CVFP Magazine 2006.indd - Paragon Publishing Inc.

www.cvfp.comCrowfoot Village Family PracticeProviding comprehensive family medicine services

2 Crowfoot Village Family Practice

Suite 201, 60 Crowfoot Crescent NWCalgary, Alberta T3G 3J9Phone: (403) 239-9733 (24 hours)www.cvfp.comCONTENTSWelcome ....................................... 3CVFP Doctors ................................ 4Comprehensive Care Model ...... 5Blood Pressure Reading ............... 6Meet the Staff ............................... 7Injury Recovery ............................. 8Diabetes ........................................ 9Public Health Nurse .................... 10Balance Problems ...................... 11Lung Health Clinic ...................... 12Chronic Disease Team ............... 12Travel Clinic ................................. 13Cover Photo:Four generations are healthy patients of Crowfoot VillageFamily Practice.Clockwise from bottom left: John and Mary Kaminsky,David and Candace Cook, Steven and Susanne Hoefling,and Emma Hoefling.Providingcomprehensive familymedicine servicesCrowfoot Village Family Practice is a progressiveand innovative group that uses a comprehensive caremodel to deliver primary health care in northwestCalgary. Our staff of family physicians, nurses andsupport staff care for newborn to geriatric patients.Crowfoot Village Family Practice is committed tostriving for excellence in family medicine. We areproud to be the only clinic of our kind in Calgary.PROJECT MANAGERART DIRECTORPUBLISHERPublished for CVFP by:PARAGON PUBLISHING INC.Calgary, AlbertaTel: (403) 287-9818ads@paragonpublish.comwww.paragonpublish.comDenis MarsonTel: (250) 550-3086dm@paragonpublish.comRichart BocxeJim ThorntonAll rights reserved ©2007. Printed in Canada.MISSION STATEMENTAt Crowfoot Village Family Practice our missionis to provide high quality, comprehensive, andcompassionate family practice care to our patientpopulation and to facilitate timely access to healthservices.Did you know you can request appointmentsthrough our website: www.cvfp.com?Crowfoot Village Family Practice 3

CVFP Physician ProfilesDr. Peggy AufrichtDr. Aufricht completed her medical degree at the University ofCalgary in 1984 and her family medicine residency at the FoothillsHospital in 1986. She is a Fellow of the College of Family Physiciansand is the project lead for the Crowfoot primary care reform pilotproject.Dr. Aufricht enjoys running, skiing, cycling and hiking with herhusband and three children.Dr. Kathy JohnsDr. Kathy Johns graduated from the U of A in 1992. She completedher Family Medicine Residency at the U of A in 1994 and herEmergency Medicine Certificate in 1995 as Chief Resident. She hasbeen practicing Emergency Medicine at the Foothills and PeterLougheed Centres from 1995 to 2006, with active participation in theSTARS Air Ambulance Service, The PARTY Program, the EMS liaisoncommittee and the teaching of medical students and residents.Dr. Johns enjoys spending time with her husband and new baby.Dr. Stephanie KubikDr. Kubik achieved her Bachelor of Science with Great Distinction in1987 before going on to complete her doctorate in medicine at theUniversity of Calgary in 1990. The year 1992 marked her completionof residency and subsequent partnership in CVFP.Dr. Kubik and her hubby are happily enjoying their roles as parentsto their beautiful daughter and new son. Together with their dogEmmet, they enjoy hiking.Dr. Janet ReynoldsDr. Reynolds completed her medical degree at the University ofSaskatchewan in 1997. She then moved to Ottawa to completeher Family Medicine training at the University of Ottawa in 1999. Sheworked in a rural setting in Ontario for two years prior to moving toCalgary.Aside from practicing family medicine, she does regular shifts at theAlberta Children’s Hospital on the oncology ward.4 Crowfoot Village Family PracticeDid you know that CVFP has a travel clinic?

Dr. Wendy StefanekAfter completing her Bachelor of Science degrees at the Universityof Calgary, Dr. Stefanek obtained her MD from the University ofAlberta in 1998. She made the move back to Calgary to completeher 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 familymedicine, Dr. Stefanek enjoys spending time with her family,running and reading for her book club.Dr. Rick WardRick Ward has been a partner at CVFP since 1988. His professionalinterests include preventative cardiology, chronic diseasemanagement, psychiatry and sexual medicine.Besides his activities with CVFP, Rick has a clinical appointment withthe Faculty of Medicine at the University of Calgary where he is aClinical Assistant Professor. He is actively involved through the U ofC with teaching at CVFP and developing educational programs forfamily physicians across Canada.He is married to Cindy, whom he met while an undergraduate at theUniversity of Guelph. They have 2 teenage boys, Evan and Austin.His hobbies include travel, fishing, reading and spending time at hisrecreational property on Vancouver Island.The Crowfoot Village Family PracticeComprehensive Care ModelThe comprehensive care model was developedin 1999 as a special initiative led by the CrowfootVillage Family Practice doctors. Working withthe Calgary Health Region, the Alberta MedicalAssociation and Alberta Health and Wellness, theCrowfoot practice has moved to a model whichincludes all major components of primary carereform recommended by the Romanow andMazankowski reports. These include:• An electronic medical record• A multidisciplinary health team with a strong rolefor nursing staff• 24/7 access to health services• Measurement of health outcomes• An alternate payment methodIn this model, our practice receives a monthly feefrom Alberta Health and Wellness to provide allprimary health care services. Health premiums andcoverage from Alberta Health and Wellness remainthe same.To be a part of the practice, patients enroll byfilling out the New Patient Enrollment Form. This isforwarded to Alberta Health and Wellness to attachyour health care number to our clinic. Enrolling withCVFP does not change your access to specialists orto any other health services available in Calgary. TheCrowfoot practice has a close partnership with theCalgary Health Region, and many regional servicesare provided at CVFP.Under this model, we ask that you call us firstbefore seeking medical attention or advice outsideof CVFP. We have a registered nurse and doctoravailable after hours to provide access to services.In case of a medical emergency, patients shouldcall 911 or proceed to the nearest emergencydepartment.We are also pleased to be a part of the CalgaryFoothills Primary Care Network, which is a jointinitiative in primary care reform with Alberta Healthand Wellness, and the Calgary Health Region. Asthe various components of the network proceed,we will educate our patients on the benefits they willreceive.Crowfoot Village Family Practice 5

MEET THE STAFFDid you know we have appointments available every day for urgent problems?Crowfoot Village Family Practice 7

REVOVERING FROM AN INJURYIn my years of practice, there is a continuing theme from anumber of patients. That is “I thought it would just get better”,Many people arrive at a local physiotherapist stating this, evenafter months of pain and limited activity. My goal in this article,therefore, is to give you some insight regarding the naturalcourse of healing, and what you can do to speed it up, and slowit down.For those of you with acute injuries, tissues should heal in about6-8 weeks. If it is simply an irritation or mild sprain/strain, 2-4 weeksmay be sufficient. And even if it takes 6-8 weeks, you should noticesome improvements within 1-2 weeks. Improvement is noted,be it less pain, increased range of motion, decreased swelling, orimproved 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 forprolonged recovery, and prolonged pain. You are doingNOTHING. The first thing to do when recovering from an injuryis being pro-active with it. Do not let it control you or your life.Seek help from any variety of sources. A physical therapist isskilled with musculoskeletal injuries. These may vary from a wristsprain to rotator cuff problems. Your physician can aid therecovery with appropriate pharmacological intervention. Themost important part in the initial recovery is MICE; that is gentleMovement, Ice, Compression (wrap the injured area) andElevation (if swelling visible).B. The acute phase of the injury will last 4-10 days, and then immediatetreatment is indicated. Once out of the acute phase,there are a number effectors that contribute to your healing/lack there of. These include:CROWFOOTPHYSIOTHERAPY LTD.8 Crowfoot Village Family Practice1. Wrong exercises - the exercises provided may be doing someharm. If you are experiencing any pain with a particularexercise, you should make your treating professional aware ofit. They won’t change it if they don’t know. Also, the exercisemay be too advanced for the affected area.2. Poor technique - always a factor. Every exercise should bedone as taught. Even minor adjustments in technique couldbe a factor. I remember Tony Little (pretty hyper guy) yelling,“It’s Technique”... and even though it drove me nuts,he is right. Talk to your Physio if unsure on how to perform anexercise.3. Not enough of the exercises - especially with back painsufferers. Some exercises for pain control need to be donefrequently 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’tthink this should be a problem, but it is. Patients often try topush through an activity, even though it hurts. You know, theNo Pain, No Gain thing. Sometimes this theory applies, butcertainly not for acute injuries.5. Missing an area - often overlooked are joints above andbelow the problem. Also, neck should be reviewed with armpain, and low back should be reviewed with leg pain. Hipstructures when tight or weak can affect the knee and ankle.Same goes for the upper extremity. Neck and back problemsoften refer symptoms to the arms and legs. I have seen manypeople for what they thought was tennis elbow, but was infact a disc problem in the neck.6. Wrong diagnosis - as with the tennis elbow problems, peoplehave come to me after attending treatments for tennis elbow- complete with ultrasound, frictions, and other modalities, withminimal 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, multiplesclerosis, and diabetes are in here, and can be picked upwith a few tests. Other things like STRESS are often overlooked.Stress seriously impedes recovery, and should not be overlooked.If stress is present, try to get rid of it. You will be amazedhow quickly progress can be made.The bottom line with any form of treatment is that you shouldhave lasting results. Not just temporary and you should noticeimprovements over time. If not, discuss it with your treating physician,physical therapist, chiropractor, or other treating professionalIf nothing is happening with your recovery, do somethingabout it. Also, the pain relief should be lasting, and injuries shouldbe preventable.The bottom line, when recovering from an injury, is that youshould be noticing improvements regularly. If not, talk to yourhealth care provider, get a test done, change treatment protocols,look elsewhere in the body, or see someone new. Sometimesa new set of eyes can make a difference. And most importantly,take charge and prevent this from happening again.Tim KutashPhysical TherapistCROWFOOT PHYSIOTHERAPY and MASSAGE

Public Health Nursehe role of the public health nurseTat Crowfoot Village Family Practice(CVFP) is to assist families with childrenunder 6 years of age in acceptingresponsibility for their own health, and tocontribute to improving overall healthof the public by providing public healthnursing services which include:1. Health assessment, consultationand teaching appropriate to alldevelopmental phases throughout thelifespan.2. Delivery of preventative and promotivemeasures including vaccination,screening, referral, follow-up, educationand client advocacy.3. Fostering appropriate use of thehealth care system on behalf of clients;facilitating cooperation and coordinationamong the many health and socialservice agencies in the Calgary region.As public health nurses, we willbe available for appointments onWednesdays and Thursdays through CVFP.You are also welcome to contact us (atthe following number) at the NorthwestHeath Centre with any further questions orconcerns.Telephone: 943-9700UNINSUREDSERVICESOur clinic aims to provide allprimary care for our patients. Someservices we provide are uninsured.That means the cost of theseservices is not covered by AlbertaHealth and Wellness.The following list outlines thecharges for uninsured servicesthat are commonly providedat the practice. The fees areestablished by the Alberta MedicalAssociation* and are subject tochange according to these sameguidelines.UNINSURED SERVICES GUIDEPRESCRIPTION REFILLS BY PHONE, FAXOR EMAIL:• Single refill ............................................. $25.00• Single patient per year ........................ $50.00• Family per year ................................... $100.00FORMS:• Cataract/dental surgery requests formedical Information for uninsuredprocedures ........................................... $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) .................................. $90.00Form only: .............................................. $40.00• Motor vehicle accident forms ............ $50.00• Seniors residence ................................. $35.00• Sick/absence confirmation note ....... $20.00• Massage, physiotherapy, orthotics,chiropractic .......................................... $15.00INJECTIONS (Travel Clinic Not Included):• Per injection .......................................... $20.00OTHER:• Warts/seb. keratosis - flat fee 1 – 5 ..... $20.00flat fee for over 5 .................................. $25.00• Cysts/mole – fee for 1st ....................... $75.00fee for each additional ....................... $25.00• Skin tags – fee for 1st ........................... $50.00fee for each additional ....................... $10.00• Circumcision ....................................... $150.00NON-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.orgPhone: 1-800-272-968010 Crowfoot Village Family Practice

DIZZINESS & BALANCE PROBLEMSOur ears are for more than just hearing. We have a mechanism in our inner ears called the vestibularapparatus, 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. Resultingsymptoms can include dizziness, vertigo or “room-spinning”,unsteadiness, blurry vision, sensitivity to motion, nausea andvomiting, and poor concentration. If it persists, one canexperience secondary problems like inactivity, isolation, anxietyand depression.What can be done to help?Vestibular Rehabilitation is a highly effective, research-based branch of Physiotherapy, only availableat select clinics. After a thorough one-hour assessment, specific techniques are taught to helpthe brain adapt to an inner ear problem, or maneuvers are performed to correct mechanicaldysfunctions in the vestibular apparatus.For more information, talk to your Doctor, go to the Dizziness & Balance Services atwww.lifemark.ca, or call Spring Hill Sport Physiotherapy at 288-8877.Crowfoot Village Family Practice 11

LUNGHEALTHCLINICChronic Disease TeamMargot Underwood, Asthma RNJanice Couperwhite R.N.Community Care CoordinatorHome Care ProgramCalgary Health RegionLaura Brule R.NCommunity Care CoordinatorHome Care ProgramCalgary Health RegionAsthma, COPD andSmoking CessationClinicOnce a month the CalgaryCOPD & Asthma Clinicprovides an educator atthe Crowfoot Village FamilyPractice office. A certifiedasthma and COPD educator,Marg Underwood, is availableto provide breathing tests(spirometry) and discussquestions about asthma,COPD and smoking cessation.Information regardingtrigger avoidance, role ofmedications, proper use ofinhalers, monitoring and selfmanagementare all covered.Handouts, links to websitesand local resources is alsoprovided. Sessions are offeredone on one, booked for 1hour and family members arewelcome to attend.This education is one ofthe Calgary Health Regionprograms offered atcommunity sites.Community Care Coordinators are Home Care health professionals whowill assess your health care needs and link you to community services andresources. They arrange for and provide Home Care Services and will work withyou, your doctor and other health care professionals to achieve your healthcare 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 ofHome Care is to help people restore their independence and prevent furtherdisability.Anyone can make a referral to Home Care by calling Community CareAccess at (403) 943-1920.As part of the Home Care Program, Janice and Laura also see people at theChronic Disease Management Clinic here at your family doctor’s office.Building on the established Home Care and physician partnership modelwithin the Calgary Health Region, the current role of the Community CareCoordinators (CCC) has been expanded to include selected chronicconditions (Diabetes, Hypertension, Dyslipidemia) of all patients cared for byfamily doctors.Each physician has a Community Care Coordinator (RN) who works withthem to monitor the health of patients with chronic conditions. The CCChas the ability to link to specialty services such as the diabetes hypertensionand cholesterol nurse, dietitians, the Living Well program and the pain clinic.Patients’ details are stored in an electronic information system that reminds theCCCs 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 annualassessments and ongoing monitoring by phone or mail.• quick links to community programs to help patients monitor and controltheir health.Did you know that not all health services are covered byAlberta Health Care?12 Crowfoot Village Family Practice

The CVFP Travel ClinicWe have established the following travel medicine fees:Travel medicine visit (inc. prescriptions) $30 (family maximum $100)Non-CVFP patients travel visit $60Travel vaccines (inc. vaccine):Hepatitis A $65 Junior (

Prescription Renewal Policyurrently, we receive a very large number of refill requests byCfax 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 isavailable, or payment can be made at the time the service isrequested. If you have any concerns or questions, please discussthese with your doctor or a staff member.Questions and AnswersIf I pay the annual fee, is there any limit to the number of times Ican use the service?No, the annual fee covers all prescription refills from November 1to October 31.If I provide my credit card number, will it be secure?Yes. Your credit card number will be stored confidentially with ourbusiness 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 youneed to use the service. However, if you use the service morethan twice a year, the annual fee option will be less expensive.I thought this service was covered under the new system. Whythe change?The convenience of prescription refills by phone or fax hasalways been an uninsured service and is not included in ourcapitation rate.If you wish to subscribe to the phone prescription service, youcan complete the prescription refills form available at www.cvfp.com or at the office.Continued from page 6 - Blood PressureCVFP is now encouraging patients who have elevated readingsin the office or who have been initiated on treatment forhypertension to have their blood pressure assessed at the localfire hall.3. Most people with high blood pressure don’t know they haveit!Despite improvements in blood pressure treatment, mostpeople with high blood pressure either don’t know they havehypertension or have their hypertension inadequately controlled.The nurses and physicians at CVFP will continue to screenpatients at risk for hypertension when they come into the clinic– even for unrelated visits.4. Acceptable blood pressure results are lower than oncethought. In the ‘old days’ we used to thing that the top bloodpressure number (or systolic pressure) was naturally elevatedas we age. We now know that patients with elevated systolicblood pressure are at particularly high risk for heart diseaseand stroke. What are blood pressure targets?The CVFP team is encouraging all patients to ‘know their bloodpressure reading’, ‘know their target blood pressure’ and ‘get totarget’!For more information on high blood pressure, how youcan prevent hypertension and what home blood pressuremonitors are recommended, visit the website of the CanadianHypertension Education Program – www.hypertension.caNext issue – ‘What we have learned about treating high bloodpressure’Continued from page 9 - DiabetesSince everyone is unique, it is important to discuss treatment withyour physician or diabetes team member. It is often difficult forpeople with a new diagnosis of diabetes to be suddenly put on 4medications – 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 donefor each patient with DM. Most will be instructed on how tocheck their blood sugars at home. As well, regular lab workchecking long term blood sugar levels (Hemoglobin A1c),cholesterol levels, and kidney function will be performed. If youhave DM you should have your eyes examined by your eye doctoryearly to check for complications of DM.The diagnosis of diabetes or pre-diabetes can be difficult forsome people. However, as one of our patients said – “What’sso bad about it? I have to start eating better, lose weight andexercise more regularly. I have to check my blood pressure andblood sugar more often and see the doctor and diabetes girlsregularly. The medications aren’t much fun but the goal is forme to live long and be healthy. It’s all good!”14 Crowfoot Village Family Practice

Know that you are in good handswhen your health care providerstores your patient record insafe, secure softwareNational Medical Solutionsis the clinical softwarevendor of choice forCrowfoot VillageFamily PracticeFind out more...(403) 245-8337www.medicalsolutions.ca Crowfoot Village Family Practice 15