Dr. Alison Khetha Van Geest Mikelsons

Dr. Alison Khetha Van Geest Mikelsons provides comprehensive family medical care for a wide variety of health concerns affecting patients of all ages, including but not limited to:

Mental Health Concerns

• Insomnia & Chronic Sleep Disturbances: Comprehensive primary care management of common sleep disorders to restore healthy sleep patterns and improve overall health and well-being.
• Attention-Deficit/Hyperactivity Disorder (ADHD) - Assessment & Management (All Ages): A comprehensive and collaborative approach to ADHD care, addressing core symptoms and associated impairments across the lifespan, often involving a multidisciplinary team approach.
• Anxiety Disorders (Generalized Anxiety, Panic Disorder, Social Anxiety - Management): Providing comprehensive assessment, psychoeducation, supportive counseling, lifestyle advice (exercise, mindfulness, sleep hygiene), evidence-based medication management (e.g., SSRIs, SNRIs, buspirone), and facilitating timely referrals for psychotherapy (CBT, DBT, etc.) or psychiatric consultation for common anxiety disorders.

Common Chronic Conditions

• Anemia (Iron Deficiency, B12/Folate Deficiency - Chronic): Primary care approach to identifying and managing deficiencies or chronic conditions that lead to persistent anemia.
• Irritable Bowel Syndrome (IBS) - Primary Care Management: Helping individuals understand and manage their IBS symptoms to improve digestive comfort and quality of life.
• Chronic Kidney Disease (CKD) - Early to Moderate Stages: Early detection, monitoring of kidney function (e.g., eGFR, urine ACR), management of risk factors that can worsen CKD (especially diabetes and hypertension), medication review to avoid nephrotoxic drugs, lifestyle counseling (dietary advice on protein, sodium, potassium), and timely referrals to nephrology for patients with early to moderate stage chronic kidney disease to slow progression and prevent complications.
• Asthma (All Ages) & Allergic Rhinitis: Comprehensive care for individuals with asthma and related allergies, focusing on patient empowerment, self-management skills, and emergency preparedness for asthma attacks.

Joint Muscle Pain

• Gout & Pseudogout (Crystal Arthropathies) - Acute Attack Management & Chronic Prevention Strategies: Providing long-term management strategies for chronic gout to prevent recurrent attacks and complications (e.g., tophi, chronic gouty arthropathy, kidney stones), including detailed lifestyle advice (dietary modifications - reducing purine-rich foods such as red meat/organ meats/shellfish, limiting alcohol especially beer and spirits, avoiding sugary drinks/high-fructose corn syrup; hydration; weight management if overweight/obese) and initiating/managing urate-lowering therapy (ULT) such as allopurinol or febuxostat to achieve and maintain target serum uric acid levels (typically <360 µmol/L or <300 µmol/L if tophi present). Monitoring for medication side effects, adherence, and regular serum uric acid levels.
• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Often co-managed with or referred to rheumatology, especially for atypical presentations, diagnostic uncertainty, difficulty tapering corticosteroids, frequent relapses, or suspected GCA. Primary care plays a key role in ongoing monitoring, patient education, and supportive care for PMR.
• Fibromyalgia & Other Widespread Chronic Pain Syndromes - Primary Care Diagnosis & Multimodal Management: Working collaboratively with individuals experiencing chronic widespread pain to develop personalized self-management strategies, set realistic functional goals, and coordinate care effectively with other healthcare providers such as physiotherapists, occupational therapists, psychologists, and rheumatologists (for diagnostic confirmation or complex cases).

Preventative Health Topics

• Weight Management & Obesity Prevention/Treatment: Personalized advice and comprehensive care plans for healthy weight loss, prevention of unhealthy weight gain, or management of obesity and its related health conditions (e.g., type 2 diabetes, hypertension, dyslipidemia, sleep apnea, osteoarthritis, certain cancers).
• Occupational Health Screening & Advice (Basic Pre-placement, Return-to-Work): Performing basic pre-employment medicals or fitness-for-work assessments as required by some employers (typically non-WCB/WSIB related, fees may apply). Providing advice on general workplace health and safety, injury prevention, and initial assessment of health concerns potentially related to occupational exposures or ergonomics, with appropriate referrals if specialized occupational medicine input is needed.
• Driver's Medical Examinations (Routine, Age-Related, Commercial): Performing comprehensive driver's medicals to ensure individuals meet the health standards necessary for safe vehicle operation, promoting road safety for all.

This list offers some examples of common conditions managed in family practice. A diagnosis is always based on an individual assessment by Dr. Mikelsons. If your specific health concern isn't listed, please contact the clinic to discuss your needs.

• Joint Injections for Pain Relief (e.g., Corticosteroid - if trained/equipped): Offering targeted injections as part of a comprehensive management plan for certain types of joint pain.
• Insomnia & Sleep Disorder Management (Primary Care Approach): Comprehensive management of common sleep disorders to restore restorative sleep patterns and improve overall health and alertness.
• Cardiovascular Disease Management (Stable CAD, Heart Failure, Atrial Fibrillation): Helping patients manage their heart health long-term after cardiac events or diagnoses, focusing on secondary prevention and maintaining functional capacity.
• Thyroid Disorder Management (Hypo/Hyperthyroidism, Nodules, Hashimoto's): Comprehensive primary care for patients with various thyroid conditions, including initial investigation of thyroid abnormalities and coordination with endocrinology if needed.
• Grief, Loss & Bereavement Counseling (Initial Supportive Care): Offering compassionate support, active listening, and initial counseling for individuals experiencing grief due to the loss of loved ones, significant life transitions, or other forms of bereavement.

Note: This list highlights some of the key services offered by Dr. Mikelsons. For a comprehensive understanding of all services, or to discuss your specific health needs, please schedule a consultation.

All services are provided in accordance with the scope of practice for Family Doctors in ON and the ethical and professional standards set by The College of Physicians and Surgeons of Ontario (CPSO).

At UHN Toronto General Hospital, family medicine is centered on a collaborative partnership to help individuals like you achieve significant improvements in your health, manage ongoing conditions effectively, and enhance your overall well-being. Dr. Mikelsons frequently works with patients towards goals such as:

• Dr. Mikelsons assists individuals in navigating discussing the pros and cons of hormone replacement therapy for menopause. A successful outcome, like gaining a much clearer and personalized understanding of their individual health risks (e.g., cardiovascular disease based on Framingham score, inherited cancer predispositions, osteoporosis risk) and practical, actionable, evidence-based steps they can realistically take to mitigate these risks effectively, means they can get back to successfully and relatively stress-free managing daily commutes on often crowded or unpredictable public transport systems or by car in heavy traffic without significant exacerbation of physical pain or anxiety symptoms.
• When experiencing unexplained bruising more easily than before impacts daily life, Dr. Mikelsons helps patients strive for receiving appropriate and timely referrals for genetic counseling or testing through <preferred_name> when indicated by significant family history of heritable conditions or specific clinical findings, making activities such as independently and efficiently performing all personal grooming and hygiene tasks (bathing, dressing, toileting) without any difficulty, assistance, or associated pain, maintaining their dignity possible again.
• Many seek Dr. Mikelsons's help for feeling overwhelmed by stress from work or family life and needing someone to talk to about coping strategies. The collaborative goal is their adolescent child receiving confidential, empathetic, respectful, and age-appropriate holistic care from <preferred_name> for sensitive health topics including sexual health, mental well-being, body image, or substance use concerns, allowing a return to valued activities like actively and responsibly participating in their own healthcare journey by consistently attending scheduled appointments with <preferred_name>, asking insightful questions, understanding their conditions, and diligently following mutually agreed-upon treatment plans.
• For many individuals, needing to get their routine immunizations updated or the annual flu shot for the whole family can be a real barrier. Dr. Mikelsons's approach focuses on achieving feeling genuinely reassured, thoroughly well-informed about all aspects of their condition, and like an empowered, active partner in all decisions regarding their health status, treatment options, and long-term care strategies discussed with <preferred_name>, making it possible for patients to once again enjoy feeling physically strong, mentally resilient, and emotionally capable of consistently handling the often unpredictable and demanding day-to-day responsibilities of active parenting, grand-parenting, or intensive caregiving roles.

Your personalized healthcare plan, developed in discussion with Dr. Mikelsons, will be thoughtfully designed to help you reach your specific functional, preventative, and wellness objectives. She believes in empowering patients with the knowledge and support needed to take an active role in their health journey.

Dr. Mikelsons practices at UHN Toronto General Hospital, located in the Downtown Guelph, Exhibition Park neighborhood of Guelph. The clinic is conveniently located near Old Quebec Street Shoppes and is accessible via Guelph Transit. Ample parking is generally accessible close to the clinic entrance; please observe local signage.

How long do appointments with Dr. Mikelsons typically last?

Appointment times with Dr. Mikelsons vary based on the reason for the visit. For a quick follow-up or a straightforward issue, 10-15 minutes is common. For annual physicals, initial consultations, or if you have several health concerns to discuss, Dr. Mikelsons will usually book a longer slot, like 30 minutes or sometimes more. Always try to be specific about your needs when booking your appointment at UHN Toronto General Hospital to ensure enough time is set aside with Dr. Mikelsons to address your concerns thoroughly.

How can I find a family doctor (Family Doctor) in ON who is accepting new patients?

Finding a family doctor in Ontario who is accepting new patients can be challenging. The College of Physicians and Surgeons of Ontario often has a "Find a Doctor" tool or list on their website. In Ontario, you can register with Health Care Connect. You can also ask friends, family, or colleagues for recommendations, or contact local community health centres or new patient clinics directly. It may take time to find a suitable doctor.

Is seeing a family doctor (Family Doctor) covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary visits to a family doctor are typically covered by the Ontario Health Insurance Plan (OHIP) for eligible residents with a valid provincial health card. However, some services, such as cosmetic procedures, most travel medicine consultations, sick notes for work/school, insurance forms, and driver's medicals, may not be covered and might have an associated fee. Please confirm with UHN Toronto General Hospital if you have questions about specific non-insured services or potential fees.

Does Dr. Mikelsons at UHN Toronto General Hospital offer virtual (video) or phone appointments?

Yes, Dr. Mikelsons at UHN Toronto General Hospital offers virtual (video) and/or phone appointments for certain types of consultations when clinically appropriate. These can be convenient for discussing some test results, managing stable chronic conditions, prescription renewals for ongoing medications (not controlled substances), or for certain mental health follow-ups. However, many conditions, new problems, or situations requiring a physical examination will still necessitate an in-person visit for accurate assessment and diagnosis. Please discuss with our reception staff or Dr. Mikelsons if a virtual appointment might be suitable for your specific needs. Provincial health plan coverage for virtual visits may vary; please check with UHN Toronto General Hospital regarding any potential fees for uninsured virtual services.

Do I need a referral to see a family doctor (Family Doctor) in ON?

Generally, you do not need a referral to see a family doctor in Ontario if the doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. Provincial resources like Health Care Connect in Ontario, or the College of Physicians and Surgeons of Ontario website, may be helpful. A referral is usually required from a family doctor to see most medical specialists.

What exactly is a family doctor (Family Doctor) and what is their role?

Your family doctor (Ontario) is your primary healthcare provider, expertly trained to care for a wide spectrum of health issues, from newborns to seniors. She manages acute illnesses and injuries, oversees the care of long-term chronic diseases, provides routine health screenings and lifestyle counseling, administers vaccinations, and ensures you get access to specialized medical services through referrals when needed. The continuity of care she provides, understanding your health history and individual needs, is fundamental to effective family medicine.

What is 'continuity of care' and why is it important with a family doctor like Dr. Mikelsons?

Having continuity of care with Dr. Mikelsons means that she is your consistent point of contact for your health needs over many years. This long-term relationship allows Dr. Mikelsons to understand the nuances of your health, track changes over time, and provide care that is personalized and proactive. It improves communication, reduces duplication of tests, helps in managing chronic conditions more effectively, and fosters a stronger doctor-patient partnership, all leading to better overall health management.

How do I get a prescription refilled by Dr. Mikelsons?

For most prescription refills, please contact your pharmacy first, at least 5-7 days before you run out of medication. Your pharmacy can often fax a refill request directly to Dr. Mikelsons's office. Please allow at least 2-3 business days for these requests to be processed by Dr. Mikelsons. For certain medications (e.g., narcotics, controlled substances, or medications requiring close monitoring), or if it has been a while since your last review with Dr. Mikelsons, an appointment will be required to assess your condition and ensure the medication is still appropriate and at the correct dose. It is always best to request refills proactively.

UHN Toronto General Hospital
Unit Room 3-805, 306-77 Westmount Rd, Division of Internal Medicine
Guelph, ON, N1H 5J1

Phone: (519) 827-1399

Dr. Alison Khetha Van Geest Mikelsons is regulated by the Regulated Health Professions Act, 1991 & Medicine Act, 1991 (Ontario) in ON and is a registered member in good standing with The College of Physicians and Surgeons of Ontario (CPSO).

Registration Number: 114977

Verify registration with The College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Mikelsons-Alison-Khetha-Van-Geest/0325791-114977

Family doctors like Dr. Mikelsons are skilled in managing a wide range of health issues. For urgent or life-threatening emergencies, please call 911 or visit the nearest emergency department. It is always recommended to maintain open communication with your family doctor about all aspects of your health, including any treatments received from other practitioners.