Dr. Myriam Lefebvre

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

Adult Common Health Issues

• Venous Insufficiency & Varicose Veins (Conservative Management & Lifestyle Advice): Initial assessment and conservative management of symptoms related to chronic venous insufficiency (CVI) and varicose veins, such as leg aching, heaviness, swelling (edema), skin changes (e.g., hyperpigmentation, lipodermatosclerosis, venous eczema), and uncomplicated superficial thrombophlebitis. Ruling out deep vein thrombosis (DVT) if acute unilateral swelling/pain.
• Allergic Conjunctivitis & Dry Eye Syndrome - Primary Care Management: Helping patients find relief from itchy, irritated, or dry eyes through appropriate primary care interventions and guidance.
• Anemia (Iron Deficiency, Vitamin B12/Folate Deficiency - Diagnosis & Management): Investigating causes of anemia (e.g., symptoms like fatigue, pallor, dyspnea on exertion, dizziness, palpitations, restless legs) through thorough history (diet, medications, menstrual history, GI symptoms), physical examination, and targeted blood tests (Complete Blood Count - CBC with differential and red cell indices, iron studies including ferritin, serum vitamin B12, serum folate, reticulocyte count, LDH, bilirubin if hemolysis suspected).

Preventative Health Topics

• Health Equity & Social Determinants of Health (SDOH) Discussion & Resource Navigation: Recognizing and sensitively discussing how social determinants of health (e.g., income, housing, education, food security, access to services, discrimination, social isolation) impact a patient's health and well-being. Providing information and referrals to relevant community resources, social services, and support programs to help address these underlying factors.
• Occupational Health Screening & Advice (Basic Pre-placement, Return-to-Work): Primary care support for general occupational health questions, routine employment-related medical screenings, and facilitating a safe return to work after illness or injury.
• Driver's Medical Examinations (Routine, Age-Related, Commercial): Conducting routine medical examinations as required by provincial transportation authorities for driver's license issuance or renewal, particularly for commercial drivers (truck, bus, taxi) or as mandated by age (e.g., for seniors at specific intervals). Assessing medical fitness to drive based on established national and provincial medical standards, including vision, hearing, cognitive function, cardiovascular health, neurological status, and medication review.
• 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).

Joint Muscle Pain

• Mechanical Low Back & Neck Pain (Acute, Subacute, Chronic - Uncomplicated): Primary care coordination for back and neck pain, including referral to physiotherapy, chiropractic, massage therapy, or specialist pain services when appropriate for persistent or disabling symptoms.
• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Long-term management of PMR involves a very slow and gradual tapering of corticosteroids over 1-2 years (or longer), carefully monitoring for clinical relapse (recurrence of symptoms) and adjusting steroid dose accordingly. Also includes monitoring for and managing potential corticosteroid side effects (e.g., osteoporosis - bone protection with calcium/vitamin D, bisphosphonates if needed; hyperglycemia; hypertension; weight gain; mood changes; skin fragility).
• 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.
• Fibromyalgia & Other Widespread Chronic Pain Syndromes - Primary Care Diagnosis & Multimodal Management: Initial assessment and diagnosis of fibromyalgia or other widespread chronic pain syndromes based on established clinical criteria (e.g., ACR criteria for fibromyalgia), after appropriate investigation to rule out other underlying systemic inflammatory or medical conditions. Developing a comprehensive, multimodal management plan focusing on patient education about the condition (central sensitization, pain neurophysiology), promoting self-management, graded exercise therapy (low-impact aerobic, strength, flexibility, aquatic therapy), optimizing sleep hygiene, stress management techniques (mindfulness, relaxation, CBT principles), pain coping strategies, and judicious use of medications targeting central sensitization and associated symptoms (e.g., tricyclic antidepressants like amitriptyline, SNRIs like duloxetine/venlafaxine, gabapentinoids like gabapentin/pregabalin). Avoidance of long-term opioid therapy is generally emphasized.

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

• Evaluation of Acute Headaches & Dizziness / Vertigo: Assessing new or sudden onset headaches or dizziness to differentiate between common causes (e.g., tension headache, migraine, benign positional vertigo) and more serious underlying conditions, providing initial management and referral if indicated.
• Comprehensive Lifestyle Counseling (Nutrition, Exercise, Sleep, Stress): Guidance on making sustainable lifestyle modifications for improved energy levels, weight management, mood regulation, and longevity.
• Care for Minor Injuries & Acute Musculoskeletal Complaints: Management of uncomplicated musculoskeletal injuries and skin wounds in a primary care setting, with referrals to specialized care when necessary.
• Management of Other Chronic Conditions (e.g., GERD, IBS, Anemia): Providing ongoing care and management for a variety of other long-term health issues such as chronic gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), chronic anemia, and more, focusing on symptom control and quality of life.
• Insomnia & Sleep Disorder Management (Primary Care Approach): Thoroughly evaluating persistent sleep problems (difficulty falling asleep, staying asleep, non-restorative sleep), offering education on optimal sleep hygiene, principles of cognitive behavioral therapy for insomnia (CBT-I) or facilitating referrals, and judiciously considering short-term medication if necessary after addressing underlying causes.

Note: This list highlights some of the key services offered by Dr Lefebvre. 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 Hôpital Marie-Clarac, 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 Lefebvre frequently works with patients towards goals such as:

• Managing needing medical clearance or a pre-participation physical for a new job, school program, or volunteer position effectively is a priority for Dr Lefebvre. The aim is their teenager demonstrating a smoother and more confident transition into managing their own health responsibilities and navigating the adult healthcare system, thanks to ongoing guidance and mentorship from Dr Lefebvre, which helps patients get back to enjoying easily and safely being able to kneel down to play on the floor with pets or young children, bend over to tie shoelaces or pick things up, or squat as needed for various daily tasks, gardening, or exercise routines without pain or instability.
• Patients with concerns about possible medication interactions between prescriptions from different doctors can find relief and achieve having a clear, actionable, and well-understood plan, along with readily available support from Dr Lefebvre, for effectively managing an acute flare-up of a chronic condition like Inflammatory Bowel Disease (IBD), Chronic Migraine, or Rheumatoid Arthritis (often in co-management with specialists) under Dr Lefebvre's care, often allowing them to resume actively and responsibly participating in their own healthcare journey by consistently attending scheduled appointments with Dr Lefebvre, asking insightful questions, understanding their conditions, and diligently following mutually agreed-upon treatment plans without former limitations.

Your personalized healthcare plan, developed in discussion with Dr Lefebvre, 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 Lefebvre's practice at Hôpital Marie-Clarac is situated in a central Montréal neighborhood. The clinic is conveniently located near local community centers, schools, and shopping areas and is accessible via major local public transit routes. Free patient parking is often available on-site or on nearby streets.

How long do appointments with Dr Lefebvre typically last?

Typically, a regular appointment with Dr Lefebvre to discuss a specific health concern or for a follow-up lasts about 10 to 15 minutes. However, if you are a new patient, scheduled for a complete physical exam, or need to discuss multiple or complex health matters, the appointment will likely be scheduled for a longer duration, such as 30 minutes. Please inform the reception staff at Hôpital Marie-Clarac about the nature of your visit when booking, so sufficient time with Dr Lefebvre can be arranged.

What does 'preventative care' involve with a family doctor like Dr Lefebvre?

Preventative care provided by Dr Lefebvre aims to stop health issues from occurring or to catch them at an early, more manageable stage. This includes regular physical exams, vaccinations, screenings for common conditions like certain cancers or heart disease risk factors (high blood pressure, high cholesterol), and personalized advice on maintaining a healthy lifestyle through diet, physical activity, and avoiding harmful habits like smoking. It’s about being proactive with your health rather than just treating problems as they arise, and Dr Lefebvre can help guide you in these efforts.

How do I get a prescription refilled by Dr Lefebvre?

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 Lefebvre's office. Please allow at least 2-3 business days for these requests to be processed by Dr Lefebvre. 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 Lefebvre, 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.

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

Generally, you do not need a referral from another doctor 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 sometimes be challenging. Provincial resources, such as the Guichet d'accès à un médecin de famille (GAMF), may be helpful. 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 (Médecin de famille) is a physician who has completed post-graduate training in family medicine. They are skilled in providing continuous and comprehensive medical care, health maintenance, and preventive services to patients of all ages. This includes diagnosing and treating a vast array of illnesses, managing complex long-term health conditions, offering health education and counseling on lifestyle choices, and acting as your advocate and guide within the broader healthcare system.

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

To find a family doctor in Quebec who is accepting new patients, you can check the website of the Collège des médecins du Québec. They often have a "Find a Doctor" tool or list. You can also use the Guichet d'accès à un médecin de famille (GAMF). Asking friends, family, or colleagues for recommendations is also helpful. Contacting local community health centres or new patient clinics directly is another option. Finding a family doctor may take time and effort.

How often should I see Dr Lefebvre for a check-up or physical exam?

The recommended frequency for check-ups or periodic health exams with Dr Lefebvre can vary based on your age, overall health, any existing medical conditions, and specific risk factors. Generally, healthy younger adults may need a full check-up less frequently (e.g., every 2-5 years if no concerns), while children, older adults (e.g., annually over 65), or individuals with chronic conditions may benefit from more frequent visits (e.g., annually or semi-annually). For specific screening tests like Pap smears or mammograms, there are established provincial guidelines based on age and gender which Dr Lefebvre follows. It's best to discuss your individual needs with Dr Lefebvre to determine an appropriate schedule for your preventative care. Even if you feel healthy, regular check-ins can be important for early detection and health maintenance.

Is seeing a family doctor (Médecin de famille) covered by Régie de l'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 (e.g., cosmetic procedures, most travel medicine consultations, sick notes for work/school, insurance forms, driver's medicals) may not be covered and might have an associated fee. Please confirm with Hôpital Marie-Clarac if you have questions about specific non-insured services or potential fees.

Hôpital Marie-Clarac
3530 boul Gouin E
Montréal, QC, H1H 1B7

Phone: (514) 321-8800

Dr. Myriam Lefebvre 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: 15745

Verify registration with The Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=15745

Family doctors like Dr Lefebvre 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.