How it works and what to expect.

To see the physician, we need a referral from your family doctor, nurse practitioner, or walk-in doctor. Once received, our administrative staff will call you to set up the appointment.

If you are not covered by OHIP, a referral is not necessary. Fees will be consistent with the Ontario Medical Association recommendations.

Gathering of health information and risk assessment: Preferred to be in person, but may be done virtually. We do not do phone appointments. We take a general history and review your medications. We assess for other comorbid medical problems (like diabetes, high blood pressure, high cholestrol). We will ask about your family history and then we will do a focused physical exam, which includes measuring your blood pressure, weight and getting other measurements like your waist circumference. This visit is essentially to assess your risk of developing cardiometabolic disease. Depending on your risk, further testing may be done or requested. For example, an electrocardiogram (ECG), 24 hour blood pressure monitoring, holter monitoring (continuous ECG), exercise stress testing or an echocardiogram (ultrasound of your heart). We may also suggest a liver ultrasound if your risk is sufficiently high.

Super important: Bring all of your medications and supplements with you (or have an accurate list of them)

Nutrition and Mental Health: We get a brief history about your nutrition, sleep, stressors and chat about your mental health as well. If needed, we will refer you to a dietitian and or/psychotherapist, as they are crucial to our program.

Treatment Decision Making: Which approach and what treatment you go for may not be decided at the initial visit, but it often is. It may be lifestyle and medications and/or surgery. The plan is also often dynamic, meaning we may start with one and add or switch to another depending on your progress and preference. We then agree on a follow up interval for reassessment. Follow up appointments are often virtual but can be in person if you prefer, or if the physician requires it.

We generally follow you for roughly a year. When things are stable, we transition you back to your family doctor or nurse practitioner.