Dr. Daniel Choiniere

Dr. Daniel Choiniere provides comprehensive family medical care for a wide variety of health concerns affecting patients of all ages, including but not limited to:

Joint Muscle Pain

• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Recognizing the characteristic clinical presentation of Polymyalgia Rheumatica (PMR) in older adults (typically age >50 years) – symmetrical morning stiffness and aching in the shoulders, neck, and pelvic girdle – often associated with significantly elevated inflammatory markers (ESR, CRP). Initiating treatment with low-dose corticosteroids (e.g., prednisone 12.5-25 mg daily) which usually results in a rapid and dramatic improvement in symptoms, thus supporting the diagnosis. Vigilantly screening for and differentiating from Giant Cell Arteritis (GCA/Temporal Arteritis), which can co-exist with PMR (or occur independently) and requires urgent higher-dose steroid therapy and specialist (rheumatology/ophthalmology) referral to prevent irreversible vision loss.
• Repetitive Strain Injuries (RSI), Tendinopathies & Work-Related Musculoskeletal Disorders (WRMSDs) - Initial Assessment & Conservative Management: Providing advice on activity modification (relative rest, avoiding aggravating activities), ergonomic adjustments (workstation setup, tool use), simple analgesia (NSAIDs - oral/topical, acetaminophen), ice/heat application, and appropriate referral to physiotherapy or occupational therapy for specific exercises (stretching, strengthening), manual therapy, splinting, and further rehabilitation or prevention strategies.
• 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.
• Mechanical Low Back & Neck Pain (Acute, Subacute, Chronic - Uncomplicated): Assessment and management of non-specific (mechanical) low back pain and neck pain, which accounts for the majority of spinal pain presentations. This includes taking a thorough history, performing a focused physical examination to rule out 'red flag' conditions (e.g., fracture, infection, malignancy, cauda equina syndrome), providing reassurance about the generally favorable prognosis of acute pain, and advising on pain relief (acetaminophen, NSAIDs, short-term muscle relaxants if severe spasm), maintaining activity as tolerated (avoiding prolonged bed rest), heat/cold application, and self-care strategies. For subacute or chronic pain, emphasis on active therapies (exercise, physiotherapy referral), addressing psychosocial factors (yellow flags), and promoting functional restoration.

Dermatological Skin Conditions

• Eczema (Atopic Dermatitis), Contact Dermatitis & Seborrheic Dermatitis: Comprehensive primary care for common inflammatory skin conditions, aiming to alleviate symptoms, prevent secondary infections, and improve patient comfort and overall skin health.
• Primary Care Skin Cancer Screening & Early Detection (Suspicious Mole/Lesion Assessment): Performing opportunistic or targeted skin examinations, especially for patients with risk factors (e.g., history of sun exposure, family history of skin cancer, multiple moles, fair skin), to screen for suspicious moles or lesions that could indicate skin cancer (basal cell carcinoma - BCC, squamous cell carcinoma - SCC, melanoma). Utilizing dermoscopy if trained to improve diagnostic accuracy. Performing skin biopsies (punch, shave, excisional) of concerning lesions or providing timely referrals to dermatology for further evaluation, biopsy, and management if skin cancer is suspected.
• Bacterial Skin Infections (Impetigo, Folliculitis, Cellulitis - uncomplicated): Effective antimicrobial therapy for common bacterial skin infections to resolve infection, prevent spread, and alleviate associated symptoms.

Mental Health Concerns

• Depression & Other Mood Disorders (e.g., Dysthymia, Seasonal Affective Disorder - Management): Providing compassionate, evidence-informed primary care and management strategies for those affected by depression and other common mood disorders, with a focus on recovery and long-term stability.
• Attention-Deficit/Hyperactivity Disorder (ADHD) - Assessment & Management (All Ages): Providing primary care support for individuals and families navigating the challenges of ADHD, helping to optimize focus, reduce impulsivity/hyperactivity, improve executive functioning, and enhance overall quality of life and academic/occupational success.
• Insomnia & Chronic Sleep Disturbances: Thoroughly evaluating persistent sleep problems (difficulty initiating or maintaining sleep, early morning awakening, non-restorative sleep), offering education on optimal sleep hygiene, principles of cognitive behavioral therapy for insomnia (CBT-I) or facilitating referrals for it, addressing underlying contributing factors (e.g., anxiety, pain, medications, restless legs syndrome), and judiciously considering short-term medication if necessary.
• Initial Assessment & Referral for Other Mental Health Concerns (e.g., OCD, PTSD, Eating Disorders, Bipolar Disorder, Psychosis): Recognizing signs and symptoms of various serious mental health issues and facilitating timely access to the appropriate level of specialist care and support.

Common Acute Conditions

• Allergic Reactions (Mild to Moderate - e.g., Hay Fever, Hives, Minor Food Allergy Symptoms): Diagnosing and managing common allergic reactions such as seasonal/perennial allergic rhinitis (hay fever), mild to moderate hives (urticaria), minor localized reactions to insect stings, and initial assessment of suspected mild food allergy symptoms. Does not include anaphylaxis management which is an emergency.
• Urinary Tract Infections (UTIs - Cystitis, Pyelonephritis - uncomplicated initial): Addressing common symptoms of UTIs and providing effective, evidence-based treatment to eradicate the infection and restore urinary health.
• Headaches (Tension-type, Migraine - Acute Symptomatic Relief): Assessment of acute headaches to differentiate types (e.g., tension headache, migraine, cervicogenic), provide initial pain relief strategies (analgesics, NSAIDs, triptans for migraine), identify potential triggers, and rule out serious underlying causes requiring urgent investigation.
• Upper Respiratory Tract Infections (URTIs - Colds, Flu, Sinusitis, Pharyngitis): Diagnosis and management of common viral and bacterial infections affecting the nose, throat, sinuses, and larynx (e.g., common cold, influenza, acute sinusitis, strep throat, laryngitis), helping to relieve symptoms like cough, congestion, fever, and sore throat.

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

• Primary Care for Overuse & Repetitive Strain Injuries: Advising on activity modification, ergonomic adjustments, stretching/strengthening exercises, and pain relief measures for overuse injuries.
• Well-Child & Well-Adolescent Visits (Growth & Development): Scheduled visits to track your child's or teen's health trajectory, address any emerging concerns, and provide guidance on nutrition, safety, and healthy habits.
• Occupational Health Aspects & Work-Related Health Concerns (Initial Assessment): Initial evaluation of the impact of work on health and vice-versa.
• Cardiovascular & Metabolic Risk Assessment & Management: Identifying individuals at higher risk for heart attacks, strokes, or diabetes to implement early interventions and promote long-term health.
• Attention-Deficit/Hyperactivity Disorder (ADHD) Care (All Ages - Initial & Ongoing): Providing primary care support for individuals and families navigating ADHD, helping to optimize function, manage symptoms, and coordinate multidisciplinary care.

Note: This list highlights some of the key services offered by Dr Choiniere. 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 Médecin de familles in QC and the ethical and professional standards set by The Collège des médecins du Québec (CMQ).

At Clinique Médicale Lorraine, 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 Choiniere frequently works with patients towards goals such as:

• Dr Choiniere supports patients through wanting to understand if genetic testing is appropriate for them based on family history, aiming for outcomes like benefiting from proactive and systematic approach to mental health screening and discussion during routine visits, leading to earlier identification and support for emerging psychological distress, so they can return to activities such as actively and responsibly participating in their own healthcare journey by consistently attending scheduled appointments with , asking insightful questions, understanding their conditions, and diligently following mutually agreed-upon treatment plans.
• When needing a physician's signature for a disability parking permit application impacts daily life, Dr Choiniere helps patients strive for feeling deeply understood, consistently validated, and never dismissed by when discussing sensitive, personal, or emotionally difficult health topics or life circumstances, making activities such as spontaneously making and eagerly keeping enjoyable plans with a wide circle of friends for various social outings such as dinners out, casual coffee chats, shared recreational activities, or weekend excursions possible again.

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

Dr Choiniere practices at Clinique Médicale Lorraine, a family medical practice in the central Lorraine neighborhood of Lorraine. The clinic is conveniently located near local community centers, schools, and shopping areas and is accessible via major local public transit routes. Ample parking is generally accessible close to the clinic entrance; please observe local signage.

Do I need a referral to see a family doctor (Médecin de famille) in QC?

Generally, you do not need a referral to see a family doctor in Quebec if the doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. Provincial resources, such as the website of the Collège des médecins du Québec, may offer assistance in finding a physician. A referral is usually required from a family doctor to see most medical specialists.

What exactly is a family doctor (Médecin de famille) and what is their role?

A family doctor, often called a general practitioner (GP), is a medical doctor specializing in comprehensive primary healthcare for individuals and families across all ages and life stages. They serve as your first point of contact for most health concerns, offering preventative care (like check-ups, immunizations, and health screenings), diagnosing and treating acute illnesses (such as infections or minor injuries), managing chronic conditions (like diabetes, hypertension, or asthma), providing mental health support, and coordinating your care by referring you to specialists when necessary. A key aspect of their role is building long-term relationships with patients to promote overall health and well-being.

How can I find a family doctor (Médecin de famille) in QC who is accepting new patients?

Finding a family doctor in Quebec who is accepting new patients may require some effort. You can check the website of the Collège des médecins du Québec; they often have a "Find a Doctor" tool or similar resource. You can also ask friends, family, or colleagues for recommendations, or contact local community health centres or clinics directly. It's important to understand that this process can sometimes take time.

Is seeing a family doctor (Médecin de famille) covered by Régie de l&#x27;assurance maladie du Québec (RAMQ) in QC?

Medically necessary visits to a family doctor are typically covered by the Régie de l'assurance maladie du Québec (RAMQ) for eligible residents with a valid provincial health card. However, some services, such as cosmetic procedures or travel medicine consultations, may not be covered and might have an associated fee. Please confirm with Clinique Médicale Lorraine if you have questions about specific services or potential fees.

Clinique Médicale Lorraine
99 boul De Gaulle
Lorraine, QC, J6Z 3Z9

Phone: (450) 621-1444

Dr. Daniel Choiniere is regulated by the Code des professions & Loi médicale (Québec) in QC and is a registered member in good standing with The Collège des médecins du Québec (CMQ).

Registration Number: 87189

Verify registration with The Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=87189

Family doctors like Dr Choiniere 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.