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29.9.09

Increase the Effectiveness of Your Workouts


There are various fitness tips that can help you to get the most from your workouts. By taking advantage of the knowledge of others, you can dramatically increase the effectiveness of your workouts.

Ironically, many fitness tips are actually common sense, but it's one of the sad facts of exercise field that many people work out in ignorance, following advice that is either outdated or simply wrong.

A classic example of that is hydration - for many years athletes worked out in hot weather without drinking water, in the mistaken belief that this would make them together - as a result many athletes died from heat stroke.

Here are some top fitness tips that can help you get more from your workouts:

  • Work your core muscles first: Many people ignore their core muscles, maybe doing a few sit-ups at the end of their workout, but these muscles are crucial - make sure to work them regularly.
  • Use a Swiss ball or gym ball for your core exercises: Research shows that doing an exercise such as crunches on a ball is up to 60% more effective than doing the same exercise on the floor.
  • Drink water: We all know need we need to drink when working out, but many people now use sports drinks instead of water. However, unless your workouts last more than an hour, stick to water - sports drinks are just extra calories.
  • Intervals are the quickest way to improve your fitness: Interval sessions are more effective than steady paced cardio sessions for burning calories, increasing your metabolism, and burning fat
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What are Stem Cells?

Stem cells are regarded as the 'building blocks' or master cells of the blood and immune system.

Stem Cells are very "clever" and can develop into many different types of cell within the body. They can be seen as a sort of repair system for the body, where a stem cell (or progenitor cell) has the potential to become a new type of cell with a more specialized function, such as a heart muscle cell to repair damaged heart muscle.
Over the past 20 years and in over 20.000 transplantations stem cells have helped treat many life-threatening illnesses by 'repairing' the damaged parts of the body . In addition to the standard medical treatments where cord blood stem cells are routinely used, ongoing research is continuously focused in finding new uses for stem cells. For example, Researchers at Great Ormond Street Hospital (GOSH) and the Institute of Child Health (ICH) have found encouraging evidence that blood-borne stem cells can be used to make lung cells in the body.

Cord blood stem cells ARE NOT the same as embryonic stem cells: they are similar to bone marrow stem cells.
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Are You A Chic Geek? The Latest Gadgets To Lust After


I may be a blogger by trade, but what I know about technology could fit inside my patent leather Miu Miu evening bag (just ask um, anyone on the Glamour staff who was forced to endure my hard drive breakdown last week). But a new line of gadgets from Swarovski and Phillips have me rethinking the phrase "geek chic."

I've seen plenty of sequin-spangled iPod headphones recently, but the latest collaboration between Swarovski and Phillips, called the Active Crystals collection, takes things to a whole new level. This little necklace may look like your average piece of bling, but it's actually a memory stick that can hold up to 2,000 photos or 500 songs.




It also comes in the form of a little bracelet/charm that I'm sure is all the rage in Harajuku.






And finally, who says a Bluetooth headset (talk time, five hours) is only for the Dockers-wearing-40-something-dude-on-the-golf-course? This Swarovski-embellished version is kinda cute, no?





They're all available at swarovski.com and at Saks Fifth Avenue stores. I'm feeling an early holiday gift for your co-worker...
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What is Carlisle Medical Journal?


Carlisle Medical Journal is a very unique, compact, and user friendly medical journal that can be used to assist anyone in organizing and recording their own medical history. The journal is divided into 7 customized sections. Each multi-colored tab contains the title for each section. The contents of the book fits into a three ring customized binder approximately 7" x 6". Simply fill in the blanks to record important information about your family medical tree; doctors and specialist information; medicines used; allergic reactions; appointments; medical test/ results; surgeries and hospital stays; and journaling your thoughts and experiences. Having access to all this information in one centrally located place can be very helpful to take with you each time you visit any doctor. It would also be helpful to a friend or relative during an emergency situation to have all of your medical history contained in one place.
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Healthy Lifestyle

  • Choose healthy food when you go shopping. That will make it so much easier to make healthier choices when you are at home looking for something to eat.
  • Eat a variety of nutritious foods every day. That means more fruit and veggies. Reduce the amount of fatty, salty, sugary, and processed foods.
  • Drink a lot of water. Avoid sugary drinks. Many times, they are high in calories and low in nutritional value.
  • Provide a substantial nutritious snack for your children to tide them over until dinner. This will help them to avoid nibbling or grazing and getting too full for dinner. Soup or a sandwich are great options.
  • Fruit is a great healthy snack. Find a local farmer whom you trust and choose apples and other seasonal fruit.
  • Get your kids involved in what they eat. Give them a range of healthy choices for their lunch box and after-school snacks..
  • Mindless eating can lead to overeating. Sit down, turn off the TV and eat together as a family.
  • Learn to use fresh ingredients and cook good basic meals from scratch.
  • Portion control - that's the name of the game. Watch your portion sizes and don't give children too much on their plate.
  • Make trying new foods fun with your children in order to get them to eat a variety of food.
  • Make healthy food choices the norm. But don't stress out over eating healthily. There is nothing wrong with the occasional biscuit or pizza.
  • Get exercise for at lease 30 minutes each day. That could mean a variety of activities - walking in the park one day, or cycling or jogging the next. Mix it up to keep it interesting.
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28.9.09

10 Essential Health Tips: The Basics to Practice Every Day


1. Move More
Make it a daily challenge to find ways to move your body. Climb stairs if given a choice between that and escalators or elevators. Walk your dog; chase your kids; toss balls with friends, mow the lawn. Anything that moves your limbs is not only a fitness tool, it's a stress buster. Think 'move' in small increments of time. It doesn't have to be an hour in the gym or a 45-minute aerobic dance class or tai chi or kickboxing. But that's great when you're up to it. Meanwhile, move more. Thought for the day: Cha, Cha, Cha…. Then do it!

2. Cut Fat

Avoid the obvious such as fried foods, burgers and other fatty meats (i.e. pork, bacon, ham, salami, ribs and sausage). Dairy products such as cheese, cottage cheese, milk and cream should be eaten in low fat versions. Nuts and sandwich meats, mayonnaise, margarine, butter and sauces should be eaten in limited amounts. Most are available in lower fat versions such as substitute butter, fat free cheeses and mayonnaise. Thought for the day: Lean, mean, fat-burning machine…. Then be one!

3. Quit Smoking

The jury is definitely in on this verdict. Ever since 1960 when the Surgeon General announced that smoking was harmful to your health, Americans have been reducing their use of tobacco products that kill. Just recently, we've seen a surge in smoking in adolescents and teens. Could it be the Hollywood influence? It seems the stars in every movie of late smoke cigarettes. Beware. Warn your children of the false romance or 'tough guy' stance of Hollywood smokers. Thought for the day: Give up just one cigarette…. the next one.

4. Reduce Stress

Easier said than done, stress busters come in many forms. Some techniques recommended by experts are to think positive thoughts. Spend 30 minutes a day doing something you like. (i.e.,Soak in a hot tub; walk on the beach or in a park; read a good book; visit a friend; play with your dog; listen to soothing music; watch a funny movie. Get a massage, a facial or a haircut. Meditate. Count to ten before losing your temper or getting aggravated. Avoid difficult people when possible. Thought for the day: When seeing red, think pink clouds….then float on them.

5. Protect Yourself from Pollution
If you can't live in a smog-free environment, at least avoid smoke-filled rooms, high traffic areas, breathing in highway fumes and exercising near busy thoroughfares. Exercise outside when the smog rating is low. Exercise indoors in air conditioning when air quality is good. Plant lots of shrubbery in your yard. It's a good pollution and dirt from the street deterrent. Thought for the day: 'Smoke gets in your eyes'…and your mouth, and your nose and your lungs as do pollutants….hum the tune daily.

6. Wear Your Seat Belt
Statistics show that seat belts add to longevity and help alleviate potential injuries in car crashes. Thought for the day: Buckle down and buckle up.

7. Floss Your Teeth

Recent studies make a direct connection between longevity and teeth flossing. Nobody knows exactly why. Perhaps it's because people who floss tend to be more health conscious than people who don't? Thought for the day: Floss and be your body's boss.

8. Avoid Excessive Drinking

While recent studies show a glass of wine or one drink a day (two for men) can help protect against heart disease, more than that can cause other health problems such as liver and kidney disease and cancer. Thought for the day: A jug of wine should last a long time.

9. Keep a Positive Mental Outlook

There's a definitive connection between living well and healthfully and having a cheerful outlook on life. Thought for the day: You can't be unhappy when you're smiling or singing.

10. Choose Your Parents Well
The link between genetics and health is a powerful one. But just because one or both of your parents died young in ill health doesn't mean you cannot counteract the genetic pool handed you. Thought for the day: Follow these basic tips for healthy living and you can better control your own destiny.
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27.9.09

What Is Health Information Technology? (2)


Potential Drawbacks to Health IT

Clearly, Health IT has great potential to revolutionize health care. But there are some negatives to establishing this type of national database.

The biggest obstacle to making Health IT a reality is the cost. Even though it has been shown that Health IT could save billions in the long run, there are significant up-front costs. Doctor’s offices and hospitals would have to purchase or upgrade their computer systems to allow for storage of electronic medical records. It would take a significant amount of time and manpower to scan in or manually enter currently existing paper records into the database. Also, medical professionals would have to go through an education process and alter some of their current practice methods to accommodate the new system. This would take time, and time is money.

Another potential drawback to Health IT is patient medical record security. Many consumer groups, including the ACLU, are concerned that maintaining these private records electronically would make it easier for unauthorized persons (i.e. hackers) to access it. As a technophile, I personally don’t think that electronic medical records are any less safe than the paper records kept in my doctors’ offices – if someone really, really wants to find my blood pressure, they’ll find it regardless of what format my records are kept in. Nevertheless, I hope that Health IT system developers do take the ACLU’s concerns to heart and use every possible data security measure to protect patient privacy. I believe that electronic medical records can be safe, but only if we do everything we can to protect them.

In conclusion, Health IT looks very promising. If such a system could be adopted, it could improve the efficiency and quality of health care, reduce health care costs, and completely change the way our health care system works. Overall, the potential benefits outweigh the possible drawbacks.
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I Wore A Bikini (And SPF 70) Yesterday


I haven’t been in a bathing suit all summer, but I got talked into spending the afternoon at the beach with some really cute boys… and an even cuter English bulldog puppy. And it was probably the last gorgeous weekend of the season. How could I pass that up?
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I’m beyond diligent with the sunscreen. I apply it 30 minutes before sun exposure, every hour or so after that and immediately after getting out of the ocean. The boys: Not a single tube of sunscreen among them. (Okay, that’s a stretch, my guy did have one, but he only used it when I nagged him about it.)

Does your man wear SPF? Do you push the issue and try to get him to slather it on when you do? Now that summer’s on it’s way out, do you plan on being less crazy about reapplying? (I don’t.)
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3 Fitness Tips


Busy schedules, tough jobs, family concerns, lazy lifestyles, unhealthy fast foods have resulted in nothing but lazy, unhealthy, unfit people. Life has become so competitive these days that keeping fit is necessary just to be able to get through the day. We are facing an increasing number of heart diseases, irregular blood glucose levels most of which is due to sedentary lifestyles which obviously lead to obesity.

It is time each one of us realizes the growing need of physical exercise. Keeping fit not only ensures good physical health but also psychological and emotional health. Is it proven that a good looking and healthy body in turn increases ones self-esteem and confidence. Here are a few ways to keep fit:

1. Eat right - healthy food is the foundational stone in the construction of a healthy body. Make sure you eat more often, say every 3 hours and see that your diet includes plenty of fruits, water and foods rich in calcium and iron. Make sure you have adequate amounts of all the other required nutrients in your diet too so that you don’t end up with any deficiencies.

2. Exercise regularly - exercise is very important in your efforts to keep fit. Different people prefer different forms of exercise like, playing a sport such as tennis, swimming, athletics, football, basketball and so on while other may prefer yoga, meditation and long walks. When you play a sport, make sure you play it right. Proper technique plays a very important role in staying safe and avoiding injury. Every player should follow the basic three steps of any sport – warm up drill, game time and cool down drill.

3. Reduce stress - At the present times, according to medical studies, stress reduces physical and mental health of an individual while increasing the chances of various systemic diseases. No doubt, jobs are often stressful with cut-throat competition and deadlines that one can barely meet, but that should not be your excuse. Health is the most precious form of wealth that one could ever posses. There are many ways to reduce stress levels. Physical activity, mediation, breathing exercises, massages, talking to your kids and pets, etc, are some of them. Some would also turn to soothing music, while others would just take a little nap to clear their head.
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Creams & Lotions Tips


If use of cosmetics is any indication of vanity, there's plenty to go around. Stores are full of products to beautify the body, including skin, hair, nails and lips. Creams, toiletries, and makeup designed to change or camouflage are all examples of cosmetics.

Today, cosmetics are not only acceptable, they're standard procedure for most women. How they're used and applied is what separates those who look silly from those who look beautiful and sophisticated. We'll outline some cosmetics tips to help you bring out your best features while concealing your flaws.

Creams & Lotions

Think of your skin as a canvas. The better the canvas, the better the art, no? There's no denying that genes play a crucial role in your overall appearance, but skin care early on in life will definitely give you the edge when it comes to texture, lines and spots when you hit your thirties and beyond.

Body lotions add comfort to dry skin while adding luster. Hands are often exposed to sunlight and may show age much quicker. We don't always pay attention to our hands but others do. Keep your hands soft and silky by using hand lotion multiple times every day, particularly after washing them and before bed.

In pre-teen and teen years it's important to keep skin clean and as clear as possible from blemishes to prevent scarring. Combination skin calls for treating problem areas accordingly. As we age, our skin loses its moisture and elasticity. There are various facial creams on the market today to add much-needed moisture to our faces and reduce fine lines and wrinkles -- thus improving our "canvas."
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26.9.09

What Is Health Information Technology? (1)


Health Information Technology is a term that is often used interchangeably with “electronic medical records”. It is a system where medical professionals store the information usually contained in a patient chart on a computer, rather than on paper.

How Can Health Information Technology Be Used?

Health Information Technology, or Health IT, can be used to improve the efficiency and quality of health care that patients receive. Many people have health conditions that require them to visit several different doctors. For example, I have a primary care physician, and also regularly visit an Ear, Nose & Throat specialist for my sinus and allergy concerns. With Health IT, both of my doctors would have access to my complete treatment chart, so each could see what the other was doing and would not duplicate their efforts. The chances of one doctor prescribing a drug that would interact unfavorably with a drug that the other prescribed would be virtually nil. And if I were to get in an accident and end up in an emergency room, the hospital would also be able to access my medical records, so they could treat me more rapidly and effectively.

Because Health IT would be a national database system that is interlinked and regularly backed up, patient records would be safe even in the face of natural disasters like Hurricanes Katrina and Rita. Many crucial medical records were lost in these terrible storms because they were kept on paper that was destroyed in the flooding. Also, people who become ill while traveling would not have to suffer because the hospital in Honolulu cannot reach their primary care physician in Tuscaloosa. Their patient records would be available and instantly transmittable electronically.

Health insurance information could also be linked to Health IT records. Imagine walking into a doctor’s office and not having to fill out 17 gazillion insurance forms. With a swipe of a card, your medical records and health insurance information would be instantly transmitted to the provider. This would make your life easier, and it would help your doctor’s administrative staff – they would immediately know which procedures your insurance policy covers and what your copay would be.

Health IT also has great potential to reduce health care costs. A recent study by the Rand Institute estimates that if 90% of all health care providers adopted Health IT, potential savings could average over $77 billion per year. An effective Health IT system would cut costs by reducing the duration of hospital stays, the amount of time that nurses spend performing administrative tasks, and drug and radiology usage.
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Cosmetics Daily Tips


If you want to find some great cosmetic tips, then check out our make-up section for just some of th etricks of the trade. If you want to look like you just stepped off the pages of a magazine, then the benefits of some cosmetic tips and tricks will leave you with beautiful subtle make-up.

It's not as difficult to achieve as you might think it is. Forget about the benefits of cosmetic surgery, the right products can work wonders with no pain at all. You are bound to know some of them - but bet there's some you don't!

The cosmetic tips and tricks that can help accentuate your features (without looking overly 'made up') are usually very quick and simple and backed up by professional makeup artists in all the hot fashion centres; from New York to Paris, to Milan to here at home in London. A little education in the tips and tricks of the professional makeup artists from salons to film sets can help you to look glamourous too! Read on for the benefits of cosmetic tips and tricks that can transform you!

  • Use a light hand with foundation. The secret to foundation is to use it to even out your skin tone, which means adding it to cover up discolorations or uneven colouring. Your real skin should show through in several places, giving you an authentic glow. If you slather foundation indiscriminately all over your face and neck you'll get a 'flat' look where your face doesn't seem to reflect any light. Also, it will be very apparent that your 'flawless' complexion comes from a bottle.
  • Choose your make up shades to flatter your skin tones, not simply because the colour is fashionable. Make up is meant to make you look beautiful. When choosing colours look at your own skin's under tones. Pinky complexions should steer clear of make up shades with yellow undertones. Yellow undertones look brilliant on olive skin, but tend to make pale skin with pink or blue undertones look sickly.
  • The best make up application flatters the woman, not the make up. In applying your make up, use a light hand. Follow the natural contours of your face, and apply dark colours to deepen existing shadows and lighter colours to enhance natural highlights. Make it your goal to look like you barely wear any make up. It's a much bigger compliment if someone says "you've got lovely eyelashes" than "I like your mascara".
  • After applying lipstick, a touch of gloss on your lower lip will make even thin lips seem full and kissable.
  • Blusher should be applied across the cheekbone leading up into the hairline, not all over your cheeks or in a round circle.

Use these pointers to achieve a beautiful, natural look!
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25.9.09

8 Secrets for Staying Healthy on the Road


There are plenty of reasons that traveling can sabotage your health. From being exposed to germ-infested airline seats to restaurant meals that are overloaded with calories, it can seem like there’s no escaping the on-the-road potholes that leave you run-down and that can make you fat. But turns out, with a few smart strategies, you can return from your trip feeling better than when you left. Whether you’re traveling for business or pleasure, here are eight ways to stay healthy and fit while you’re away from home.

1. Don’t catch someone else’s bug. Many surfaces in hotel rooms, including the phone, may be contaminated with the cold virus, according to a University of Virginia study. After 15 people with colds spent one night in a hotel, the researchers swabbed everything the congested guests had touched and found the rhinovirus residing on 35 percent of room surfaces. And although the germ count was conducted before housekeeping came knocking, the hot spots—light switches, the phone, and the TV remote—are often only dusted. That’s important, because “a person’s cold virus can linger on surfaces for at least another day,” says researcher Owen Hendley, M.D. Pack a travel can of Lysol spray and annihilate the virus when you arrive.

Extra tip: Watch out for these 10 surprising places (and people) bacteria clings to.
2. Take cover (with you). Chances are, seat selection won’t improve your odds of surviving a plane crash. (Although a seat near an exit could help in a fire.) You can, however, make your plane seat safer by using a personal cover. Plane Sheets, in both washable and disposable forms, block germs deposited on the headrest or cushions by the thousands of passengers who previously sat in 12A.

3. Check your fluids. A jet cabin’s air can be dry as the Sahara—as low as 5 percent humidity, according to aircraft manufacturer Boeing. This can lead to excessive nasal dryness, which can trigger tearing of mucous membranes and facilitate infection. For your nostrils, pack an over-the-counter saline gel, like Ayr. To keep your skin hydrated, drink 20 ounces of water while you’re in flight, says travel-medicine specialist Terri Rock, M.D.

Extra tip: It’s easy to feel bloated when you fly, so steer clear of these 20 sodium-packed foods to avoid in-flight discomfort.

4. Forget about the menu. At restaurants, determine your order before you even see the options. "Most people choose with their eyes and not with their heads," says Christopher Mohr, Ph.D., R.D., a personal nutrition consultant in Louisville, Kentucky. At dinner, for example, you should decide that you're ordering a salad as your appetizer, and steak, chicken, or fish with the vegetable of the day for your entrée.

Extra tip: Ditch the free bread, and anything on the list of America’s 10 worst appetizers, sides, and starters.

5. Manage temptation. When reserving a room at a major hotel, ask for your minifridge to be stocked for a diabetic. "This is a frequent request, and most hotels oblige by swapping out high-sugar junk foods for milk, cheese, vegetables, diet soda, and fruit," says Cynthia Finley, R.D., a clinical dietician at the Johns Hopkins Weight Management Center. The downside? Don't expect a break from the normal in-room price-gouging.

Extra tip: Save money and calories andpack your own arsenal withthis list of the 15 best snacks with 100 calories or less.
6. Keep your laptop on the desk. "If you work in bed, the bed becomes associated with being awake and active, not sleep and relaxation," says Mark Rosekind, Ph.D., president of Alertness Solutions and a former sleep scientist at NASA. Why is that so important? Because people average 2 to 3 fewer hours of sleep when they travel for business. Not only is that bad for your health, it’s bad for your belly. This disturbance in your internal clock decreases your levels of leptin, a hormone that delivers feelings of satiation, and increases grehlin, a hormone that sparks hunger. "The net effect is that your appetite increases by 23 percent," says Rosekind.

Extra tip: For more simple ways to improve your life, use these 100 perfect fitness training tips—small gems that make a huge difference.

7. Invite a new client to dinner. In a recent study, researchers at the State University of New York at Buffalo observed that men downed 35 percent fewer calories when eating with strangers as when breaking bread with friends. If you're eating alone in your room, don't rely on your television for company. University of Massachusetts scientists found that people who watch TV during a meal consume, on average, 288 more calories than those who eat with the boob tube off.

8. Download a pedometer. Enter your location, and this Google feature—found at gmap-pedometer.com—allows you to design running routes, complete with mileage on its high-tech satellite maps. So you can get your 3-mile walk or run in anywhere.
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21.9.09

Sugaring hair removal

Have you thought about sugaring hair removal instead of the rather more usual waxing treatments? Sugaring is an age old practice that first came into being in Persia and has been around for 1000's of years.

The practice of sugaring hair removal is very similar to waxing, but it has several key differences that may help you make the decision of whether it's for you.

Firstly, this practice uses a sugar solution often made of sugar, water and lemon juice, instead of the standard wax. There are two different procedures for applying the solution.

The first procedure is very similar to waxing in that the solution is applied with a spatula or wooden applicator stick, and then pieces of muslin or linen are applied to the area with the solution and then removed quickly, pulling the hairs out by the roots. The second procedure involves making a large, sticky ball out of the solution and rolling the ball quickly over the area in the direction of hair growth, thus removing hairs.

People who prefer this procedure to waxing feel that it has several key advantages. They are as follows:

  • The procedure tends to hurt less as the solution isn't as hot, and only sticks to the hairs, and not the skin
  • Since the hairs are removed in the direction of growth rather than against it, there is more chance of getting the hair by its root, and less chance of breakage
  • The ball method is more hygienic than traditional waxing because the solution is not shared between people
  • When it comes to the clean up, it's easier because the excess solution simply washes away with warm water

If you're interested in trying the procedure, why not make an appointment at your local beauty salons?
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20.6.09

Inability to Consent Due to Incapacity

A determination of incapacity with respect to the consent
to collection, use or disclosure of personal health
information may be different from a determination of
incapacity with respect to consenting to health care
under the Health Care Consent Act, 1996.
With respect to substitute consent in the case of an
incapable patient, physicians should consult section
23 of PHIPA to determine who may be capable of giving,
withholding or withdrawing consent.

Patient Access to Records

Generally speaking, all information contained in the
record must be released to patients upon request,
including letters from consultants, even when such
letters are stamped or indicated as confidential documents.
However, in very limited circumstances, physicians
can use their discretion and refuse to provide
patients with access to their records. Physicians should
consult section 52 of PHIPA for a comprehensive list
of such circumstances. Examples include situations
where the information was collected for use in a proceeding
(e.g., a proceeding in a Court or before a
committee of the College), or where granting access
could reasonably be expected to result in a risk of serious
bodily harm.
Physicians cannot refuse to grant a patient access to their
records for the purpose of avoiding a legal proceeding.
If a physician has refused a patient access to his or her
medical record, the patient has the right to challenge
the physician’s decision in Court under subsection
54(8) of PHIPA.
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30.5.09

CONFIDENTIALITY

In most cases, it is professional misconduct to give
information concerning the condition of a patient or
any services rendered to a patient to any other person
except with the consent of the patient.18 However,
there are some instances in which physicians are able
to, or are required to, disclose personal health information
without patient consent. Examples of these situations
are included below. For further detail, physicians
should consult the College’s Confidentialty of Personal
Health Information policy.

Withdrawal of Consent and Conditional
Consent
Physicians should be aware that patients are entitled to
withdraw their consent to the disclosure of their personal
health information. While this withdrawal will
not affect disclosures made prior to the withdrawal, it
will apply to any disclosures made after the withdrawal.
Physicians should exercise care and caution when disclosing
personal health information, once the patient
has withdrawn his or her consent regarding disclosure.
There may be some situations in which patients will
give their consent to the collection, use or disclosure
of their personal health information, but will impose
conditions or restrictions on the manner in which
their information is used or disclosed. Where patients
wish to give conditional consent, physicians should
ask patients to set out any and all restrictions in writing.
No restriction or condition imposed by a patient
shall prevent physicians from recording information
that is required by law, by standards of professional
practice, or by standards of instititutional practice.
The physician disclosing the record must indicate on
the record that clinically relevant information is missing
from it.
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27.5.09

Patient Requests Transfer

If a patient requests that a physician transfer his or her
records, the transfer should take place in a timely fashion.
The physician may charge the patient a reasonable
fee to reflect the cost of the materials used, the time
required to prepare the material and the direct cost of
sending the material to the requesting physician.12
Prepayment of the fee for a transfer of medical records
may only be requested when, in the best judgment of
the treating physician, the patient’s health and safety
will not be put at risk if the records are not transferred.
In some circumstances, it will be desirable for the
transferring physician to prepare a summary of the
records rather than to provide a copy of the whole
record. This is acceptable to the College as long as it is
acceptable to the receiving physician and the patient.
The physician is still obligated to retain the original
record, in its entirety, for the time period required by
regulation.
The obligation to pay the account rests with the
patient or with the third party who has requested the
records. Fulfilling such a request is an uninsured service
and reasonable attempts may be made on the part
of the physician to collect the fee.
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15.5.09

PROCEDURAL MEDICINE

Consultation requests should include:
• Reasons for referral;
• Urgency of the consultation;
• Relevant medical history;
• Current medications;
• All relevant test and procedure results.
For billing purposes, it is not necessary for the referring
physician to retain a copy of the referral note but
the College recommends that he or she do so – both
in order to maintain a record of the date and nature
of the referral and as part of the ongoing record of the
patient’s story.

Consultants’ Records

A consultant’s records should follow the same guidelines
as those outlined above under the heading
“Progress Notes.” In addition, the consultant should
ensure that the record indicates who is the most
responsible physician for the purposes of providing
follow-up or ongoing care.
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27.4.09

Patients with Chronic Conditions

For patients with chronic conditions, such as diabetes
mellitus, it is often useful to have flow sheets that
allow the physician to record important clinical information
about the patient’s management over long
periods of time. Flow sheets permit the physician to
see trends that enhance his or her ability to identify
the appropriate treatment. Flow sheets will, of necessity,
deal only with one disease. The CPP and the
progress notes will be the principal information used
to ensure comprehensive care.
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General Assessments

The general assessment is a comprehensive examination
conducted to establish a diagnosis, ascertain target
organ involvement, and develop an investigative
and treatment plan for a specific medical condition.
The physical examination should include all body
parts and systems relevant to the condition at issue
(e.g., if the presenting problem is chest pain, the
physician would examine the body parts that might
be involved, but might not conduct a pelvic or rectal
examination).
This type of encounter should be recorded as a general
assessment. Again, the CPP should be used to
review and update the patient’s medical history, family
and social history, ongoing health concerns or problem
list, immunizations, allergies, and medications.
The record of the visit should reflect all of the elements
of the physical examination.
[ ... ]
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