Personalized 
Functional & Integrative 
Clinic FAQs
Dr Cindy de Villiers
Why should I see Dr Cindy de Villiers and Rose Middleton MN?
As patients we are often told to “live with it.” It being chronic problems for which mainstream medicine has no real answers except a pill for the rest of our life, which we have to take to suppress our symptoms. While there is seldom a single reason for a particular problem, by piecing together parts of the puzzle which may be adding to our state, we may lead ourselves down the path of health.  A registered Functional & Integrative medical doctor is qualified and experienced to guide you towards this path.

Dr Cindy de Villiers & Rose Middleton provide the flexibility and independence of a Natural Health Practitioner without losing the rigour, capabilities and oversight of an experienced Registered Medical Doctor & Nurse.

The private clinic isn't subsidized by govt capitation funding and doesn't profit from the sale of supplements in order to maintain independence of advice, so the service being purchased is Independent Personalized Registered Medical advice.
Why Independent Personalized Registered Medical advice?
The clinic's purpose is to increase quality of life while appropriately decreasing reliance on pharmaceuticals. 

As one example, a well known and promoted drug has a much acclaimed 30-50% benefit for reducing heart risk, which sounds impressive.  In real terms, it means only 1% of those taking it will gain any benefit despite many encountering significant unpleasant side-effects.  

Nonetheless registered Medical Doctors have extended access to Research, Training and Capabilities.

Independent Personalized Registered Functional Medical Advice matters when patients wish to collaborate in making informed health choices.  
What is Personalized Functional & Integrative Medicine?
By New Zealand legal definition, your appointments with Dr Cindy de Villiers are for a Complementary and Alternative Medicine (CAM) consultation. CAM is also known as “Nutritional & Environmental Medicine” and “Functional & Integrative Medicine”.

For more information about CAM, refer MCNZ Doctors and CAM

Health Function provides Complementary Medical care that does not take the place of usual GP medical care. Health Function does not provide General Practice services.  Patients are expected to continue enrolment with their GP. Health Function does not provide govt funded acute or emergency medical care. 

 Patients see Dr Cindy de Villiers at Health Function to investigate in depth a chronic medical condition or to optimize energy and performance.

Dr Cindy de Villiers is post graduate FACNEM qualified and specializes in the treatment of thyroid and auto-immune and other chronic medical conditions.
Lots of people advertise online as doctors.  Is Dr Cindy de Villiers a genuinely qualified and registered medical doctor in NZ/Australia?
It's easy to tell.  Genuinely qualified and registered medical doctors in NZ and Australia are listed with MCNZ and AHPRA respectively.    
Is Dr Cindy de Villiers a Natural Health Practitioner?
A Natural Health Practitioner and a Registered Functional Doctor are different e.g. a registered FACNEM qualified doctor has a minimum 11 years of formal tertiary and postgraduate medical training and has access to a wider medical toolkit. 
What was Dr Cindy de Villiers' journey to specializing in the Personalized Functional & Integrative medical approach?
"In the early days, I was brought up in an environment where food was considered important for health and at Med School in the early 90s, I was inspired to do my research project in homeopathy.
Then while practicing as a GP in NZ in the late 90s and trying to find a way to add value to patients, I stumbled upon Mike Cushman.  Mike founded Pharmaceutical Compounding (CompoundLabs) and ran an educational series for GPs, which introduced me to bio-identical hormone replacement and a whole new world.  The well known Dr Tessa Jones was also one of the speakers at the same educational series and I would later do some locum-ing for Tessa.
In early 2000 a family member had a personal health crisis, which eventually turned out to be mercury poisoning.  The mainstream medical toolkit on its own was inadequate to deal with the presenting symptoms, which led me to delve into aspects beyond the pharmaceutical approach.
Then in the early 2000s, Professor Ian Brighthope of ACNEM was instrumental in opening up the world of Nutritional and Environmental Medicine and re-igniting my belief in the value that could be added by medicine.
I've been supported along the way by progressive companies like FxMed and CompoundLabs as well as leaders in their field like Dr Tim Ewer."
Will the clinic be a good fit for me?
The clinic is likely a good fit for those with significant chronic condition medical need, who want and are able to make changes.
 
Are you passionate about getting well and ready to make appropriate lifestyle, diet, medication, supplement and exercise changes?

Do you feel you have the courage and willingness to take the next step towards wellness? 

Are you interested in "Eat fresh, local, seasonal whole food produce according to your cultural beliefs & environment, reducing sugar & processed 'food'"? (credit Dr Gary Fettke) 

Once a plan is agreed with your doctor and nurse, are you able to commit to the plan?
 
If the answer to these questions is no but you are interested, have a think what next step you might be able to take to answer yes.
When might the clinic not be a good fit for me?
- Those who are pregnant should best wait until after birth to visit Dr Cindy de Villiers, as she is unable to institute the full program during pregnancy.
- Those who need WINZ forms completed should see their GP or after-hours, who are funded and staffed and have the electronic forms to cater for urgent needs.
- Those who wish a formal documented medical legal opinion.  The clinic no longer provides a service to document medical legal opinions.
- Those who are unable to use the online Patient Portal on a smartphone, tablet or laptop for messaging and appointments.  While we do our best to help those unable to use online resources, the clinic's cost structure and collaborative vision are geared to the use of the Patient Portal.
- Due to WIFI, the clinical environment is unsuitable for those with EMF/EMR sensitivity.  
- The clinic isn't a good fit for those not interested in getting well and staying well.  For prospective patients where self-worth, social status or financial security may be linked to illness, it is best to carefully consider whether to proceed.
Will it work?
While Dr Cindy de Villiers is a gateway to the latest medical research and capabilities for Thyroid/Autoimmune and other chronic conditions, the question of whether treatment will work is largely up to the individual patient.  There are no guarantees in health and largely "you get out what you put in".

For a rule of thumb from observation:
- About 7/10 patients will respond well to treatment within the first 1-3 months.  It's difficult to be exact, because the clinic often doesn't hear from patients who feel well for a year or more.
- A shade less than 3/10 will take longer to respond, either because complex requirements take time to unravel and/or patients for a variety of reasons are unable to follow the agreed wellness plan arising from the initial consultation.
- 0.005% of patients in 2018 weren't able to be helped.  We expect this percentage to drop as the clinic tunes its induction processes towards where it can provide the most impact.
Will I be listened to, or will I be fobbed off and ridiculed?
A number of patients finish consult quite emotional to have it confirmed for the first time that their symptoms are not all in their head.  Patients say "Cindy looks at things in a different way and that's what I want".
Is it OK if I have a specific treatment in mind that I wish Dr Cindy de Villiers to consider?
Dr Cindy de Villiers is happy to explore all treatment options on a time and materials basis. 
Don't registered doctors just get me to pop pills or undertake surgery with little long term evidence of benefit?
Internationally there are signs that governments and the medical industry are looking in the mirror for why the public is losing some confidence in mainstream medical institutions, despite the hard work of those in the field.  The recent decision by AHPRA with respect to Dr Gary Fettke is both an interesting story and heartening for doctors and patients alike.  The Functional & Integrative approach is one response by experienced registered medical doctors looking to treat chronic conditions successfully without having their hands tied behind their backs.
How do Lab, Blood & Functional Tests work?
Lab, Blood & Functional Tests are important to understand underlying causes and to avoid treatments merely suppressing symptoms.  

Functional Lab Tests differ from Standard Lab Tests in that they provide information on functionality rather than pathology e.g. how well you are using food for energy as opposed to measuring your blood glucose level.

A registered medical doctor is held responsible by the Medical Council for ensuring that lab tests are appropriate and that results are acted upon.  Consequently, lab tests may ONLY be requested by Dr Cindy de Villiers at a consult in conjunction with a follow-up consult.

Reasons why you may wish to get test kits from a registered Functional & Integrative medical doctor include:
- formal qualifications to provide advice as to whether a test is relevant and the best option
- access to all tests including registered-doctor-only tests
- formal qualifications for interpretation to fully understand the complex physiological pathways
- the full intervention toolkit, including alternative supplements/nutrition/lifestyle and mainstream prescriptions/referrals.
- a professional medical Patient Portal (not a re-purposed salon booking app), where you can securely collate and access all your lab results alongside your medical history  

Lab tests range in cost and the consultation can prioritize according to budget and effectiveness which tests will be beneficial, which ones you should start with and which ones you might budget for later.
What about Supplements?
A functional doctor will evaluate your unique nature and nurture and propose the most effective and appropriate supplements as one spoke in a wheel of an overall plan of treatment, leading to fewer more effective supplements, which are better suited to individual circumstances. 

Tried a supplement that was ineffective?  Without a personalized plan, there are likely to be adverse supplement/medication/lifestyle interactions that often impact upon supplement effectiveness.  The complexity with regards to mass marketing of supplements leads to many contradictory messages from quoted scientific papers and media headlines.  While there's no such thing as a magic bullet that works for all people all the time, personalized use of supplements shows good results. 

Dr Cindy de Villiers uses supplements either to address a deficiency or therapeutically to aid recovery. The trick for effectively using supplements is only using the ones your individual system will benefit from and then choosing the most effective brand. There's a wide range of quality and effectiveness for the same supplement depending upon brand.  Information around effectiveness is constantly being updated and hence the brands that Dr Cindy de Villiers recommends will change if there's one that turns out to be more effective for a reasonable price. The clinic recommends the brands we use personally. 

Inner Strength operate under delegated authority to carry the specific supplement brands which Dr Cindy de Villiers recommends.  They provide a helpful combination of value and service with their "one stop shop" for the many different supplement suppliers.  Inner Strength and Health Function are independent companies with a shared vision of patient well-being, but no shared financial interests or governance.  Inner Strength staff have been provided privacy training.

Ordering, payment and subsequent enquiries about the delivery of Supplements should be made to Inner Strength via their Shopify Website, or visit the Gym/Shop in Richmond at 5 McIndoe Place Richmond, or call Annie & Krysta on (03) 5447786.

When visiting the Inner Strength Gym in Richmond for supplements, you MUST provide your Supplement Plan (provided as a printout by Cindy after each consultation, or available in Handouts section of Labs&Docs folder on the Portal).  Note the Supplement Plan is different to the General Plan in that it only contains the supplement information Inner Strength need, without any other patient information.

With the Supplement Plan Annie & Krysta can:
- identify you as a patient of Dr Cindy de Villiers to get access to restricted practitioner-only supplements.  For privacy reasons, Inner Strength don't have access to clinical systems and as supply of higher dose supplements are restricted by suppliers, patients without identification regrettably cannot be served
- efficiently identify which supplements you need
Inner Strength map
Why doesn't Health Function profit from the sale of Supplements as many clinics do?
The Medical Council is suitably concerned about misuse of the doctor-patient relationship and the clinic has chosen not to profit from the sale of supplements to avoid conflicts of interest and maintain independence of advice i.e. the major investment for patients pursuing functional health may be in the cost of supplements and so the clinic is positioned to recommend the most appropriate supplements without financial fear or favour. 

Also at a practical level, providing good customer service with the complexity of stocking and supplying supplements from many different suppliers is a complex & time-consuming specialist role.  The clinic is focused on providing independent expert medical advice, rather than trying to be a jack of all trades.  A big thank you to the team at Inner Strength for investing in the technology, personnel and training to make it easy for patients to get the required supplements.  
Lifestyle & Nutrition: why Low Carb High Fat (LCHF) diet & Intermittent/Extended Fasting (IF & EF) ?
Paradoxically, a high fat diet can be an effective way to lose weight and increase energy.  Keto is a strict version of this diet which has been used for treatment of epilepsy and is now being studied as an adjunct to some cancer treatments.  Being in ketosis through a ketagenic diet (or by specific supplementation) is associated with reduction in inflammation and increased cognitive function.  

On the other side of the coin, restricting calories may lead to slowing the metabolism.  Combining Intermittent Fasting with LCHF can be the best of both worlds, simultaneously reducing inflammation while maintaining metabolic rate.  Dr Jason Fung is a leading proponent of the science behind Fasting, with other notables including Dr Stephen Phinney and Dr Tim Noakes.

Dr Cindy de Villiers can provide advice on how to appropriately approach LCHF, Intermittent Fasting and Keto diets for each individual.
What are Compounding Pharmacies and why are they useful?
Compounding Pharmacies provide advanced prescribing options associated with the latest medical research.

Through Dr Cindy de Villiers being registered in Australia and New Zealand, patients are able to take advantage of the capabilities of CompoundLabs in New Zealand and Tugun/Kingsway in Australia. 
Will Gene Testing be helpful?
Summarizing a passage from a talk by Dr Andrew Heyman:
Just because you have a gene snp, you don't know whether it's live or not.  It all changes based upon what you ate this morning and your epigenetics.  Be suspicious of people manipulating genetic pathways, saying what fats you can eat based upon your genetic snps, because they're selling a book, a dietary supplement, or want you to come to their workshop.  It's amazing what's going on, but it's not there yet. 

Dr Cindy de Villiers' approach to gene testing is to focus on genes for which there is evidence that lifestyle changes can be effective. Gene testing is one tool in an overall toolkit, starting with the specific area of interest and interpreting from there.  Gene tests get correlated with clinical presentation, response to intervention & functional testing.

If interested in gene testing, one option is to order Fitgenes.

If you have already completed a 23andme test (the USD99 ancestry one is fine), Dr Cindy de Villiers can provide guidance around medical interpretation.
Why might I want a referral to a Specialist?
Reached the end of the road with your existing medical approach and being told to "live with it"?  Dr Cindy de Villiers' approach includes referrals to specialist registered medical services in NZ and beyond.  Some specialist services are only available where supported by a large population base e.g. a short flight to Brisbane opens up access to different medical capabilities at Qscan Radiology Clinics.  Dr Cindy de Villiers' sister who is a specialist in Brisbane describes some of the opportunities with the latest Radiology & Neurovascular capabilities in this article.
How much will it cost to apply to see Dr Cindy de Villiers?
Applying as a new patient costs NZ$455, which includes a 1 hour consultation (NZ$250), 1 online medical inquiry (NZ$30), a half hour follow-up consultation 3-6 weeks later (NZ$125) and the NHI lookup and other setup administration (NZ$50 non-refundable).

As a rule of thumb when commencing the Starter Package, please in addition budget NZ$600 for the first 2-3 months test kits, supplements & prescriptions.

For further information refer fee schedule. 
Can I get suitable medical treatment cheaper?
Natural Health Practitioners provide some of the same services and are sometimes cheaper.

Mass-market services including supplement sales and seminars are likely more expensive, by definition less tuned to individual circumstances and often without recognized formal qualifications to interpret registered medical services.

Govt funded GP services available to enrolled patients are part of the solution, but for better or worse are constrained by the guidelines.

If you are reading this, it's reasonable to assume that the available healthcare options aren't meeting your needs.  They didn't meet ours either.  The decision then is what to do about that.  If improving your health is important to you and the failure to invest in your health will cause stress, then the Specialized Personalized Functional & Integrative Private Registered medical service provided by Dr Cindy de Villiers may be a good choice.
What are the longer term maintenance commitments/costs associated with seeing Dr Cindy de Villiers?
Some patients finish the Starter Package and need no more than annual maintenance (e.g. Methylcobalamin B12 injection therapy may produce immediate results), while other treatments will take longer and cost more. 

For those with prescriptions, the Medical Council requires 6 monthly follow-ups, otherwise Dr Cindy de Villiers cannot issue repeat prescriptions.

Patients need to see Dr Cindy de Villiers at least annually to be able to access the Patient Portal for Online Medical Inquiries.

Patients who haven't seen Dr Cindy de Villiers for 2 or more years will need to re-apply for the Starter Package (because so much changes in 2 years).
Can patients claim consultations and costs against Insurance or ACC?
The clinic cannot guarantee insurance can be claimed, but can provide patients with all the information needed to submit a claim i.e. the clinic runs accounting processes suitable for providing itemized patient accounts. Some health insurance plans cover appointments with General and Specialist Doctors but we recommend you seek pre-approval.

Likewise you are welcome to keep any receipts and contact ACC about possible reimbursement of costs e.g. the amount that GPs are subsidized for ACC visits.
How do I get started?
Click on the Starter Package to get started.

Upon payment, you get access to request your first consult and will then be provided with an IFM medical questionnaire.  The format of the questionnaire is optimized to collect the clues Dr Cindy de Villiers needs.  

For Yes/No questions where you feel "Maybe" would be more appropriate, techniques to try include: 
(1) try to avoid over-thinking and answer what first springs to mind or ...
(2) leave blank if that feels best.  

If you have a NZ Passport, birth certificate or Residency Visa, a scan should be uploaded into the "Labs & Docs" tab for access to some services (or bring the document to the first consult for scanning).

Patients who have undertaken their own research and come in with specific questions or concerns often make the fastest progress.
Does the clinic offer Emergency and After Hours care?
Dr Cindy de Villiers' role is to turn an hour into influencing a lifetime of nature and nurture towards a patient wellbeing reset.  The clinic as a whole spends considerable effort towards creating the environment where these wellbeing resets can occur.  Emergency care runs counter to being able to provide this considered creative environment, so see GP and After Hours services for acute and emergency care.  
Why is Dr Cindy de Villiers registered as a medical doctor in Australia as well as New Zealand?
Registration in Australia & NZ means Dr Cindy de Villiers can treat Australian & NZ patients and provides access to a library service of published scientific papers through the Royal Australian College of Practitioners.

Australian registration also provides useful prescribing options for patients e.g.
- Kingsway Compounding for specific personalized B12 injections
- Tugun Compounding for purpose made personalized multi-vitamins 
Will my GP be OK with me seeing Dr Cindy de Villiers and will Dr Cindy de Villiers be OK with me seeing other practitioners?
GPs frequently refer patients to Dr Cindy de Villiers.  Dr Cindy de Villiers is the Medical Architect for coordinating treatment of Chronic Medical Conditions and you go to your GP (or After-Hours) for anything acute like colds, flu or other PHO funded services.  What Dr Cindy de Villiers does is complementary to your GP, in the manner that might be familiar with a specialist referral.

Likewise, Dr Cindy de Villiers routinely collaborates with multiple approved practitioners in the best interests of patients.
Are Telehealth/Skype/Zoom consults offered?
Yes. Dr Cindy de Villiers' work Skype address is cindy.de.villiers but the clinic prefers to use Zoom because its easier to use and more reliable.  Dr Cindy de Villiers will message you a Zoom link prior to your appointment.  Please click on the link 10 minutes before you are due to start, to give your browser time to download any necessary plugins.  If Dr Cindy de Villiers is running a few minutes behind, reception will be in touch to keep you posted.   
What's the clinic environment like and is it suitable for those with sensitivities?
The clinic is located at 3/16 Bridge Street until the 1st March 2019.

From 4th March 2019, the clinic will be located at 33 Atmore Terrace, Maitai.  Shifting to Maitai will give better light and ventilation and an environment more in keeping with the service the clinic wants to provide.  The new clinic is a 5 minute drive from Trafalgar Street or a brisk 15 minute uphill walk from the centre of town.  There's loads of signage and space for parking.

The clinic consists of a reception/waiting room, a consult room and a bathroom.  VOC free paints and untreated macrocarpa paneling have been used for wall linings and cork/wool/double-glazing is used for acoustic absorption.  The clinic is fragrance free (staff wear no perfumed products), but an essential oil diffuser may be used.  Bike and dog friendly environment - if you can hear a couple of yapping small dogs behind a fence somewhere, you are in the right place.

Filtered water and Pomeroy's organic Lemon & Ginger tea are available in the waiting room. Reverse Osmosis filtered water available by request.

Note the clinic uses WIFI and is not suitable for patients with EMF/EMR sensitivities. The clinic perimeter is monitored by CCTV.

Look for the intro video on the website in the next couple of weeks, which Wild Tomato are kindly facilitating so you can familiarize yourself ahead of time. We're providing a running commentary on facebook about progress with the new clinic if you are interested and the appointment reminder emails and SMS will also include the new address to help minimize confusion.

We hope you'll like the new clinic.
Will Dr Cindy de Villiers call to discuss Lab Results?
Medlab results arrive electronically to the clinic and are then reviewed and released to the portal for patients. Dr Cindy de Villiers will call in the event that a Lab Result requires immediate attention, otherwise the results will be discussed at the next scheduled consult.  

Please note sometimes the results published in the portal are colour-coded Amber or Red, but are OK for an individual patient's circumstances e.g. a red Cortisol result may occur with a patient using Prednisone and is considered normal under those circumstances.

Please also note Dr Cindy de Villiers is not able to call clients at their request outside of scheduled consults to discuss results i.e.
- she is in consult seeing other patients
- it's not viable to play telephone tag
- a 5 minute conversation is unfortunately never a 5 minute conversation
- the clinic is not an emergency service

If concerned about a test, patients may wish to queue an online medical inquiry via a secure message in the Portal.
Can the clinic send my Lab Results to my GP or other practitioners?
The clinic can't email Lab Test results to another practitioner due to privacy regulations around sharing medical information.  

Instead alternatives include:
- the GP or other practitioner may make a request via Healthlink or similar.  This is a routine procedure, but may take time
- the Lab Results are available electronically in the "Labs & Docs" folder of the Patient Portal and can be printed, or you can login to the portal with the practitioner who needs to see the result
What about Intravenous Vitamin C (IVC) and other IV therapies?
High dose Vitamin C is given intravenously to treat and/or ameliorate the symptoms of a number of medical conditions. Intravenous therapies include Myers Cocktails and Glutathione.

It takes time to make up the IV fluids and they cannot be used after 24hrs once made up, so it is important to let us know if you are unable to attend an IV appointment by 9am that day at the absolute latest (if an IV infusion has been prepared and a patient misses the appointment without letting us know, the fee for the infusion will be charged to recover costs). 

All patients need to sign a consent form prior to receiving IV therapy.

Where possible and particularly if you may have difficult veins, please undertake brisk exercise of some sort before your IV appointment to pump up your veins.

Allow 1-3 hours for an IV depending upon what's being given and the circumstances.

Refer IV info for more information.

IV Therapies are only available upon application and subject to approval.  
What is Anti-Ageing and why is Dr Cindy de Villiers an A5M Practitioner?
There are 2 branches to Anti-Ageing, cosmetic and medical.  The clinic is focused on the medical and lifestyle aspects of Anti-Ageing to avoid masking symptoms e.g. irregularities on the face might be an indication of excessive alcohol consumption and/or oxidative stress.  One approach might be to reduce alcohol and increase liver and kidney support and another might be an expensive and well marketed course of topical treatments and moisturizers.  Dr Cindy de Villiers is interested in the former approach.  Refer A5M for more info.
What about Muscle Testing (Applied Kinesiology)?
Muscle testing is one tool available in the toolkit.  If you are specifically looking for Muscle Testing for food allergies, there are local options in Nelson which may be more immediately available e.g. Alison Singleton.  For more information about muscle testing, refer Muscle Testing info
Where do I go if I have a Radiology referral?
Either Pacific Radiology (03 548 2745) or Koru Radiology (03 541 0050) in Nelson or Richmond.  You need to call first for an appointment.
What if I want CBD?
CBD is prescribed where appropriate by Dr Cindy de Villiers and other registered doctors in the Nelson area including Dr Tim Ewer and Dr Caroline Wheeler out at Mapua.
What about things like FIR Sauna & Sensory Deprivation Floating & Cryo-Sauna?
There are a number of reasons for having regular saunas for enhanced physical performance and detoxification.  The clinic can recommend local providers.

Sensory deprivation floats are very calming and physically therapeutic due to the magnesium absorption through the skin. The clinic can recommend local providers.

Cryosaunas and ice baths are promoted by biohackers for increased energy.  The underlying idea is to tap into primordial energy pathways in a similar way to Tummo breathing.  The medical advice is to not undertake Cryosauna or ice baths unless cleared by your doctor.
Does the clinic provide a Patient Portal so I can see my information and collaborate easily and securely with the clinic?
The Patient Portal is fundamental to the Functional & Integrative medical approach.  
It is the best way to:
- make and update appointments
- send and receive messages to and from the clinic
- upload and download documents, handouts, test results, ID documents etc 
- update contact details
- set preferred pharmacies so your prescriptions arrive at the right place 
What about Privacy for my Medical Data?
Dr Cindy de Villiers, staff and suppliers make every attempt to comply with the Privacy Act 1993 and Health Information Privacy Code 1994.  Every patient interaction is subject to review by www.hdc.org.nz, www.mcnz.org.nz, www.rnzcgp.org.nz, www.ahpra.gov.auwww.racgp.org.au etc and equally Dr Cindy de Villiers is a member of www.medicalprotection.org.    

All staff and contractors receive privacy training and Health Function has invested in professional medical software for efficiently managing the complex data from medical collaboration in a HIPAA compliant facility to help comply with medical council requirements.  

The clinic's policy is not to release patient information to external parties, unless for procedural reasons to the benefit of the patient (e.g. lab tests and delivery of supplements), or where required to do so by court order.
But I don't care about my privacy.  Why can't the clinic send medical information in an email?
The clinic operates within the environment set by the Medical Council, www.hdc.org.nz, the Privacy Act 1993 and Health Information Privacy Code 1994.  The clinic is unable to email medical information.  

Using the Patient Portal is also better for patients than an email because:
- emails are unreliable and get lost in junk mail etc.
- emails cause confusion where the clinic can't tell which patient the email is from, or the clinic is not allowed to reply to an email address not associated with the registration
- emails have to be manually copied and pasted by the clinic to maintain medical council record requirements; time which could better be spent
- emails can't be managed in a shared centralized queue, which risks mistakes on tasking and follow-ups

Want immediate accurate answers to your questions 24x7?  When all information is in one place, you get fast efficient service. 
How responsive is the clinic if I ask a question?
Patient Portal queries made during NZ business hours arrive in a central queue, which is continually reviewed and tasked to the appropriate person. In this manner, nothing gets lost and we endeavour to provide fast reliable responses.

Prospective patients may also contact the clinic through the website or Facebook or the phone.

Note there is one clinic phone line, which may not be answered if the phone is already engaged or there is a patient at reception.  The clinic's policy is that those at reception take priority over phone calls.
Is there a facility for Online Medical Inquiries to Dr Cindy de Villiers?
For patients who have been seen in consult within the last year, Dr Cindy de Villiers offers a service for online medical inquiries via Secure Messages in the Patient Portal.  

The Health Act precludes Dr Cindy de Villiers sharing medical information via email except in emergency circumstances, so patients shouldn't email medical questions as the clinic is unable to respond with medical information by email.

Any online medical inquiries requiring a medical response from Dr Cindy de Villiers (i.e. subject to review by the Medical Council) will incur the minimum online medical inquiry consult fee of NZ$30.
How can patients help the clinic to deliver the warm wonderful experience and outcomes we all want?
- Apply under the same name and email to be used subsequently.  It leads to confusion when patients apply under one name and then contact the clinic using a different name.  
- Provide an email and phone number where the clinic will be able to contact you for appointment reminders and waitlist updates.  
- Provide a personal email address not a work email, so there won't be issues if you change jobs. 
- Update your details using the Patient Portal when they change.
- Only make appointments for yourself, not on behalf of someone else.  Dr Cindy de Villiers prepares for you individually the night before an appointment and your consult is also linked to a government NHI number, so someone else can't replace you without notice.
- If you know your appointment is about many complex matters, give yourself and the subsequent patients a break and book an hour unless you can prioritize just a few issues.
- Try to avoid last minute prescriptions or appointment changes; the clinic is using best endeavours and technology to deliver a seamless service, but there are many patients and only one highly qualified and experienced doctor and nurse to share around.
- If paying an invoice via internet banking, providing the invoice number in the payment reference saves time and confusion.
- The clinic can't accept files on data keys (they are akin in security/privacy terms to a ticking bomb). 
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