Clinic Policies

Your doctor will always try to prescribe enough medication to last until your next appointment. Your doctor will also aim to “line up” long-term medications so that the prescriptions expire at the same time. It is important that your doctor sees you again in clinic before renewing medications, as this is usually at an appropriate interval to re-evaluate your health. Please pay attention to your medications and plan ahead so that you do not run out. Bringing all your medications to your appointment (or list of your medications) is always a good idea. Please note that renewing your medications remotely (i.e. without having you come to clinic) is considered an uninsured service, and as a result, there is a charge for this service.

Please note that your family doctor is an expert in providing primary care services. Referrals to specialists will, of course, be used if deemed appropriate. However, your family doctor may feel that the issue you are presenting with is something that does not require involving a specialist and can instead be managed at our clinic. For example, some patients request a referral to a dermatologist for moles that appear to be quite benign. Your doctor may provide a different plan instead of pursuing a referral right away. We ask to please keep an open mind. Also, some referral cannot be made without doing the initial investigations first, such as bloodwork and imaging. These investigations would provide a more thorough assessment that makes a referral request more complete and would actually expedite the process. It may also uncover issues that need to be dealt with sooner.

Your family doctor will keep same day appointments available in order to ensure you have good access to our clinic. Please note that these appointments are meant for urgent issues only. Please respect your fellow patients by not booking at the last minute for a non-urgent issue.

Your doctor may participate in medical education by supervising medical students or resident physicians. They are members of our health care team and will all be supervised appropriately. You always have the option of declining to be seen by one of these providers; however, these providers are excellent at being thorough and may actually bring a fresh eye to your health concern. As a result, this may be a good opportunity to help these trainees along their medical education journey and also ensure that you are receiving the best possible care.

At Vivo Family Medicine, our philosophy is to provide evidence-based medicine. Your doctor will certainly prescribe antibiotics if deemed appropriate, such as if you are having a skin infection or pneumonia or a UTI. However, antibiotics would not be appropriate for certain infections, and in fact, may actually cause harm such as upset stomach, diarrhea, rash, and possible allergic reaction. For example, the common cold is caused by viruses that cause symptoms of a sore throat, cough, runny nose, and chest congestion. Antibiotics kill bacteria but not viruses and thus do not treat the common cold. Your doctor will prescribe other treatments to help you manage those symptoms. Your doctor will also counsel you on what to expect in terms of recovery and when to return if you are not getting better.

Narcotics such as percocet, oxycodone, hydromorphone, morphine, Tylenol #3, tramadol, etc., are only meant to be used for acute issues (such as severe trauma). When used for long-term periods, these medications have a high risk of side effects. Your doctor may feel that it would be inappropriate to continue taking these medications and, in that case, would not prescribe them. However, if you have already been taking these medications chronically, your doctor may need to taper you off these medications gradually and safely.

If a doctor does prescribe these medications, you will need to sign a contract and participate in regular urine drug testing. Any breach of the contract would result in these medications being reduced, more tightly controlled, or stopped altogether.

The same stipulations apply to two major classes of sedative medications: benzodiazepines (lorazepam, diazepam, oxazepam, etc.) and the “Z-drugs” (zopiclone, zolpidem, etc.). There are significant consequences to long-term use of these medications and the circumstances that warrant this are exceedingly rare. If you are experiencing difficulties with sleep or anxiety, your doctor would be happy to discuss this with you and find another solution.

Medicare covers most, but not all, medical treatments and services. Some common examples of services which are not covered include forms for school, work or insurance purposes, Driver’s Physicals, cosmetic procedures (e.g. skin tag removal, some wart treatments), TB skin testing, and some vaccinations. You are responsible for the payment of these services. We have a list of these services with the pricing for each item. You can ask your Patient Services Representative for a copy.

If a doctor does prescribe these medications, you will need to sign a contract and participate in regular urine drug testing. Any breach of the contract would result in these medications being reduced, more tightly controlled, or stopped altogether.

The same stipulations apply to two major classes of sedative medications: benzodiazepines (lorazepam, diazepam, oxazepam, etc.) and the “Z-drugs” (zopiclone, zolpidem, etc.). There are significant consequences to long-term use of these medications and the circumstances that warrant this are exceedingly rare. If you are experiencing difficulties with sleep or anxiety, your doctor would be happy to discuss this with you and find another solution.

If you have a form to be filled out, please let the staff know when you book your appointment. Please make sure that you fill out all the sections that are “to be filled out by the applicant.” Some forms are quite simple, but others cannot be filled out at the time of the visit. Usually, forms can be filled out within 1-2 weeks, but it depends on the form. Please allow plenty of time for your doctor to complete your forms. In rare occasions, your doctor may feel that further information (such as testing or a specialist opinion) is needed before completing the form.