are reassured by the results. Sometimes it triggers a response that the doctor should re-check the pressure. You may even have been hooked up to an automated blood pressure measurement device that takes several blood pressure readings with no health care professional in the room. Often, patients are asked to get their blood pressure checked at the pharmacy, any fire hall or encouraged to purchase a blood pressure machine to check their pressures at home. Occasionally, your physician may order a 24-hour BP monitor through the hypertension clinic at the Foothills Hospital. This provides a 24-hour snapshot of a patients blood pressure throughout the day and night.

But which measurement is most accurate?

High blood pressure, or hypertension, is a major risk factor for heart attack and stroke. It can cause kidney disease and is often associated with other diseases and conditions like diabetes, high cholesterol and smoking.

Hypertension is very common and the incidence increases with age. The good news is that we have many effective and well-tolerated treatments for high blood pressure. Lifestyle

modification is the important first step – a heart healthy diet, weight loss, regular physical activity and smoking cessation. However, most patients with hypertension will require medical therapy to control blood pressure.

Accurate blood pressure assessment is the key to proper diagnosis and monitoring.

What have we learned about blood pressure assessment and how is CVFP responding?

1. Blood pressure measurements that are the most reliable indicators of health risk are those done outside the doctor’s office. Proper home blood pressure monitoring on an approved automated cuff is more accurate assessment of blood pressure than the casual readings done by a physician or nurse in the doctors office.

CVFP now recommends patients take blood pressure readings at home and bring in a diary with multiple readings to more accurately assess blood pressure.

2. Blood pressure taken by a trained professional in a standardized fashion outside of the physician’s office is also an excellent way to assess blood pressure. The Calgary Firefighters have a world-class blood pressure screening program for the public. Trained firefighters will take blood pressure in community fire halls and record the results for patients. This is a free service provided to the public on a drop in basis seven days a week, from 1300 hrs to 2100 hrs – providing they aren’t out fighting fires!

Acceptable blood pressure for most people - < 140/90

Acceptable blood pressure for people with diabetes - < 130/80

Continued on page 14


MEET THE STAFF

Did you know we have appointments available every day for urgent problems?


In my years of practice, there is a continuing theme from a number of patients. That is “I thought it would just get better”, Many people arrive at a local physiotherapist stating this, even

after months of pain and limited activity. My goal in this article, therefore, is to give you some insight regarding the natural course of healing, and what you can do to speed it up, and slow it down.For those of you with acute injuries, tissues should heal in about 6-8 weeks. If it is simply an irritation or mild sprain/strain, 2-4 weeks may be sufficient. And even if it takes 6-8 weeks, you should no-tice some improvements within 1-2 weeks. Improvement is noted, be it less pain, increased range of motion, decreased swelling, or improved strength. If you are not experiencing an improvement, a number of factors may be contributing:

A. Doing nothing - this is probably the number one factor for prolonged recovery, and prolonged pain. You are doing NOTHING. The first thing to do when recovering from an injury is being pro-active with it. Do not let it control you or your life. Seek help from any variety of sources. A physical therapist is skilled with musculoskeletal injuries. These may vary from a wrist sprain to rotator cuff problems. Your physician can aid the recovery with appropriate pharmacological intervention. The most important part in the initial recovery is MICE; that is gentle Movement, Ice, Compression (wrap the injured area) and Elevation (if swelling visible).

B. The acute phase of the injury will last 4-10 days, and then im-mediate treatment is indicated. Once out of the acute phase, there are a number effectors that contribute to your healing/lack there of. These include:

1. Wrong exercises - the exercises provided may be doing some harm. If you are experiencing any pain with a particular exercise, you should make your treating professional aware of it. They won’t change it if they don’t know. Also, the exercise may be too advanced for the affected area.

2. Poor technique - always a factor. Every exercise should be done as taught. Even minor adjustments in technique could be a factor. I remember Tony Little (pretty hyper guy) yell-ing, “It’s Technique”... and even though it drove me nuts, he is right. Talk to your Physio if unsure on how to perform an exercise.

3. Not enough of the exercises - especially with back pain sufferers. Some exercises for pain control need to be done frequently throughout the day (even every hour sometimes). Discuss with your therapist how often things need to be done, and do them.

4. Still doing something which is aggravating the problem - didn’t think this should be a problem, but it is. Patients often try to push through an activity, even though it hurts. You know, the No Pain, No Gain thing. Sometimes this theory applies, but certainly not for acute injuries.

5. Missing an area - often overlooked are joints above and below the problem. Also, neck should be reviewed with arm pain, and low back should be reviewed with leg pain. Hip structures when tight or weak can affect the knee and ankle. Same goes for the upper extremity. Neck and back problems often refer symptoms to the arms and legs. I have seen many people for what they thought was tennis elbow, but was in fact a disc problem in the neck.

6. Wrong diagnosis - as with the tennis elbow problems, people have come to me after attending treatments for tennis elbow - complete with ultrasound, frictions, and other modalities, with minimal success. Once the proper diagnosis was reached (i.e. Neck), the pain was reduced within a short period of time.

7. Non-mechanical pain - this is a big one. Stuff like cancer, mul-tiple sclerosis, and diabetes are in here, and can be picked up with a few tests. Other things like STRESS are often overlooked. Stress seriously impedes recovery, and should not be over-looked. If stress is present, try to get rid of it. You will be amazed how quickly progress can be made.

The bottom line with any form of treatment is that you should have lasting results. Not just temporary and you should notice improvements over time. If not, discuss it with your treating physi-cian, physical therapist, chiropractor, or other treating profes-sional If nothing is happening with your recovery, do something about it. Also, the pain relief should be lasting, and injuries should be preventable.

The bottom line, when recovering from an injury, is that you should be noticing improvements regularly. If not, talk to your health care provider, get a test done, change treatment proto-cols, look elsewhere in the body, or see someone new. Some-times a new set of eyes can make a difference. And most impor-tantly, take charge and prevent this from happening again.

Tim KutashPhysical Therapist CROWFOOT PHYSIOTHERAPY and MASSAGE

REVOVERING FROM AN INJURY

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ROLE OF THE DIABETES TEAMThe Diabetes team consists of a Registered Nurse from the Diabetes, Hypertension and Cholesterol Centre

and a Registered Dietician from the Living Well with a Chronic Condition Program. This team of educators supports and collaborates with the CVFP (Crowfoot Village Family Practice) physicians, by assessing and reviewing treatment plans and assisting with ongoing follow up for patients with diabetes. Together with patients, we review lifestyle factors and set goals to promote healthy self-care targeting exercise and healthy food choices. An assessment may involve discussion of risk factors and baseline checkups of your eyes, kidneys, and circulation, and a review of your diabetes, cholesterol, and blood pressure medications and lab values.

The dietician also takes referrals from the physicians for other conditions requiring special diets (e.g.) Crohn’s Disease, Colitis. People with weight management issues may be referred to other Calgary Health Region programs.

The team offers a Diabetes Basics class monthly at CVFP or weekly at the Crowfoot YMCA. People may self refer themselves to these classes by calling 9-Health (943-2584)

Diabetes – the new epidemic?You have probably heard about it in the media and we are

seeing it at CVFP – the incidence of Type 2 Diabetes is on the rise. Every week, two or three patients are newly diag-

nosed with diabetes or “pre-diabetes”. This article will provide some answers to common questions.

What is diabetes mellitus (DM)?Diabetes is a condition where patients have elevated levels of blood sugar. A person without diabetes would have fasting blood sugar levels below 6.0 mmole/L. Fasting blood sugar levels above 7.0, on two separate occasions, make the diagnosis of diabetes. If fasting blood sugar levels are between 6 and 7, we label the condition ‘pre-diabetes’.

Is there more than one kind of diabetes?Yes. The majority of our patients with diabetes have Type 2 DM. This is also known as “adult onset” or “non insulin dependent” diabetes. This is caused by a combination of the pancreas pro-ducing insufficient insulin and the cells in the body not respond-ing to the level of insulin present to allow sugar into the cells. Type 1 DM (also known as juvenile diabetes or insulin dependent diabetes) commonly starts in childhood or early adulthood. It is a different disease in that the pancreas stops producing insulin. Patients with Type 1 DM take insulin for life. Those with Type 2 DM are treated with lifestyle changes (diet and exercise), and often with medications.

Why is diabetes an important disease?Patients who have diabetes are considered high risk for heart attack and stroke. Most patients with DM will also have other risk factors – high blood pressure, high cholesterol and obesity. There is also a greater incidence of kidney disease, infections, eye problems and some cancers in patients with DM.

Is pre-diabetes important?Yes. Pre-diabetes has some of the same risks as DM. Most impor-tantly, those with pre-diabetes will proceed to DM unless specific action is taken. Patients with pre-DM are advised to modify diet and exercise to reduce their blood sugars and minimize their risk of developing DM. Weight loss is almost always recommended. As well, because of the increase in risk for heart disease, specific medication is often suggested. These may include daily aspirin, medications to protect the blood vessel lining and reduce blood pressure, or medications to reduce cholesterol.

Is there a link between obesity and diabetes?Almost inevitably patients with Type 2 DM are overweight. In those with pre-diabetes, weight loss is an important intervention in helping prevent progression to DM. Even a modest weight loss of 5 to 10% of body weight results in dramatic improvement in health.

How do I know if I have DM?The classical symptoms of diabetes are thirst, blurred vision, increased frequency of urination and fatigue. Most patients we diagnose with DM have no or minimal symptoms. We screen for DM by measuring blood sugar during our routine health assess-ments. You should have your blood sugar assessed by the time you are 40, or sooner if you have a family history of DM, have high blood pressure, are overweight or have any symptoms of DM. You should be checked for diabetes every two or three years – more frequently if you have risk factors.

What does CVFP do when patients are diagnosed with dia-betes?After the diagnosis of DM is confirmed, we will place patients on a list of patients who have diabetes. Our Chronic Disease Coor-dinator (Nurse Janice) will contact the patient and start diabetes education. Patients with DM will be invited to attend special classes that teach the basics of diet, self-assessment of blood sugar, exercise and general disease education. Some patients with DM will also see our diabetes team – Nurse Margaret, and Dieticians Shannon and Salimah.Our goal is to ensure that our patients with diabetes get first-rate disease education, monitoring and treatment.

Why can’t I just see my doctor if I have DM? Don’t they know it all?The best care for patients with diabetes is through a multi-disci-plinary team that works together to provide you with the best information and monitoring. Each team member has unique expertise to provide optimum care. While your physician un-derstands the disease process and overall health implications of DM, we are not experts in giving specific diet recommendations, teaching home blood sugar monitoring and so on.

If I have DM or pre-DM, why do I have to take so many medi-cations?Because patients with diabetes are at risk for so many other diseases, current guidelines suggest aggressive preventative treatments. Lifestyle intervention – healthy eating, maintaining a good body weight and regular physical activity, remain the foundation of treatment. However, most patients with DM should be on a minimum of 4 medications – Aspirin (usually 81 mg of ASA), a medication to reduce blood sugars and improve the ability of insulin to work on the cells (usually metformin, Actos or Avandia), an ACE – inhibitor or ARB class of medications (these lower blood pressure, protect the kidney and heart). Finally, a class of drugs known as “statins”, lower cholesterol and dramati-cally improve the health of blood vessels. We know from major trials that the use of statins reduces heart attack risk by 25% and stroke risk by 30% even in patients with DM who have “normal” or “low” cholesterol.

Marg

Continued on page 14


The role of the public health nurse at Crowfoot Village Family Practice

(CVFP) is to assist families with children under 6 years of age in accepting responsibility for their own health, and to contribute to improving overall health of the public by providing public health nursing services which include:

1. Health assessment, consultation and teaching appropriate to all developmental phases throughout the lifespan.

2. Delivery of preventative and promotive

Public Health Nurse measures including vaccination, screening, referral, follow-up, education and client advocacy.

3. Fostering appropriate use of the health care system on behalf of clients; facilitating cooperation and coordination among the many health and social service agencies in the Calgary region.

As public health nurses, we will be available for appointments on Wednesdays and Thursdays through CVFP. You are also welcome to contact us (at the following number) at the Northwest Heath Centre with any further questions or concerns.

Telephone: 943-9700

UNINSURED SERVICES Our clinic aims to provide all primary care for our patients. Some services we provide are uninsured. That means the cost of these services is not covered by Alberta Health and Wellness.

The following list outlines the charges for uninsured services that are commonly provided at the practice. The fees are established by the Alberta Medical Association* and are subject to change according to these same guidelines.

UNINSURED SERVICES GUIDE

PRESCRIPTION REFILLS BY PHONE, FAX OR EMAIL: • Single refill ............................................. $25.00• Single patient per year ........................ $50.00• Family per year ................................... $100.00

FORMS: • Cataract/dental surgery requests for

medical Information for uninsured procedures ........................................... $30.00

• Disabled parking .................................. $25.00• Extensive forms –

eg. long term disability ........................ $60.00• Less extensive forms ............................. $40.00• Simple forms -

e.g. EI, pregnancy, tax credit ............. $40.00• Insurance APS (Attending Physician Statement)

for insurance application .................. $190.00• All third party medicals and form

(includes drivers) .................................. $90.00 Form only: .............................................. $40.00• Motor vehicle accident forms ............ $50.00• Seniors residence ................................. $35.00• Sick/absence confirmation note ....... $20.00• Massage, physiotherapy, orthotics,

chiropractic .......................................... $15.00

INJECTIONS (Travel Clinic Not Included): • Per injection .......................................... $20.00

OTHER: • Warts/seb. keratosis - flat fee 1 – 5 ..... $20.00 flat fee for over 5 .................................. $25.00• Cysts/mole – fee for 1st ....................... $75.00 fee for each additional ....................... $25.00• Skin tags – fee for 1st ........................... $50.00 fee for each additional ....................... $10.00• Circumcision ....................................... $150.00

NON-INSURED PATIENTS: • Regular visit ........................................... $35.00• Physical ................................................. $60.00• Out-of-country visit .............................. $80.00• Out-of-country physical .................... $100.00

(revised October 2005)*Website: www.albertadoctors.org Phone: 1-800-272-9680


DIZZINESS & BALANCE PROBLEMSOur ears are for more than just hearing. We have a mechanism in our inner ears called the vestibular apparatus, which tells our brain about head motion and head position with respect to gravity.

What can cause problems?Inner ear function can change due to factors such as trauma (motor vehicle accidents, blows to the head), infections, mechanical problems in the apparatus, and aging. Resulting symptoms can include dizziness, vertigo or “room-spinning”, unsteadiness, blurry vision, sensitivity to motion, nausea and vomiting, and poor concentration. If it persists, one can experience secondary problems like inactivity, isolation, anxiety and depression.

What can be done to help?Vestibular Rehabilitation is a highly effective, research-based branch of Physiotherapy, only available at select clinics. After a thorough one-hour assessment, specific techniques are taught to help the brain adapt to an inner ear problem, or maneuvers are performed to correct mechanical dysfunctions in the vestibular apparatus. For more information, talk to your Doctor, go to the Dizziness & Balance Services at www.lifemark.ca, or call Spring Hill Sport Physiotherapy at 288-8877.


LUNG HEALTH CLINIC

Margot Underwood, Asthma RN

Asthma, COPD and Smoking Cessation Clinic

Once a month the Calgary COPD & Asthma Clinic provides an educator at the Crowfoot Village Family Practice office. A certified asthma and COPD educator, Marg Underwood, is available to provide breathing tests (spirometry) and discuss questions about asthma, COPD and smoking cessation. Information regarding trigger avoidance, role of medications, proper use of inhalers, monitoring and self-management are all covered. Handouts, links to websites and local resources is also provided. Sessions are offered one on one, booked for 1 hour and family members are welcome to attend.

This education is one of the Calgary Health Region programs offered at community sites.

Did you know that not all health services are covered by Alberta Health Care?

Chronic Disease Team

Community Care Coordinators are Home Care health professionals who will assess your health care needs and link you to community services and

resources. They arrange for and provide Home Care Services and will work with you, your doctor and other health care professionals to achieve your health care goals.

Home Care is a health care service for people living at home, seniors’ apartments, lodges, assisted living environments and personal care homes. Home Care is also delivered at community clinics and schools. The goal of Home Care is to help people restore their independence and prevent further disability.

Anyone can make a referral to Home Care by calling Community Care Access at (403) 943-1920.

As part of the Home Care Program, Janice and Laura also see people at the Chronic Disease Management Clinic here at your family doctor’s office.Building on the established Home Care and physician partnership model within the Calgary Health Region, the current role of the Community Care Coordinators (CCC) has been expanded to include selected chronic conditions (Diabetes, Hypertension, Dyslipidemia) of all patients cared for by family doctors.

Each physician has a Community Care Coordinator (RN) who works with them to monitor the health of patients with chronic conditions. The CCC has the ability to link to specialty services such as the diabetes hypertension and cholesterol nurse, dietitians, the Living Well program and the pain clinic. Patients’ details are stored in an electronic information system that reminds the CCCs when a patient is due to have assessments and laboratory work done. This provides:• proactive planned care with an interdisciplinary team.• informed, empowered patients.• coordinated care such as annual laboratory work, necessary annual

assessments and ongoing monitoring by phone or mail.• quick links to community programs to help patients monitor and control

their health.

Janice Couperwhite R.N. Laura Brule R.NCommunity Care Coordinator Community Care CoordinatorHome Care Program Home Care ProgramCalgary Health Region Calgary Health Region


The CVFP Travel Clinic

Ann, Travel Clinic Nurse

Travel medicine is considered by Alberta Health and Wellness

to be an uninsured service. We are able to advise patients on common travel vaccines and malaria prophylaxis. We need to know where you are going, what types of activities you will be participating in and how long you plan to be away. As we are not fully certified travel medicine specialists there will be patients who need to be seen by the Odyssey or Bowmont Travel Clinics in Calgary.

We have established the following travel medicine fees:

Travel medicine visit (inc. prescriptions) $30 (family maximum $100) Non-CVFP patients travel visit $60 Travel vaccines (inc. vaccine):Hepatitis A $65 Junior (<18 years) $45 Hepatitis B $40 Junior (<18 years) $30 Combined Hepatitis A and B $65 Junior (<18 years) $45 Flu shot (private) $15 Typhoid fever $45

CERVICAL CANCER VACCINE

A new vaccine has recently become available for women

between the ages of 9 and 26. It protects women against the Human Papilloma Virus (HPV) – the virus responsible for most cases of cervical cancer. The physicians at CVFP recommend this as an excellent preventative health option. Additional information on the HPV vaccine is available at www.hpvinfo.ca.

As a convenience to patients, we are providing vaccine to immunize young women. This is an uninsured service and the cost will be $500 for all 3 doses (given at 0, 2 months and 6 months). Many private insurance companies will reimburse the cost of this service.


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Prescription Renewal Policy

CVFP is now encouraging patients who have elevated readings in the office or who have been initiated on treatment for hypertension to have their blood pressure assessed at the local fire hall.

3. Most people with high blood pressure don’t know they have it!

Despite improvements in blood pressure treatment, most people with high blood pressure either don’t know they have hypertension or have their hypertension inadequately controlled.

The nurses and physicians at CVFP will continue to screen patients at risk for hypertension when they come into the clinic – even for unrelated visits.

4. Acceptable blood pressure results are lower than once

Continued from page 6 - Blood Pressure

thought. In the ‘old days’ we used to thing that the top blood pressure number (or systolic pressure) was naturally elevated as we age. We now know that patients with elevated systolic blood pressure are at particularly high risk for heart disease and stroke. What are blood pressure targets?

The CVFP team is encouraging all patients to ‘know their blood pressure reading’, ‘know their target blood pressure’ and ‘get to target’!

For more information on high blood pressure, how you can prevent hypertension and what home blood pressure monitors are recommended, visit the website of the Canadian Hypertension Education Program – www.hypertension.ca

Next issue – ‘What we have learned about treating high blood pressure’

Continued from page 9 - Diabetes

Since everyone is unique, it is important to discuss treatment with your physician or diabetes team member. It is often difficult for people with a new diagnosis of diabetes to be suddenly put on 4 medications – so often these will be introduced over time.

What monitoring is necessary for people with DM?The diabetes team will outline what monitoring should be done for each patient with DM. Most will be instructed on how to check their blood sugars at home. As well, regular lab work

checking long term blood sugar levels (Hemoglobin A1c), cholesterol levels, and kidney function will be performed. If you have DM you should have your eyes examined by your eye doc-tor yearly to check for complications of DM.

The diagnosis of diabetes or pre-diabetes can be difficult for some people. However, as one of our patients said – “What’s so bad about it? I have to start eating better, lose weight and exercise more regularly. I have to check my blood pressure and blood sugar more often and see the doctor and diabetes girls regularly. The medications aren’t much fun but the goal is for me to live long and be healthy. It’s all good!”

Currently, we receive a very large number of refill requests by fax or phone monthly. We are happy to provide this service,

but cannot do so without recovering the cost.The option of an annual fee to cover the cost of this service is available, or payment can be made at the time the service is requested. If you have any concerns or questions, please discuss these with your doctor or a staff member.

Questions and AnswersIf I pay the annual fee, is there any limit to the number of times I can use the service?No, the annual fee covers all prescription refills from November 1 to October 31. If I provide my credit card number, will it be secure?Yes. Your credit card number will be stored confidentially with our

business manager and used only when the service is required. What if I am not sure I need to use the service?You can provide your credit card number for payment when you need to use the service. However, if you use the service more than twice a year, the annual fee option will be less expensive. I thought this service was covered under the new system. Why the change?The convenience of prescription refills by phone or fax has always been an uninsured service and is not included in our capitation rate.

If you wish to subscribe to the phone prescription service, you can complete the prescription refills form available at www.cvfp.com or at the office.


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Crowfoot Village Family Practice - Paragon Publishingparagonpublish.com/pdfs/cvfp.pdf · and innovative group that uses a comprehensive care model to deliver primary health care in