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What is a Family Doctor Good For?

 

Have you ever heard your family or friends from back home tell you this?

"Don't bother going to the family doctor, you should go see a specialist for your problem."

"Family doctors know a little bit about many things, but not alot about anything."

 

When  you come to Canada, you will learn that Canadians are very proud of their health care system (or at least the ideals of what it should be like), and the success of their system is based on strong primary care. Leading the primary care system are specialists called Family Doctors.

"In my home country, when I have stomach pain, I go to the hospital and see a gastroenterologist (intestinal specialist) and get a colonoscopy right away!"

Beware of playing choose-your-own-adventure medical care, do so at your own peril !

In Canada, patients need to go to their family doctor first for any non-emergency medical problems. The hospital emergency department is reserved for people with emergencies (like you are going to die or be severely disabled if you don't get immediate help). You can go to the emergency department (ED) or emergency room (ER) for your problem, but you will likely wait for hours, be seen for 2 minutes by a busy ER doctor, and then be kicked out and told to see your family doctor anyways. You can try to go to a walk-in-clinic (WIC), but those doctors do not consider themselves your family doctor, as they only deal with your one-time specific problem, and then tell you to find a family doctor. Meanwhile, you would have wasted so much time, money and effort, when you could have just seen your family doctor in the first place.

"But, I think the general practice doctors (GP) in Canada must be similar to the general practitioners / doctors in my home country!"

In some countries, most doctors train to be specialists because there is no such thing as a family doctor. In some countries, the doctors who aren't specialist but see general simple problems, may only have basic medical training (starting right after highschool) because they couldn't study any further or couldn't climb up the hospital ladder. These rural general practitioners may do alot because they have to, and their experience gives them the needed skills. It is understandable, that you may insist on "seeing the best", and "the best must be a specialist."

In Canada, doctors need to have finished a university degree before even applying for medical school. Most doctors don't even get to go to medical school (get an MD) until they have finished a Masters, or even a PhD! For the lucky few who are admitted to medical school after a Bachelor's degree, they are usually considered to be at the top of their class. All doctors trained in Canada go through a minimum 4 years of an MD degree. Then they do more training in residency, another 2-3 years. The specialists only start their specialty training after that when they decide to focus on one particular medical field. By then, they are relieved that they don't need to remember the other medical fields, because they will have nothing to do with their own chosen specialty.

In the past, there were a breed of Canadian doctors called general practioners (GP), who only finished 1 year of rotating internship after their MD degree, and became family doctors for the Canadian population. However, their ongoing years of continual medical education (CME) learning and decades of on-the-job experience made them valuable and highly qualified to diagnose and manage your health.

As science progresses, and as people live longer, there is an ever increasing body of knowledge that a doctors needs to know. The textbooks are thicker, people's medical problems became more complicated, and so emerged the specialty known as Family Medicine. All family doctors that graduate now from the Canadian medical system must be trained in the specialty of Family Medicine (a minimum 2 year post-graduated program).

So if you want a "specialist" to be your family doctor, then you should find a Specialist in Family Medicine (with the certification CCFP).

Family Medicine specialists are trained to take your problem or symptom, which could be caused by hundreds of different things under the sun, and rapidly narrow down the possibilities to make a diagnosis. For all the problems that are not diagnosable (NYD), they can at least tell you that it is a benign condition (not a serious problem), because they have seen alot of conditions under the sun. You can rest well at night with confidence. Not only can these family doctors diagnose, they also treat and manage your conditions. That's right, in Canada, family doctors treat the majority of specialty conditions for the general population. There is not enough medical specialists (nor money) around to have everyone see a medical specialist. Family Medicine specialists have trained alongside other medical specialists to develop competencies in areas such as: cardiology, gastroenterology, respirology, endocrinology, obstetrics and gynecology, pediatrics, psychiatry, neurology, nephrology, otolaryngology, opthalmology, dermatology, urology, hematology, general surgery, rheumatology, orthopedics, emergency medicine, infectious diseases, geriatrics, radiology, and more! A large proportion of medical burdens such as hypertension, heart disease, diabetes, asthma, COPD, arthritis, pediatric care, women's health, and mental health are managed by mainly by your family doctors.

"So when can I see a real specialist?"

When your particular family doctor cannot manage your specific problem because of time, experience, or complexity, then you doctor may refer you to see a specialist. That's right, to see a medical or surgical specialist in Canada, you need to be referred by a family doctor, after having assessed you and making a medical judgement that your problem warrants a specialist. Otherwise, your family doctor will have been able to assess, diagnose, and provided the medically necessary treatment to you already. If your family doctor recommends surgery, then they will refer you to a surgeon. If your family doctor recommends seeing a specialist, then they will refer you to a medical specialist.

If you go, yourself, to a medical or surgical specialist with a problem that ends up not being part of the particular specialist's field of medicine, then they will likely tell you to go home and see your family doctor. It is not the specialist's problem. They can't be bothered by you. It is still your problem, and you are not satisfied. Do yourself a favour, see your family doctor first and let them determine what the right course of action is for caring for your whole person.

"But I don't need a family doctor now. I just ask Dr. Google when I have a problem!"

That may be the case. However, when you do need a doctor, you will need a family doctor. But when you want a family doctor, you may not be able to find an available family doctor. Therefore, find yourself a family doctor now, so when you eventually need medical care, you will have an existing doctor-patient relationship to draw upon for help.

Besides, Dr. Google brought you here, and we're telling you to find a family doctor. So Dr. Google must be right!

"I went to a family doctor / walk-in doctor, and he mis-diagnosed me!"

Sorry about your experience. That sounds terrible. Mistakes do happen in medicine. Medical problems can also be an evolving process; meaning at the early stages of an illness, you may not show all the signs and symptoms, and it could still be several different possibilities. Diagnosis is both an art and science. This is the challenge of Family Medicine, making the diagnosis when it is not blatantly obvious. There are also bad doctors out there. However, a majority are good doctors, and they do have your best interest at heart. They've studied, and worked hard to be the best at what they do: to make the right diagnosis and manage your health. Find yourself a good doctor. If you are not getting better, or your condition is getting worse, then go back to your good doctor, and they will reassess the situation. This helps prevent missing something important that is slowly evolving.

"So you are telling me that Family Doctors are Specialist?!"

Family Medicine is considered a Specialty. AAFP. CPSO.

Did you Know...?

Did you know that the doctors you might see in the emergency department, or take care of you in the hospital ward, or deliver your babies are Family Medicine specialists (CCFP) who have additional training in emergency medicine, obstetrics, or internal medicine fields? You think you are seeing a regular specialist, but really you are seeing a family medicine specialist! If they're good enough for Canadians, then its good enough for you!

So are you feeling lost in the healthcare system?

The practice of Family Medicine is meant to be a Patient's Medical Home, providing seemless care, through all the stages of your life, and integrating with your other health services.

At Get Well Clinic... We Welcome You Home!

 

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Varicose Veins and Compression Stockings

Shannon Youn, DCh

 

Varicose veins are enlarged and sometimes twisted veins found most commonly on the lower limb. At times, varicose veins along with reticular and spider veins (smaller, less prominent dilated veins) are more of a cosmetic concern, while other times, they may be signs of circulatory problems, specifically venous insufficiency. In other words, your veins are not functioning efficiently to work against gravity and bring the blood back to your heart. Rather, the blood pools and consequently dilates the veins in your lower body. See your health care professional when varicose veins are accompanied with aching, heavy, swollen, and/or painful legs, or skin discolourations.

 

Compression Stockings or compression socks are significant components to the management of venous issues. Compression stockings offer gradual compression up the limb, with the highest level of compression at the ankle to promote blood flow back to the heart. They also come in various degrees of compression to accommodate different severities of venous conditions. They are great for people who work sitting or standing for long periods of time throughout the day, as well as pregnant women and frequent travellers.

 

Book an appointment with a Chiropodist today for compression stockings. He or she can provide more information and tell you if you would benefit from them. A Chiropodist can measure and dispense compression stockings if you bring with you a doctor’s prescription.

 

Contact us now to be fitted for compression stockings today! 416-508-5691.

 

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Warts and Treatment Options

Shannon Youn, DCh

 

A wart is a skin growth caused by a virus called the human papillomavirus (HPV). Plantar warts are ones that are specifically found on the sole of the foot. If found on a weight bearing area, a wart tends to grow inward under a thick layer of hardened skin/callus. There are generally three tell tale signs a lesion on your foot is a wart: 1. Disturbed normal skin lines 2. Black pinpoint dots which are clotted blood vessels 3. Pain with pinching of the lesion. Some warts will go away without treatment over time, while others may require a visit to a Foot Specialist.

At your visit to the Chiropodist, he or she will tell you there is not one treatment that will clear your foot of warts indefinitely. There are a number of treatment options and each person responds differently; therefore, what worked for someone may not work for you. In addition, the general rule is the more invasive the procedure, the higher the success rate. Less invasive procedures typically require multiple visits.

 

Treatment options include:


1.    Silver nitrate

Your health care practitioner will shave off the overlying thickened skin until pinpoint bleeding and then apply silver nitrate to the lesion. The silver nitrate acts as a caustic and forms a black eschar. This procedure is relatively painless.

2.    Salicylic Acid

Salicylic acid is a common over the counter (OTC) treatment option for warts. Your health care practitioner will prescribe you a topical solution with a higher dosage than ones you can purchase OTC, which can increase the effectiveness of treatment. This procedure is also relatively painless.

3.    Freezing

Freezing kills living cells, including the virus and may even stimulate an immune response. This procedure can be uncomfortable and may even be painful for the patient.

4.    Canthacur

Canthacur is a topical solution which will blister the skin it comes in contact with. Consequently, burning or extreme tenderness may develop. This procedure is more aggressive than the ones listed above, but typically has a higher success rate.

5.    Needling

This technique is for someone with multiple recalcitrant warts. It is much more invasive and requires local anaesthesia to numb the foot. A thick needle is then used to puncture the largest and thickest wart approximately 100 times. This will introduce the viral tissue into the blood stream and initiate an immune response.

6.    Excision

This procedure typically provides the highest long term success for resistant plantar warts. Local anaesthesia is used to numb the foot and as the name suggests, the wart is excised using a scalpel blade and the base of the cavity cauterized.

 

Book an appointment with a Chiropodist to find out which treatment is best suited for you! 416-508-5691.

 

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Diabetes and Your Feet

Shannon Youn, DCh

 

Diabetes is a chronic metabolic disease characterized by elevated levels of glucose or sugar in the blood due a lack of insulin, insufficient levels of insulin, or increase in insulin resistance in the body. Insulin is required so that the body can absorb sugar from the blood and use it as an energy source; without it, the body will be left with high levels of sugar remaining the bloodstream. Consequently, chronically elevated blood sugar levels can lead to long term, sometimes debilitating complications, including blood vessel damage, neuropathy, and a compromised immune system.

Your body needs sufficient blood flow to receive oxygen and nutrients for its survival. Damage to this system leads to poor circulation and reduced bloody supply. When large vessels are affected, this leads to heart disease and stroke and when small vessels are affected, such as those in eyes and kidneys, this can cause blindness, kidney disease, or kidney failure.

Neuropathy is another common diabetes related complication in which the nerves in one’s body do not function properly, impairing sensation, movement, and gland or organ function. Often times, people will feel tingling, numbness, or burning sensations in their lower limbs, and their feet are not able to detect sensations such as pressure, temperature, and injury. As a result, the risk of getting a diabetic foot ulcer is increased as well as the risk of a non-traumatic lower limb amputation.

Finally, a person with diabetes is also more prone to fungal, bacterial, and viral infections as the body's ability to fight off infection is dimished. That is why it is very important to always try to prevent the introduction of harmful bacteria, fungi, and viruses into the system by maintaining the integrity of the skin.

Put your feet in professional hands and get your feet checked today! At your appointment, expect to receive a diabetic foot assessment which includes assessments for good circulation, signs of neuropathy, risk of foot ulcers, and management for any nail and skin concerns. Receive a diabetic foot assessment by a Licensed Chiropodist who will be able to meet your foot needs and educate you on how to keep your feet healthy.

 

Contact Us to discuss how we can take care of your feet! 416-508-5691

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Get Well Clinic

649 Sheppard Ave West
Toronto, ON, M3H 2S4
Tel: (416) 508-5691
Fax: (647) 478-7604

www.getwellclinic.ca

 

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