This post is now closed to applications - thank you to all that applied.
We are expanding and we are looking to hire a second full time receptionist.
We have a very busy, exciting, paperless practice with over 3,000 patients in brand new premises in the Sherwood Medical Center in Charlottetown.
The successful candidate will have excellent people skills, a positive outlook, good computer skills, a love of learning, a desire to embrace positive change, and a personality that will fit in well with our close, informal team.
The rate of pay is $16.00/hr
If you are interested in this post, or you know someone who might be, then download an application form and job description using the links below.
The closing date for applications is June 7th.
Receptionist / Secretary job description
Receptionist / Secretary application form
May 22, 2010
New telephone switchboard - no more busy tones!
We are a very busy, large medical practice. As a result, our telephone line was often busy and patients complained it was difficult to get through to us.
Now we are in our new offices, we have installed a new telephone switchboard just for our office. It has five lines, three of which are dedicated incoming lines. We also now have a dedicated receptionist who will be manning the switchboard full time.
So when you call, you will be placed in a queue and your call will be answered in turn by the switchboard receptionist. No more busy tones. (We hope!)
Now we are in our new offices, we have installed a new telephone switchboard just for our office. It has five lines, three of which are dedicated incoming lines. We also now have a dedicated receptionist who will be manning the switchboard full time.
So when you call, you will be placed in a queue and your call will be answered in turn by the switchboard receptionist. No more busy tones. (We hope!)
Treatment Room Nurse - get your tests done locally, even if you are not our patient.
Dawn Rodd, L.P.N, is our full time Treatment Room Nurse*.
The Treatment Room Nurse is able to provide a wide range of service to everyone - even if they are not our patient.
Services provided include:
Medicare services (no charge to patients - tests in bold require a requisition from a doctor, tests marked ** require to be booked in advance):
- PAP tests
- Blood tests
- Intramuscular injections (requires prescription medication in original container)
- Cardiograms (12 lead ECG/EKG)
- Cardiac event monitoring
- Mini-spirometry (breathing test)
- 24 hour Blood Pressure monitoring**
- Overnight oximetry** (sleep studies)
- Ear syringing
- Wart care
- Wound care
- Post-op staples removal
Private services: (fees apply)
- Travel advice
Coming soon:
- Audiometry
You don't have to be one of our patients to see our Treatment Room Nurse, but some medicare items require a requisition from a doctor (marked in bold above). For blood tests simply bring the normal requisition that you would take to the hospital. For other services, ask your doctor to fill out one of our special requisition forms (which can be downloaded here), or to write the request on a prescription pad. If in doubt call us on 894 7369 for advice or visit our reception desk.
You can either walk in any weekday between 10am and 4pm (1pm on Fridays), or you can call and make an appointment in advance. Don't forget, you must bring your Health Card with you.
Call us on 894 7369 if you would like to make an appointment to see our Treatment Room Nurse.
* The Treatment Room Nurse used to be called our Walk In Nurse, but we have changed the name because (1) patients were getting confused with the Walk In Clinic doctor downstairs, (2) you can now book appointments with the nurse and saying 'book an appointment with the Walk In Nurse' sounded silly, and (3) Treatment Room nurse is the British name for it and we aiming for a British-style medical practice.
The Treatment Room Nurse is able to provide a wide range of service to everyone - even if they are not our patient.
Services provided include:
Medicare services (no charge to patients - tests in bold require a requisition from a doctor, tests marked ** require to be booked in advance):
- PAP tests
- Blood tests
- Intramuscular injections (requires prescription medication in original container)
- Cardiograms (12 lead ECG/EKG)
- Cardiac event monitoring
- Mini-spirometry (breathing test)
- 24 hour Blood Pressure monitoring**
- Overnight oximetry** (sleep studies)
- Ear syringing
- Wart care
- Wound care
- Post-op staples removal
Private services: (fees apply)
- Travel advice
Coming soon:
- Audiometry
You don't have to be one of our patients to see our Treatment Room Nurse, but some medicare items require a requisition from a doctor (marked in bold above). For blood tests simply bring the normal requisition that you would take to the hospital. For other services, ask your doctor to fill out one of our special requisition forms (which can be downloaded here), or to write the request on a prescription pad. If in doubt call us on 894 7369 for advice or visit our reception desk.
You can either walk in any weekday between 10am and 4pm (1pm on Fridays), or you can call and make an appointment in advance. Don't forget, you must bring your Health Card with you.
Call us on 894 7369 if you would like to make an appointment to see our Treatment Room Nurse.
* The Treatment Room Nurse used to be called our Walk In Nurse, but we have changed the name because (1) patients were getting confused with the Walk In Clinic doctor downstairs, (2) you can now book appointments with the nurse and saying 'book an appointment with the Walk In Nurse' sounded silly, and (3) Treatment Room nurse is the British name for it and we aiming for a British-style medical practice.
May 19, 2010
Oxycodone prescribing
The serious topic of oxycodone and hydromorphone prescribing has been in the news again. Some of our patients may have concerns about the issues raised in the CBC stories. Some may be affected by oxycodone addiction, or may have relatives that are affected by it, now or in the past. On the other hand, some patients may be concerned that they will be left in pain because of under use of these drugs.
The first thing to point out is that our prescribing policy on oxycodone and hydromorphone has not changed. We have not stopped prescribing oxycodone, because we never have prescribed oxycodone. We have only ever prescribed oxycodone to patients as part of terminal care. The Strachur Medical Practice, our Scottish branch, had only one patient taking the drug when I last checked with them.
The second thing is to reassure patients that we will be very aggressive in treating their pain. We are very experienced in treating chronic pain using a wide range of medications. We take chronic pain very seriously. We look at the patient as a whole, and we use lots of different medications to treat pain. This includes opiates such as tramadol, codeine, morphine and fentanyl where necessary. We have been able to control pain in vast majority of patients using this strategy for years. We are very experienced in terminal care, including palliative care at home. We are also experienced in dealing with drug addiction and how to support patients who are trying to overcome their addictions.
Finally, with regard to oxycodone/hyrdomorphone we have only asked patients to find another doctor if they have been dishonest or abusive. Some patients have chosen to go to other doctors who have different prescribing policies, and that is entirely up to them. Hopefully, the great majority of patients who have joined our practice who are on these drugs have understood our reasons for our policy and that we have their best interests at heart.
Not prescribing oxycodone is not news to us. It is the norm. I have not been prescribing these drugs for my 13 years as a family doctor.
I hope this information is reassuring to our patients. If anyone has any concerns or questions about oxycodone prescribing please let us know.
The first thing to point out is that our prescribing policy on oxycodone and hydromorphone has not changed. We have not stopped prescribing oxycodone, because we never have prescribed oxycodone. We have only ever prescribed oxycodone to patients as part of terminal care. The Strachur Medical Practice, our Scottish branch, had only one patient taking the drug when I last checked with them.
The second thing is to reassure patients that we will be very aggressive in treating their pain. We are very experienced in treating chronic pain using a wide range of medications. We take chronic pain very seriously. We look at the patient as a whole, and we use lots of different medications to treat pain. This includes opiates such as tramadol, codeine, morphine and fentanyl where necessary. We have been able to control pain in vast majority of patients using this strategy for years. We are very experienced in terminal care, including palliative care at home. We are also experienced in dealing with drug addiction and how to support patients who are trying to overcome their addictions.
Finally, with regard to oxycodone/hyrdomorphone we have only asked patients to find another doctor if they have been dishonest or abusive. Some patients have chosen to go to other doctors who have different prescribing policies, and that is entirely up to them. Hopefully, the great majority of patients who have joined our practice who are on these drugs have understood our reasons for our policy and that we have their best interests at heart.
Not prescribing oxycodone is not news to us. It is the norm. I have not been prescribing these drugs for my 13 years as a family doctor.
I hope this information is reassuring to our patients. If anyone has any concerns or questions about oxycodone prescribing please let us know.
May 5, 2010
New Office Now Open!
Well we are finally in our new offices! (We've been dreaming about them for months.)
We are now upstairs on the second floor above the new Sherwood Drug Mart.
All the team worked incredibly hard over a long weekend (Friday to Tuesday). I'd like to thank everyone for there dedication and effort - including all the spouses, children, and friends who came in to help too. The Marathon Saturday Ikea Furniture Buildathon went very well. Special thanks to our Practice Manager, Joanne, who will probably be dizzy for weeks after four solid days of being spun from problem to problem. Thanks also to Rob MacLellan our landlord who managed to get us in on schedule (I know it was touch and go!), Barry at Sherwood Drug Mart for his tireless help with the heavy lifiting and other jobs, and Jason at Tech Guru and Les for getting our network and servers up and running.
All the furniture for the office comes from Ikea - Ellie, the children, and I spent four days in February in the Ikeas in Elizabeth New Jersey, New Haven Connecticut, and Boston Mass. filling a 12x6 trailer and the back of the truck with tables, chairs, office supplies, and leather sofas.
I think it was all totally worth it - the new waiting rooms are fantastic with comfortable sofas and chairs, racks of subscription magazine and daily newspapers (including the Sunday New York Times which delighted one patient recently!), a large childrens' play area, and free WiFi. And the offices are spacious and light which makes providing health care much less stressful to both patients and staff. We now have eight clinical rooms and three offices rather than the three clinical rooms and one office we had before.
The move was not without glitches - the blinds were the wrong size, so we have no blinds at present, and our wonderful new electric exam tables did not arrive as planned (they won't be here now until mid June). Also, some of the nurses new uniforms (more on that later) were the wrong sizes. (That's the last time I place the uniform order!)
We hope all our staff, patients, and visitors will enjoy and the new space.
We are now upstairs on the second floor above the new Sherwood Drug Mart.
All the team worked incredibly hard over a long weekend (Friday to Tuesday). I'd like to thank everyone for there dedication and effort - including all the spouses, children, and friends who came in to help too. The Marathon Saturday Ikea Furniture Buildathon went very well. Special thanks to our Practice Manager, Joanne, who will probably be dizzy for weeks after four solid days of being spun from problem to problem. Thanks also to Rob MacLellan our landlord who managed to get us in on schedule (I know it was touch and go!), Barry at Sherwood Drug Mart for his tireless help with the heavy lifiting and other jobs, and Jason at Tech Guru and Les for getting our network and servers up and running.
All the furniture for the office comes from Ikea - Ellie, the children, and I spent four days in February in the Ikeas in Elizabeth New Jersey, New Haven Connecticut, and Boston Mass. filling a 12x6 trailer and the back of the truck with tables, chairs, office supplies, and leather sofas.
I think it was all totally worth it - the new waiting rooms are fantastic with comfortable sofas and chairs, racks of subscription magazine and daily newspapers (including the Sunday New York Times which delighted one patient recently!), a large childrens' play area, and free WiFi. And the offices are spacious and light which makes providing health care much less stressful to both patients and staff. We now have eight clinical rooms and three offices rather than the three clinical rooms and one office we had before.
The move was not without glitches - the blinds were the wrong size, so we have no blinds at present, and our wonderful new electric exam tables did not arrive as planned (they won't be here now until mid June). Also, some of the nurses new uniforms (more on that later) were the wrong sizes. (That's the last time I place the uniform order!)
We hope all our staff, patients, and visitors will enjoy and the new space.
May 1, 2010
Pharmacy Technician to help with cost of medications
Patients can now book an appointment with our Pharmacy Technician, Melissa Murphy.
Melissa can help if you are having problems meeting the cost of of your medications. For example, there may be a cheaper equivalent drug. Or you may be able to obtain a Drug Exemption from Medicare. Or you may be able to obtain the drugs free from the manufacturer on a compassionate basis.
There is no charge for this service.
We are also developing a Pharmacy Adviser service. This will be a pharmacist who will advise us on our prescribing. For example, if there is new evidence about the effectiveness or safety of medications. Or if a medication is withdrawn, the Pharmacy Adviser can recommend the best alternative.
Also, the Pharmacy Adviser will be able to help us draw up and monitor our Practice Formulary. This is the list of medications that we will be recommending as being the best choice for various conditions. At the same time, the Pharmacy Adviser can monitor the level of prescribing of various types of drugs via our computer system and advise us of any areas where we might be prescribing too few or too many medications.
This will help us provide a better and safer service to our patients.
Melissa can help if you are having problems meeting the cost of of your medications. For example, there may be a cheaper equivalent drug. Or you may be able to obtain a Drug Exemption from Medicare. Or you may be able to obtain the drugs free from the manufacturer on a compassionate basis.
There is no charge for this service.
We are also developing a Pharmacy Adviser service. This will be a pharmacist who will advise us on our prescribing. For example, if there is new evidence about the effectiveness or safety of medications. Or if a medication is withdrawn, the Pharmacy Adviser can recommend the best alternative.
Also, the Pharmacy Adviser will be able to help us draw up and monitor our Practice Formulary. This is the list of medications that we will be recommending as being the best choice for various conditions. At the same time, the Pharmacy Adviser can monitor the level of prescribing of various types of drugs via our computer system and advise us of any areas where we might be prescribing too few or too many medications.
This will help us provide a better and safer service to our patients.
April 26, 2010
Prostate Cancer: to Screen or Not to Screen
One of the areas in which our medical practice aims to excel is in screening and prevention.
Having a computer system as sophisticated as ours and having a large team of Practice Nurses makes us uniquely suited to screening for preventable diseases. The Practice Nurses will be actively inviting and recalling patients for screening tests and health advice each year.
So it has come as a bit of a shock to some of our male patients to find that we are not routinely screening for prostate cancer. So much so, that I thought it would be a good idea to look at the pros and cons of screening in general, and the specific problems with prostate screening.
The perfect screening test will be (1) safe, and (2) reliable and will look for a disease that is (1) serious and (2) is either preventable or treatable.
Unfortunately, there is no such screening test in existence. Let's take prostate cancer. The test itself (called the PSA test) is safe - it's just a blood test - but it is very far from reliable. Having a high PSA does not mean you have cancer, and having a low PSA does not mean you do not have cancer.
Then there is the question of how serious prostate cancer is. Everyone is afraid of the 'C' word, so anything that is cancer must always be bad. Not so. The great majority of men who get prostate cancer will not suffer any real harm from it. However, a small number of men with prostate cancer will die from it. It's not possible to tell the 'indolent' cancer from the dangerous one.
This means that you have to 'treat' a lot of men who have nothing serious wrong with them in order to catch the small number who do have a serious cancer. And the treatment is not safe and simple - it is a biopsy or an operation can lead to incontinence and sexual dysfunction.
In fact, to treat a single man with a serious cancer you have to screen around 1,400 men and you will end up 'treating' around 48 men who had nothing serious wrong with them. So only around 2% of men who think they have had treatment for prostate cancer actually had serious prostate cancer. The other 98% had nothing serious wrong with them. Except, now they think they have a cancer. Worse, we will likely never know which patient is which.
Patient's don't believe me when I tell them that the evidence is that if you have a PSA test your chances of being harmed can go up. ("Just from a blood test!? Are you sure you're a real doctor?")
Ironically, this is because of what is called the Popularity Paradox. This is what happens:
Worse still, the side effects of treatment are all 'front-loaded' - they happen at the time of treatment - but the possible benefits (if any) are all 'tail-loaded' - they don't happen for decades (if ever).
And yet, prostate cancer kills over 4,000 men a year in Canada (around 11% of all cancer deaths in men).
So this gives us a real dilemma. If the evidence is that your chances of being harmed go up or stay the same when you get a PSA test, then should we be doing PSA's at all?
Well, that depends on a lot of things. Do you have a family history of prostate cancer (in a first degree relative at a young age)? Do you have symptoms? (Our nurses will give you a questionnaire to fill out.) What are you more afraid of personally? What is your attitude towards risk?
That's why we won't be performing routine PSA screening at present. As recommended by Health Canada, the NHS in the UK, and the US Preventive Task Force We'll want to go over the risks and benefits with each patient carefully before they decide whether to have the test or not.
Research continues in this area, and as any fresh information comes to light we will review our advice.
Links:
Health Canada Prostate Cancer page
New England Journal of Medicine Perspective Roundtable: Screening for Prostate Cancer
(Any patient interested in prostate screening should call to make an appointment with one of our Practice Nurses to discuss the test.)
Having a computer system as sophisticated as ours and having a large team of Practice Nurses makes us uniquely suited to screening for preventable diseases. The Practice Nurses will be actively inviting and recalling patients for screening tests and health advice each year.
So it has come as a bit of a shock to some of our male patients to find that we are not routinely screening for prostate cancer. So much so, that I thought it would be a good idea to look at the pros and cons of screening in general, and the specific problems with prostate screening.
The perfect screening test will be (1) safe, and (2) reliable and will look for a disease that is (1) serious and (2) is either preventable or treatable.
Unfortunately, there is no such screening test in existence. Let's take prostate cancer. The test itself (called the PSA test) is safe - it's just a blood test - but it is very far from reliable. Having a high PSA does not mean you have cancer, and having a low PSA does not mean you do not have cancer.
Then there is the question of how serious prostate cancer is. Everyone is afraid of the 'C' word, so anything that is cancer must always be bad. Not so. The great majority of men who get prostate cancer will not suffer any real harm from it. However, a small number of men with prostate cancer will die from it. It's not possible to tell the 'indolent' cancer from the dangerous one.
This means that you have to 'treat' a lot of men who have nothing serious wrong with them in order to catch the small number who do have a serious cancer. And the treatment is not safe and simple - it is a biopsy or an operation can lead to incontinence and sexual dysfunction.
In fact, to treat a single man with a serious cancer you have to screen around 1,400 men and you will end up 'treating' around 48 men who had nothing serious wrong with them. So only around 2% of men who think they have had treatment for prostate cancer actually had serious prostate cancer. The other 98% had nothing serious wrong with them. Except, now they think they have a cancer. Worse, we will likely never know which patient is which.
Patient's don't believe me when I tell them that the evidence is that if you have a PSA test your chances of being harmed can go up. ("Just from a blood test!? Are you sure you're a real doctor?")
Ironically, this is because of what is called the Popularity Paradox. This is what happens:
- A healthy 45 year old man with nothing wrong with him takes a PSA test.
- The PSA comes back falsely high.
- The man (and his doctor) think he has prostate cancer because of the high PSA.
- The man has a biopsy, which is inconclusive.
- The man has prostate surgery which results in life-long incontinence and impotence.
- The man thinks his life has been saved by the surgery and tells all his friends and relatives that they must have the test too.
Worse still, the side effects of treatment are all 'front-loaded' - they happen at the time of treatment - but the possible benefits (if any) are all 'tail-loaded' - they don't happen for decades (if ever).
And yet, prostate cancer kills over 4,000 men a year in Canada (around 11% of all cancer deaths in men).
So this gives us a real dilemma. If the evidence is that your chances of being harmed go up or stay the same when you get a PSA test, then should we be doing PSA's at all?
Well, that depends on a lot of things. Do you have a family history of prostate cancer (in a first degree relative at a young age)? Do you have symptoms? (Our nurses will give you a questionnaire to fill out.) What are you more afraid of personally? What is your attitude towards risk?
That's why we won't be performing routine PSA screening at present. As recommended by Health Canada, the NHS in the UK, and the US Preventive Task Force We'll want to go over the risks and benefits with each patient carefully before they decide whether to have the test or not.
Research continues in this area, and as any fresh information comes to light we will review our advice.
Links:
Health Canada Prostate Cancer page
New England Journal of Medicine Perspective Roundtable: Screening for Prostate Cancer
(Any patient interested in prostate screening should call to make an appointment with one of our Practice Nurses to discuss the test.)
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