General information

• Dr Lindenberg is passionately involved with all her patients and appreciates feedback about the patients she is treating.
• Please include a recent photograph of your child when reporting about a child.
• Due to time constraints we encourage patients to rather schedule appointments to discuss health matters, rather than requesting treatment or actions via e-mail or telephone. Short questions and certain feedback can be handled on e-mail, but complicated discussions should be done in allocated time slots.
• Dr Lindenberg needs to see the patients in her chronic care at least once every 6 months.

Time allocation

• While it is very challenging to assess the amount of time required for a consultation, dr Lindenberg has tried to be as accommodating as possible by scheduling very long consultations. We have found that we need approximately 90 minutes to get to know a patient during a first visit.
• If we see a patient regularly, follow-ups can be as short as 30 minutes, but if a long period of time has gone by, a longer consultation of an hour is necessary.
• To discuss test results can take 15 minutes long, if there are no discussions about further outcomes.
• Some patients have the need for longer discussions or have more complicated problems. At the practice it is not always possible for us to be aware of this before the consultation, which leads to consultations running over time. As a courtesy to other patients and all concerned, we would like to request that we keep consultations within our time boundaries.

Follow-up

The first follow-up should ideally take place 2 months after the initial consultation and once the requested test results have been received. That would be the opportunity to discuss the outcome of initial treatment options and to discuss therapy in more depth. In the case of established chronic medication 6 monthly follow-up is mandatory according to good clinical practice principles (and prescribed by law for health professionals).

Reports and forms

Reports take further time outside consultation and will be charged. The filling in of forms for tax purposes, medical aid claims and motivations will also require time and will need to be billed.

Repeat prescriptions

Certain prescription medications are highly scheduled and strict assessment and monitoring is necessary. We have a standard operating procedure in place for the requesting of repeat prescriptions, so please enquire form the practice staff when this is necessary. The issue of prescriptions is charged at a standard rate.

Ordering of supplements

This practice is registered as a dispensing practice for supplements, and herbal medicines. You are welcome to make use of this facility. We stock most of the products that we trust and use in practice. We are able to send products to patients in South Africa via local courier companies. A lot of the products are also available at health stores, pharmacies and occasional wholesalers, where our patients and parents can purchase them.

Quality control on complimentary medicines and supplements is not fully functional in South Africa at this stage, so please make sure that you use a good quality and comparable product to that which has been prescribed to ensure optimal outcome.

Tests

Dr Lindenberg prefers not to do unnecessary testing, so testing is individually based and requested after assessment only. Our philosophy is to only do a test if clinically indicated, and if the results will change the mode of therapy. The following tests are the most common ones that may be requested:

• Blood tests at a Pathology laboratory

We mostly refer children to have the tests done at the labs, as dr Lindenberg does not like to alienate the children by performing the procedure at the practice. We encourage parents of young children to request a script for Emla (local anaesthetic), which can be applied 1 hour before the procedure. Dr Lindenberg will fill in a request form that has to go to the lab. The results usually reach us within a few days. Dr Lindenberg sends an e-mail to confirm the interpretation of the results. If further discussion is necessary a consultation – either in person or telephonic could be arranged.

• Urine tests, for Organic Acids/Metabolic Profile or Amino acids – or Neurotransmitter assessment – will most likely be sent to a lab abroad. These results reach us within a few weeks. Patients are requested on the lab form to indicate if the payment should be deducted from dr Lindenberg’s account or if they are going to pay themselves: if the choice is made that dr Lindenberg’s practice is going to pay for the test, please let Loraine know by e-mail, and also indicate which test had been requested and when it had been sent. We will bill you and payment has to be made before the results can be discussed. These results need to be discussed in consultation (telephonic or physical) as the results need to be correlated with certain clinical presentations and treatment options need to be discussed. We will need 30-60 minutes to discuss these tests.

• Urine challenge tests for the assessment of heavy metal toxicity, when applicable – will be done at a local pathology lab. They subcontract the test, so the results take over a month to reach us. Dr

Lindenberg will normally let the patient know once we receive the results.

• Stool analysis: different labs are used for different reasons and at different costs. Results need to be discussed (telephonic or physical consultation), but if no abnormalities are found an e-mail will be sent to the patient or parent. To discuss these results we mostly need 15-30 minutes.

• Personal genomic profile: these tests are individualised and can be done on blood or a saliva specimen. Different labs are used. Results take a few weeks to reach us and the results need to be discussed during consultation (telephonic or physical): an hour will be necessary.

• Further testing will be dependent on specific cases.