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  • About
  • For Patients
    • What is Internal Medicine
    • New Patient Form
    • Current patients
  • For Providers
    • Referral process
    • Accepting Referrals
    • Required referral info
    • Wait times
  • For students
  • Contact Us

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REQUIRED INFORMATION FOR REFERRALS:

FOR ALL REFERRALS, PLEASE INCLUDE THE FOLLOWING:

  1. Referring provider name, billing number, and contact information
  2. Patient demographics including OHIP number
  3. Reason for referral
  4. Urgency of referral (URGENT, SEMI-URGENT, ROUTINE -  CLICK HERE OR SEE BELOW FOR GUIDANCE CHART)
  5. Brief history of presenting illness
  6. Past medical history
  7. Medications
  8. Additional information requested based on reason for referral - CLICK HERE OR SEE BELOW

GUIDANCE ON REFERRAL URGENCY / PRIORITY

ADDITIONAL INFORMAITON REQUESTED BASED ON REFERRAL REASON

Cardiology

Gastroenterology

Pulmonology

Cardiology referrals (All):

Please include reports for prior non-invasive stress test and / or coronary angiography. 


Please also include results of, or consider obtaining, as appropriate: 

  1. Cardiac risk factor labs (Hgb A1C, Lipid panel)
  2. Baseline ECG
  3. Echocardiogram
  4. Chest imaging (Chest x-ray or chest CT) 


Syncope / presyncope / palpitations: Please include reports, or consider obtaining cardiac monitoring.

  • 24-48 hour holter for daily symptoms.
  • 2-14 day holter for every other day to weekly symptoms. 
  • Consider 14 day holter for symptoms that occur every 1-2 weeks.
  • Holter monitoring is low yielf for symptoms occurring less frequently than every 2 weeks.

Pulmonology

Gastroenterology

Pulmonology

Pulmonology referrals (All):

Please include reports for, or consider obtaining:

  1. Pulmonary function test reports
  2. Recent chest imaging (CXR or chest CT). 


For the issues below, please include results of, or consider obtaining:

 

Dyspnea NYD / Pulmonary hypertension:  

  1. PFTs, 
  2. BNP, 
  3. Echocardiogram, 
  4. Sleep study.

Gastroenterology

Gastroenterology

Gastroenterology

GI referrals (All):

Please include reports for prior endoscopy:


For the issues below, please include results of, or consider obtaining: 


Iron deficiency anemia:

  1. CBC with reticulocyte count
  2. Iron indices (Ferritin, transferrin, transferrin saturation).
  3. H Pylori antigen + Celiac panel (Anti-TTG + total IgA)


Chronic diarrhea:

  1. Stool C&S, O&P
  2. H Pylori antigen
  3. Celiac panel (Anti-TTG + total IgA).


Chronic abdominal pain

  1. H Pylori antigen
  2. Celiac panel (Anti-TTG + total IgA)
  3. Abdominal imaging (Abdo / pelvis CT preferrable, otherwise ultrasound) 


Transaminitis / liver synthetic dysfunction NYD:

  1. Liver enzymes (ALT, AST, ALP +/-, GGT)
  2. Liver synthetic indices (Total bilirubin, INR, Albumin, platelet count)
  3. Hepatitis B/C serology
  4. Iron indices (Ferritin / Transferrin / Transferrin saturation)
  5. Ceruloplasmin
  6. Alpha 1 anti-trypsin
  7. Autoimmune panel - ANA, Anti-smooth muscle antibody, anti-mitchondrial antibody
  8. abdominal u/s (including portal vein doppler to rule out thrombus and assessment for radiologic signs of cirrhosis and biliary tract dilation)
  9. Liver elastography - Fibroscan


Unintended weight loss NYD 

  1. Iron indices (Hemoglobin, Ferritin, transferrin, transferrin saturation, reticulocyte count),
  2. Nutrition indices - Albumin / INR / Vitamin B12 level
  3. TSH
  4. CT Chest/abdo/pelvis  

Endocrinology

Endocrinology

Gastroenterology

For the issues below, please include results of, or consider obtaining: 

 

Hyperthyroidism:

  1. TSH
  2. Free T4/T3
  3. Radioactive uptake iodine scan (RAI-U) scan (If no RAI-U scan, please consider Thyroid receptor antibodies (TRAB)).


Calcium disorders

  1. Calcium + albumin OR ionized calcium 
  2. Phosphate (PO4)
  3. Parathyroid hormone (PTH)

GIM / Other

Endocrinology

GIM / Other

 

Stroke prevention:

  1. CVA risk factor labs (Hgb A1C, Lipid panel),
  2. neurovascular imaging with non-contrast computed tomography (NCCT) and including CT angiography (CTA),
  3. echocardiogram.


* Consider obtaining 14 day holter monitor to assess for atrial fibrillation for patients with embolic ischemic stroke or transient ischemic attack of undetermined source whose initial short-term ECG monitoring does not reveal atrial fibrillation, but a cardioembolic mechanism is suspected, and patient the patient is not already receiving anticoagulant therapy and would be a candidate. 

QUESTIONS OR SUGGESTIONS ON ACCEPTING REFERRALS?

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SOUTH MUSKOKA Internal Medicine

1-36 Macdonald Street, Bracebridge, Ontario P1L 1R7, Canada

705-995-5065

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