Patient Services

My practice provides gastroenterology services covered by OHIP, which includes diagnostic and therapeutic services, including reports to referring physicians and copies to other involved specialists.

Procedures include gastroscopy, sigmoidoscopy, colonoscopy, removal of polyps, treatment of gastrointestinal bleeding, and ERCP (endoscopy of the biliary tree and pancreas - including but not limited to treatment of benign and malignant obstruction of the bile ducts). I previously performed EUS, but this service is now provided at RVH by Dr Kyle Fortinsky.

Some reports and requests for information (such as to insurance companies, lawyers etc) are not covered by OHIP, and these may require discussion of fees as defined and laid out by OMA (Ontario Medical Association).

We have to charge for cancellations, without adequate notice, or no-show's.  This policy is approved by OMA and CPSO.

 

JULY 24TH, 2022 - CONCERNING MEDEO:

Over the past 18-24 months, we have introduced Medeo messaging, to facilitate communication, mostly from Dr. Lalor to his patients, but also providing the opportunity for his patients to contact him directly.  Unfortunately, the system, which is provided at our experience to improve patient care, is somewhat limited and we cannot "turn it off" temporarily, such as with vacations or office closure, and the secretary/office staff does not have direct access to all the messages.  We understand that many physicians in the community do not activate, or "turn on", the option for the patient to respond or reach out to the physician.

For this reason, we need you to understand:

If you have reached out to Dr. Lalor through Medeo, and he is not responding, please understand that he may be either on-call in the hospital, temporarily too busy, or away, and the office might be closed.  You will need to contact the office staff by telephone, and please tell them that you have sent a Medeo message.  Alternatively, you can speak to your PCP with that question, to see whether he/she can answer the question or help you, and as you know, they do receive detailed letters from Dr. Lalor.

We think the benefits of Medeo outweigh the disadvantages, but we are concerned if you use Medeo, especially for anything urgent, and you do not hear back.  Please seek alternative methods for getting the appropriate health information or medical advice.

EMAIL POLICY (AND ESPECIALLY CONCERNING IBD FLARES OR QUESTIONS)

Lately we have had an increasing number of patients contacting us by email with important medical information.  This can include symptoms, new or pre-existing conditions, reactions to medications or details about disease flare.

Our email system is not secure, and we do not have the capacity to process these emails.  The College of Physicians and Surgeons of Ontario and the Canadian Medical Protective Association strongly recommend against email with patients, unless a variety of safeguards are in place.

Dr Lalor asks many patients, and continues to do so, to call us and leave a message to update us about how things are going.

1) This message needs to be by telephone, and if it is brief, it can be voicemail, but if it is at all detailed, you will need to speak to a member of the office staff.

2) In most cases, we need to know just one thing: better, worse, or the same.  We will respond appropriately, although often this may involve a recommendation for you to go to the primary care practitioner or to the ER department.

3) If you are calling to report a flare, especially in IBD, you need to have read the "flare documents", on this website, under health information, under inflammatory bowel disease.  The definition of a flare is provided there.

4) The "flare documents" describe clearly that you will need to see a  PCP ie a primary care practitioner (nurse practitioner or family doctor), or go to a walk-in clinic or an emergency department, to be assessed, to provide blood work and if there is diarrhea, a stool sample (for C. difficile), before we can do anything.

5) Whether you have been advised by a PCP to call our office, or not, and we have not received the blood work or the stool culture, or any direct communication from the PCP, we will be unable to help you.  Dr. Lalor or one of his gastroenterology colleagues is available, 24 hours a day, to any PCP, and especially to the emergency room physicians at RVH, and other hospitals in Ontario.  An on-call gastroenterologist is happy to advise, but all patients with an IBD flare need medical assessment, the blood test, and the stool test, otherwise there is a serious risk of deterioration and potentially hospitalization and/or surgery.

We hope this helps you understand the office process and get you the appropriate advice and treatment more quickly.