Dr. Laura Foster
103-2200 Fairview St
Burlington, On L7R 4H9
Message from Dr. Laura
It has been almost three months since we have been back to our “pre-covid” office procedures and we are reaching out to give you an update and some reminders.
Missed appointments: We have had a surprising number of missed appointments over the last couple months, including those that are booked for extra time due to the nature of the medical issue (pap smears, counselling, male exams, etc). As you can imagine, the office is EXTREMELY busy as we attempt to return to full in-person visits and deal with a variety of your medical issues that have arisen over the last 2.5 years of the pandemic. We appreciate your compliance and efficiency with prioritizing only one important issue to deal with at each appointment time, it becomes problematic and unconscionable when individuals miss their appointments!! Those appointment slots could have been used for another patient’s needs and merely adds to the backlog of more appointments that will need to be rebooked in the future. Please be advised that patients who miss appointments without 24hr warning will be billed $75 according to the OMA guidelines. Please note that EMAIL is an unacceptable mode of cancelling appointments. You must call the office and speak to Mary or Kim.
2. Office email was discontinued 18 months ago because of medico-legal concerns yet we are still receiving from patients email requests for appointment bookings or medical advice. Email is only used for information that WE request (such as for pictures of a skin rash) and it is NOT checked on a regular basis, nor is it ever used to deliver medical advice. Email usage is also restricted to patients who are enrolled in the block fee program.(please see our website or ask in office about the block fee program)
3. Phone call medicine has proven to be a substandard way to practice medicine and just has not worked safely for physicians or patients. Our office is fully open for in-person appointments just it was pre-covid, so please call and book an appointment to have your medical issues dealt with.
4. Same day appointments and Booked appointments: Our new office hours are posted in the office and online at our website www.drfosterfamilyphysician.ca. Same day appointments are BOOKED ON THAT DAY to allow for rapid access for urgent medical issues. Please remember these are not walk in appointments. We have same day appointments three days per week, so our goal is to see you within 24-48hrs. Booked appointments (those done in advance) are reserved for very specific medical problems such as pap smears, diabetic checks, male exams, MTO physicals, counselling, etc. After your appointment, I will tell you when to return for follow up but that means you call the office THAT WEEK to be seen (i.e., in 4 weeks) for a same day appointment.
5. Phone Appointments: During the covid pandemic, phone visits were acceptable given the risks to patients and staff. They were a temporary measure and could never replace what is garnered by the physician during an in-person visit. Some individuals have not been seen by a physician in over 2.5 years. We are fully open and are deferring phone appointments currently in order to facilitate an in-person assessment. We are mandating masking in our office (So please COME WITH YOUR MASK) and are continuing with heightened disinfection protocols.
6. Walk in Clinics: As a reminder to all patients: the government considers rostering to be a two-way street between physician and patient. We contract to look after your medical needs, and you contract to obtain all your medical needs through our office. Every single time a patient attends a walk-in clinic or family physician not affiliated with our group of physicians, I am “negated “and penalized so I PAY FOR ALL THOSE MEDICAL SERVICES out of my own pocket. We have reinstated our same day appointments to allow you to rapidly access your OWN physician (who knows your medical problems, medical history, family history, medications, allergies/etc. Please call our office prior to attending any walk-in clinic. Repeat offenders will jeopardize their position on our roster.
7. Fax Prescription renewals: Our fax prescription renewal fee was reinstated on October 1, 2022. This policy was in place long before the pandemic in the times of my father. Given our inability to see patients in person for prescription renewals during the pandemic, we courteously waived this fee and waived the block fee. Prescription renewals are done on my own personal time after office hours and at night and are not as simple as quick 2 second “click and send”. Medico-legally prior to refilling medications without seeing you in person, a multitude of time-consuming different factors must be checked: updated bloodwork, blood pressures, weights, periodic screening tests, pap smears, colonoscopies etc. If you wish to use fax prescription renewals, your best option is to participate in the block fee program (which would also cover sick notes and forms/ etc). If you do not wish to pay the block fee, you will be charged $30 PER FAX. Alternatively, we can see you in-person in the office for fax renewals, at which time a longer duration of medications can be prescribed (ie 6mo – 1 year). Please ensure your pharmacy is faxing ONE request only as multiple faxes not only add to your costs (if you are requesting three refills and your pharmacy sends one medication per faxed page, you will be billed $90 (3x$30/fax) but also add to the paperwork backlog and add to Mary and Kim’s administrative duties. PLEASE bring a list of your medications and medication containers to those appointments to ensure we correctly renew all your medications at that time. With the arrival of over 40 fax renewals per day, a 24-48hr turn-around for approval is impossible! It is your responsibility to ensure that you are contacting our office well in advance of running out of medication. Do not ask for a renewal the day your meds run out!
8. Counselling: The pandemic has taken a toll on everyone’s mental health, and we have noticed a drastic increase in the number of patients requesting counselling appointments. While we prioritize accommodating all patient’s problems, the reality is counselling has a very long wait-time. Counselling is an intensive commitment, and I can only allocate so many counselling appointments per day and per week. Patients should explore work EAP (employee assistance programs) for benefit coverage of counselling services prior to an appointment with me. All mental health issues require counselling and my expertise in psychiatric medication prescription may not be required. There are many well trained counsellors in Burlington with whom you can establish a productive long-term relationship. There are other mental health resources available on our website.
9.Harassment: It is unfortunate that this topic must be addressed. I understand that the pandemic has changed the landscape of many people’s lives adding immensely to individual stresses, but over the last year, our office has been subject to an unbelievable number of patient interactions that can be described not as rudeness rather harassment and intimidation! both in person and over the phone. It is completely unacceptable and will NOT be tolerated. If you treat Kim and Mary with disrespect, you are disrespecting me, and I have a ZERO TOLERANCE policy. Any unacceptable behaviour by patients may result in their dismissal from the practice.
I appreciate your understanding and cooperation with these important issues as we transition back to the pre-covid office times. BACK TO NORMAL TIMES!! I look forward an old fashioned in-person appointment with you, as there are so many patients with whom I have only spoken to on the phone since I took over from my father some 18 months ago.
P.S. The original Dr. Foster is doing very well. He is enjoying a well-deserved change of pace in retirement. While he does still assist Dr. Pyper in the OR with orthopedic surgery and knee and hip replacements, his most important job is grandbabysitting my 8month old on his days off J. He is looking forward to getting back onto the slopes this winter (yes, his neck is OK!), albeit maybe skiing a little more cautiously than he used to.
The office will be returning to a more pre-Covid working environment this September.
Many of you patients have not been seen in the office for the last 2.5 years and we do not know if you still wish to continue as patients of the practice. We are carrying you “on the books” as it were, but we do not know if you are getting your primary care elsewhere; for instance, another family physician or from Walk In Clinics.
So that we get a clearer idea as to who wants to maintain their spot in the practice, we are asking you to officially roster with Dr.Laura. Rostering in the practice will close soon in 2022.Only rostered patients will be allowed to have pharmacy faxed prescription renewals. All non rostered patients must be seen in office for prescription renewals and will not have any email access to the practice.
For those patients who already are attending another medical clinic, please let us know where to send your medical records.
Over 10 years ago all patients were required to officially REGISTER or ROSTER with my father's practice
at which time my father committed to function as your family physician and you committed to have your medical care be performed at his office. This was a win-win situation as my father as your family physician was paid to look after all your medical needs for a year and you received comprehensive continuing care for your whole family from births to deaths. Non appropriate and Episodic medical care through Walkin clinics and the Emergency department was to be discouraged via a program of negation. (Described elsewhere but essentially if you don't receive medical care through our office then we pay for the medical service that the other the physicians bill to OHIP). Now some 158months after
my father's retirement in June 2021 the Ministry of health requires you to sign a NEW PATIENT
DECLARATION at which time you commit to remain a member of the practice.
We recommend that you reroster ASAP in order to maintain your place in the practice.
The Office in New Normal of Post Covid
Office phones are being answered by Kim and Mary every day from 930-12 noon and from 1 until 3 pm. They will ask about your vaccine status and screen your call. As you have read recently i the news, with our return to office appointments there will be much less access to telephone appointments. While many patients found Covid phone calls and emails convenient and time saving, most physicians are glad to see the end of them as they were medically, legally and privacy compromised. Both patients and the medical profession compromised to get the job done over these past 30months when patients could not come to the office for non emergency problems. Despite ramping up the number of office appointments per day, ongoing office inefficiencies and the backlog of patients who have not been seen in 30months requires us to impose A ONE PRIORITY PROBLEM PER VISIT policy.
REMEMBER PLEASE CALL THE PHARMACY NOT OUR OFFICE The office is reinstituting the $30 prescription refill on October 1,2022. Please follow the rules. Call pharmacy one week before running out of meds and remember to call the Pharmacy first NOT the office as the pharmacies must fax us the refill request in order to maintain a paper trail in your EMR chart.
Every day a new patient contacts the office with mental Health problems.
Coping skills are important. Do not self medicate with alcohol or drugs.
In Alberta more people have died of OPIOD overdose than of Covid.
Stay physically active and hopefully outside
Practice relaxation techniques with Yoga, tai Chi, meditation or prayer
Psychology skills of trying to be positive, find the silver lining of the dark cloud and not ruminating indark thoughts are important. Self helpbooks emphasizing CBT are available.
End of Life Care
103-2200 Fairview St, Burlington, Ontario L7R 4H9, Canada
Not wishing to be morbid but more practical in discussing a topic neglected by both doctors and their patients. The majority of deaths to Covid have happened to Care Home institutionalized seniors. All of these patients would have had End of Life plans to include directives such as: No transfer to hospital, No assisted Ventilation. No Feeding tubes. No CPR(chest compressions). Many of these interventions cause pain and suffering and simply are not effective in really sick patients. The death rate of a Covid patient on a ventilator is 80-100%!!
At this time of the Grim Covid Reaper I would suggest that every patient develop their own personal End of Life Plan discussing each of these directives with family members so that everyone knows exactly what are the patients wishes( NOT the family's) if the patient gets critically ill. Many times
families make decisions on behalf of patients because they want everything done at a time of crisis, yet the patient probably just wanted to pass with comfort and dignity. We do not use the term DNR (DO NOT RESCUSITATE) anymore as it gives a connotation that we are withdrawing something. The terms we use now are AND (ALLOW NATURAL DEATH) with active measures(IV fluids antibiotics) or comfort measures (pain meds and sedation). Have the discussion with your family and let us know