• Mutual Respect & Honesty

---

A healthy patient-physician relationship is predicated on respectful behaviour and communication. This extends to all medical learners, members of the collaborative care team, and office staff. Office staff execute their duties according to the policies in which they were instructed. Any form of abuse and belligerent behavior from patients and/or their family and friends will not be tolerated and a single incident may result in termination of the patient-physician relationship and all further access to the office.

Honesty is crucial to establishing an accurate diagnosis and management plan. A physician has just grounds to terminate the relationship in the event of patient dishonesty.

• Invalid BC Services Cards

---

It is the patient’s responsibility to ensure that their health care coverage is active. In the event that patients do not hold active health care cards or other health insurance coverage, charges incurred for medical services are the direct responsibility of the patient. These charges must be paid in full prior to the next scheduled appointment.

• Missed Appointments

---

We reserve the right to charge a fee for missed appointments. These fees are commensurate to the fees that would be charged to the Alberta Health Care based on the nature of the appointment missed. Circumstances can and will happen and in most cases a warning is provided on the first missed appointment. Repeatedly missing appointments may result in termination of services.

• Appointment Cancellation

---

We ask that patients provide sufficient notice when cancelling appointments. As a courtesy to other patients, please provide at least 24 hour notice prior to cancellation as this allows us to accommodate patients with acute issues. This holds particularly true for longer comprehensive medical examinations and procedural appointments. Cancellations within an hour of the scheduled appointment time will be recorded as a missed appointment.

• Email Communication

---

Standard email services are generally not encrypted and therefore email communication is not sanctioned by the College of Physicians and Surgeons of British Columbia.

• Office Facsimile

---

Specific expressed permission to fax information to the office must be obtained prior to send information by facsimile. Sending faxes to the office places a significant burden on our office fax machine, as the office cares for an estimated 8000 patients collectively.

• Physician Documentation

---

A physician must document important details pertaining to a visit. Asking a physician to withhold information from the chart is not allowable. If you do not wish to have specifics charted, please do not share these with the physician.

• Double Doctoring

---

Seeing two family physicians for routine care in parallel is discouraged and can compromise care. This also applies to prescribing pharmacists or nurse practitioners who independently manage a patient’s conditions long-term. Double doctoring may result in termination of services to the office, as it can compromise safe practice. This does not apply to physician associates that work in conjunction within the office at womenMD.

• Telephone Prescription Refills

---

Telephone prescription refill requests will not be honoured. Special consideration may be given for those living in long-term care facilities at the discretion of the attending physician. Prescription duration and refill quantity will generally reflect the maximum allowable as warranted by the clinical situation. If a short-term prescription is provided, it is for compelling medical reasons. If you believe a prescription is written in error, please promptly notify the office (in person or by telephone) for clarification.

Having a pharmacist dispense a short-term prescription to cover you until your appointment is encouraged and acceptable. Using your pharmacist as a primary care provider and obtaining long-term prescription refills is strongly discouraged. While it is tempting and convenient to accept long-term prescriptions (>1 month) from a pharmacist, we ask that you please see your physician only for such prescription refills. Physicians often evaluate when you are due for a refill as they may wish to discuss a matter of importance and long-term pharmacist refills disrupt this schedule.

• Opioids

---

For patients who require triplicate prescriptions, please note that these can only be provided for short-term intervals for public safety reasons. Our physician associates adhere to a strict “one-strike” policy. If prescription opioid abuse is suspected or confirmed, this may result in termination of all future access to services provided by the clinic. In certain cases, a physician may request that a patient sign an ‘opioid contract’. Violation of this contract will result in termination of the patient-physician relationship.

• Confidentiality

---

All patients have the right to confidentiality. Family member’s requesting information on a patient’s file is strictly prohibited without the expressed verbal or written consent of that individual. Adolescent minors have the right to privacy for clinical visits. As such, parents accompanying minors may be asked to leave the examination room for the clinical visit, or a portion thereof. We are unable to release information to a third party (law offices, insurance companies), without signed authorization from a patient or their guardian.

• Insurance Company Disclosure

---

By law, physicians are obligated to disclose all health-information requested by the insurance company if signed consent is provided by the patient. Providing selective information is prohibited. Infrequently, some patients make specific requests to not have their medical issue documented in order to remain compliant with insurance company policy. This is also prohibited and infringes upon the legal interests and medical obligations of the physician. Requesting that a prescription be filled under an alternate individual who holds extended medical insurance is also strictly prohibited.

• Switching Physicians

---

Switching from one physician to another within womenMD is prohibited.

• Dropping Off Medical Information

---

We kindly ask that you do not drop-off medical information for physicians to review without a face-to-face meeting with a physician, unless specifically requested by the physician. This generally creates confusion in the office as to the purpose of the information and what it was intended for.

• Chaperones

---

It is our policy to have a chaperone present for examinations of a sensitive nature, though patients may decline a chaperone if this is their preference.

• Information Disclosure

---

In some cultures, intentionally withholding medical information from the patient is the norm, particularly in the setting of a terminal illness. The diagnosis and prognosis are divulged to the family, and the patient is thought to be protected from the ‘burden of diagnosis’. While this philosophy is acceptable abroad, this practice is considered unethical in the Canadian medical setting.

• Number of Concerns Per Visit

---

Quite frequently, patients have a tendency or desire to present numerous clinical issues/concerns in a single visit. These additional concerns inevitably lead to scheduling delays. Coupled with the unforeseen delays that are an unavoidable part of regular medical care, this can create an unpleasant wait-time. It is important that patients present only a single MAJOR issue at each visit. This is to ensure that we can provide focused and accurate medical care while making every attempt to stay on time. Presenting several MAJOR issues in a single visit leads to fragmented care that can potentially lead to medical and administrative errors. If you are concerned about many medical issues, we are happy to address them over a series of visits. Take into consideration this analogy; one does not typically see a dentist for a routine check-up, dental cleaning, a root canal, a wisdom tooth extraction, and a referral to an orthodontist in a single visit.

Examples of major issues would include but are not limited to: assessments for chest pain, abdominal pain, headache, depression, referral requests to a specialist, motor vehicle collisions, comprehensive medical examinations (annual physicals), and office procedures. If uncertain, the staff will guide you accordingly.

To appropriately address a MAJOR medical concern, a physician must take a focused history and perform a physical examination. Factor in chart reminders, charting time, chart and lab review, and drafting referral letters, a single complaint may require upwards of 20-30 minutes. Care extends well beyond the time the patient leaves the clinical exam room. On any given day, a physician quite easily spends 2-3 hours completing charts an additional paperwork.

We are sometimes able to accommodate a couple of small requests in a single visit, but please be reasonable with your requests. Please realize that even seemingly trivial requests can generate considerable paper work after hours and this can be overwhelming.

An end-of-visit question often prompts an end-of visit response. These responses are typically brief, uninformative, and offer minimal benefit to the patient. Good medicine isn’t fast, and fast medicine isn’t good. Simple questions are often not simple. End-of-visit referral request require obtaining a sufficient history, chart review, letter preparation, and arranging appropriate work-up. This is a requirement by medical consultants. A single request adds 15 minutes to physician charting time. When many patients make this type of request, this demands hours.

Some patients will request a much longer appointment time in order to provide sufficient time for their multiple complaints. Unfortunately, the health care system is not structured in a way that enables multiple concerns without compromising the financial feasibility of the office and practicing physician. This additionally compromises access for the fellow patient.

It is strongly discouraged to call the office requesting medical advice. If you have a concern, please book an appointment. These phone calls frequently go unaddressed due to time constraints.