Patients are requested to have their own family doctor
Functional medicine is complimentary to, but does not replace, the services of a regular family doctor.  Dr. Coombs focuses on the management of complex chronic illnesses, and does not handle acute medical illnesses, acute injuries, or prenatal care, nor does he do routine physicals, well baby care, or immunizations.  For these services a person will need a regular family doctor.

If you wish, copies of progress notes outlining the treatments being undertaken here and copies of laboratory tests can be sent to your family doctor.

Usually at least 4 months notice is required for new appointments, and the appointment must be made by the person (or child's parent) him or herself, not by a third party.  The first interview takes 50 minutes.  The second visit is usually booked for 20 minutes. Subsequent follow-up visits are usually 20-50 minutes long, depending on the complexity of the medical issues being addressed.

Even though they are uninsured services, most people are opting for telephone consultations or e-mail consultations for issues that are straightforward, since this saves them time and travel.

 Missed appointments
Because of the prolonged visit times in this practice, a missed appointment removes a significant portion of the day's schedule.  Therefore, when you are cancelling an appointment, please give at least 2 business days notice for a 50 minute appointment, and at least one business day notice for shorter appointments.  When patients miss appointments without giving adequate notice, and without just cause, their access to further appointments will be limited.

Office hours
Telephones are answered 9:00 AM to 5:00 PM on Monday, Tuesday, Thursday, and office appointments are held 10:00 AM to 4:00 PM on Tuesday and Thursday. Monday is reserved for telephone consultations. The office is closed on Wednesday and weekends.

 Telephone and e-mail inquiries
Because of the large number of calls and e-mail messages handled by the office staff, patients are asked not to contact us about issues that could wait until the next appointment [e.g., calls asking for an opinion on products that Dr. Coombs has not recommended, or questions regarding the health of people who are not his patients]. Sometimes Dr. Coombs specifically requests that you contact the office between appointments to provide follow-up about an issue. In this case, it is helpful to send the details by e-mail or fax. Since incoming e-mails are not always opened and read daily, if a prompt response is required from Dr. Coombs, please follow the e-mail with a telephone call to the office. Please read the disclaimer on the 'Contact' page of this website regarding use of e-mail communication. 

Emergency situations
In emergency situations, you should contact your family doctor, or the closest emergency department for urgent medical care.

Prescription renewals
Prescription renewals are best obtained at the time of an appointment.  If telephoning for a prescription renewal, please leave with the receptionist the name, dose, and amount of medicine that you need refilled, and the name and telephone number of your pharmacy.  Particularly if your call comes late in the day, it may take 1 business day for the pharmacy to be contacted. A charge of $12.00 will be made for prescription renewals made between appointments.

 Filling of forms and medical letters
Short forms can be filled out in the course of a medical visit.  Lengthy forms and medical letters not so covered are charged for on a time basis.

Charges for uninsured services
Not all services are covered by the provincial health plan. Services which are not covered, including telephone and e-mail consultations, are charged for on a time basis, at a rate of $3.13 per minute.

 Confidentiality of medical records
Dr. Coombs uses paper charts, and is not connected to an electronic health network. Dr. Coombs is the only one who reads the files. Sensitive information, if recorded at all, is summarized and encoded in a manner understandable only to Dr. Coombs. Medical records are transferred only at the request of a patient. 

 Transfer of medical records
For transfer of medical records, Dr. Coombs usually has to write a summary letter, selecting from the lengthy medical records those aspects directly related to medical treatment (such as diagnosis, medications, and laboratory results) that will be relevant to the person receiving the records-i.e., family doctor vs. specialist vs. lawyer.  A charge is therefore made for this service on a time basis, plus photocopy charges.

Additional specialized laboratory testing
The provincial health plans pay only for standard laboratory testing.  However, some more specialized laboratory tests not covered by provincial health plans are very valuable in determining the underlying causes of chronic illness.  Dr. Coombs orders such tests only when they are likely to make a difference to the management and outcome of a case.  The patient who decides to have these tests done will have to pay the laboratory directly for these fees, as well as any shipping costs involved.

Notification regarding laboratory results
If Dr. Coombs decides that you be need to be notified regarding significant laboratory results before your follow up appointment, then you will be contacted by telephone or e-mail, and if you cannot be reached, then by ordinary mail. Sometimes he will specifically ask you to call for results of tests before your next appointment. Otherwise, laboratory results which are not urgent (e.g., test results for food sensitivities, and other tests from specialized US laboratories) will not be discussed until the next follow up appointment. If you do want copies of results sent to you before your next appointment, there will be a $12.00 charge for doing this.