Palliative Medicine Referral
PLEASE READ COMPLETELY AND FOLLOW INSTRUCTIONS
Effective April 22, 2013, Dr. Maida’s work in Palliative Medicine and Wound Management have been both designated as “Focused Practices” by the OMA and MOHLTC. Therefore, referring doctors will NOT experience penalties or claw-backs to their “Access Bonuses” by referring patients to Dr. Maida.
- Requires referral from MD
- PLEASE DO NOT FAX MORE THAN 5 Pages in total!!!!!!!!!!!!!!!!!!!!
- Please fax referral form + supporting documents to 416-747-3618 or 905-605-3178
- Please specify if patient requires home consultation or palliative care unit admission
- Patient must reside within the catchment area of the Etobicoke General Hospital (north of Eglinton Avenue, south of Major Mackenzie Drive, west of Weston Road, and east of Highway 50)
- Please specify the patient’s goals & objectives of care as this will determine the level of involvement in the case (consultative vs. MRP). For example, if the patient wishes active/aggressive medical micromanagement, the referring MD and/or family physician should remain the MRP while Dr. Maida operates in a consultative role for conservative pain and symptom management. Should patient wish a completely conservative palliative approach (aka “comfort measures only”) Dr. Maida will then become the MRP.
- Dr. Maida works in an interprofessional collaboration model of care. As such, he does not schedule routine visits on community patients. He relies on liaison from visiting community nurses to determine when his reassessments are indicated.
- The referring physician must agree to relinquish their ability to bill code G512 after the patient is seen by Dr. Maida.
- Download Referral Form Below: