Dr. Nancy Shink

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

Preventative Health Topics

• Travel Medicine Advice & Routine/Travel Vaccinations: Offering essential travel health services and tailored advice to protect your health while abroad, based on current international health regulations, CDC/WHO recommendations, and your specific travel plans.
• 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.
• Health Equity & Social Determinants of Health (SDOH) Discussion & Resource Navigation: Advocating for patients facing health inequities and working to connect them with resources that can improve their overall health outcomes and reduce disparities.

Mental Health Concerns

• Depression & Other Mood Disorders (e.g., Dysthymia, Seasonal Affective Disorder - Management): Helping individuals navigate feelings of sadness, hopelessness, and other depressive symptoms, aiming to restore emotional well-being, daily functioning, and prevent relapse.
• Initial Assessment & Referral for Other Mental Health Concerns (e.g., OCD, PTSD, Eating Disorders, Bipolar Disorder, Psychosis): Providing a safe and confidential first point of contact for individuals experiencing symptoms suggestive of other mental health conditions like Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), eating disorders, bipolar disorder, or early psychosis. Includes initial screening, supportive listening, crisis intervention if needed, risk assessment, and prompt, appropriate referral to specialized psychiatric, psychological, or emergency mental health services for accurate diagnosis and comprehensive treatment.
• Insomnia & Chronic Sleep Disturbances: Helping you identify and address factors contributing to poor sleep, and develop effective, sustainable strategies to improve sleep quality, duration, and daytime alertness and functioning.

Joint Muscle Pain

• Mechanical Low Back & Neck Pain (Acute, Subacute, Chronic - Uncomplicated): Helping patients understand the nature of their mechanical spinal pain, empowering them with self-management techniques, and discouraging reliance on passive treatments or unnecessary imaging for uncomplicated cases, in line with clinical practice guidelines.
• 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.
• 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).

Dermatological Skin Conditions

• Acne Vulgaris (Mild to Moderate) & Rosacea Management: Diagnosis and management of common acne (comedonal, papulopustular) and rosacea (erythematotelangiectatic, papulopustular types) with topical treatments (e.g., benzoyl peroxide, retinoids, topical antibiotics, metronidazole, azelaic acid, ivermectin), oral antibiotics (e.g., tetracyclines for inflammatory acne/rosacea, if indicated), and comprehensive lifestyle/skincare advice (gentle cleansing, non-comedogenic products, sun protection for rosacea, trigger avoidance for rosacea). Referral to dermatology for severe, cystic, or treatment-resistant acne/rosacea.
• Benign Skin Lesion Assessment & Management (Skin Tags, Seborrheic Keratoses, Cysts, Lipomas): Evaluating common benign (non-cancerous) skin growths like skin tags (acrochordons), seborrheic keratoses ('age spots'), cherry angiomas, dermatofibromas, epidermal cysts, and lipomas. Providing reassurance regarding their benign nature and offering in-office removal (e.g., cryotherapy, snip excision, curettage, simple excision for cysts/lipomas if trained/equipped) for cosmetic reasons, if causing irritation, or for diagnostic certainty if there's any ambiguity.
• Primary Care Skin Cancer Screening & Early Detection (Suspicious Mole/Lesion Assessment): Playing a vital primary care role in the early detection of skin cancer, which significantly improves prognosis, and facilitating prompt access to specialist dermatological care when needed.
• Eczema (Atopic Dermatitis), Contact Dermatitis & Seborrheic Dermatitis: Diagnosing and managing various forms of eczema/dermatitis, including atopic dermatitis (the most common type, often starting in childhood), irritant/allergic contact dermatitis (identifying and avoiding triggers), and seborrheic dermatitis (affecting scalp, face, chest). Management focuses on skincare education (frequent emollients, gentle cleansers, lukewarm baths), trigger identification and avoidance, topical corticosteroids (appropriate potency for site and severity), topical calcineurin inhibitors (TCIs like tacrolimus, pimecrolimus), and antihistamines for itch relief. Referral for patch testing or to dermatology for severe or refractory cases.

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

• Evaluation of Acute Musculoskeletal Injuries (Sprains, Strains): Assessing acute injuries like ankle sprains, muscle strains (e.g., hamstring, quadriceps), and ligament injuries, providing advice on RICE (Rest, Ice, Compression, Elevation), pain control, and determining the need for imaging or specialist referral.
• Travel Medicine Consultations (Preventative Advice & Routine/Travel Vaccinations): Offering essential travel health services and advice to protect your health while abroad, tailored to your destination and activities.
• Care for Minor Injuries & Acute Musculoskeletal Complaints: Assessing and treating minor injuries such as sprains, strains, simple fractures (initial assessment and referral for casting/splinting if needed), minor cuts/lacerations (suturing if appropriate), superficial burns, and acute episodes of back or neck pain.
• Assessment & Management of Common Joint Pain (Knee, Shoulder, Hip, Back): First-line medical care for a variety of musculoskeletal complaints, aiming to alleviate pain, improve function, and guide appropriate further management.
• Diagnosis & Management of Common Acute Childhood Illnesses: Providing prompt, effective, and child-friendly care for common infections and acute conditions to ensure quick recovery and prevent complications.

Note: This list highlights some of the key services offered by Dr Shink. 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 Méd Ass de Sainte-Croix, 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 Shink frequently works with patients towards goals such as:

• Many patients have successfully addressed experiencing unexplained bruising more easily than before with Dr Shink's support. This often leads to their elderly parents or relatives receiving thoughtful, patient, dignified, and age-appropriate comprehensive care from Dr Shink that demonstrably enhances their functional abilities, safety, and overall quality of life in their later years and the ability to fully participate in wholeheartedly enjoying a diverse range of seasonal outdoor activities such as cross-country skiing or snowshoeing in winter, beachcombing or lake swimming in summer, vibrant apple picking or leaf-peeping hikes in autumn, and early spring gardening once more.
• Dr Shink's care for experiencing panic attacks and wanting to find ways to manage them is designed to result in successfully managing their multiple (often complex) medications with significantly fewer side effects, demonstrably better adherence to the prescribed regimen, and a much clearer understanding of each medication's specific purpose, benefits, and potential interactions, thanks to Dr Shink's careful oversight, so patients can resume activities such as feeling mentally clear, exceptionally sharp, highly focused, and consistently productive throughout their demanding workday, during important decision-making processes, or when engaged in complex cognitive tasks with confidence.

Your personalized healthcare plan, developed in discussion with Dr Shink, 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 Shink practices at Méd Ass de Sainte-Croix, a family medical practice in the central Sainte-Croix neighborhood of Sainte-Croix. 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.

What happens if Dr Shink determines I need to see a medical specialist?

As your family doctor, Dr Shink acts as your primary care coordinator. If she believes your condition requires specialized assessment or treatment, she will explain why a specialist consultation is necessary and will arrange the referral. Dr Shink will send your pertinent medical details to the specialist. The specialist's office will then typically contact you to book the appointment. It's important to keep Méd Ass de Sainte-Croix informed of any specialist appointments you attend and any new diagnoses or treatments recommended by the specialist so Dr Shink can continue to coordinate your overall care effectively.

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 that doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. You may find it helpful to use provincial resources to find a doctor accepting new patients. A referral from a family doctor is usually required to see most medical specialists.

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

Your family doctor (in Quebec) is your primary healthcare provider, expertly trained to care for a wide spectrum of health issues, from newborns to seniors. They manage acute illnesses and injuries, oversee the care of long-term chronic diseases, provide routine health screenings and lifestyle counseling, administer vaccinations, and ensure you get access to specialized medical services through referrals when needed. The continuity of care they provide, understanding your health history and individual needs, is fundamental to effective family medicine.

What should I bring with me to my appointment with Dr Shink?

For every appointment with Dr Shink, please bring your valid provincial health card (e.g., Régie de l&#x27;assurance maladie du Québec (RAMQ) card). It is also very helpful to bring an up-to-date list of all your current medications, including prescriptions, over-the-counter drugs, vitamins, and herbal supplements, along with their dosages. If you have them, any relevant medical records, recent test results (blood work, imaging reports), or letters from other doctors can be useful, especially if you are seeing Dr Shink for the first time or for a specific complex problem. Having a written list of your questions or concerns can also help ensure you cover everything you need to during your visit.

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

The recommended frequency for check-ups or periodic health exams with Dr Shink 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 Shink follows. It's best to discuss your individual needs with Dr Shink 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.

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 take time and effort. You can check the website of the Collège des médecins du Québec, which may have a "Find a Doctor" tool or list. You can also ask friends, family, or colleagues for recommendations, or contact local community health centres or clinics directly. The Guichet d'accès à un médecin de famille (GAMF) may also be a helpful resource.

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 health card. However, some services, such as cosmetic procedures, most travel medicine consultations, sick notes, insurance forms, and driver's medicals, may not be covered and may have an associated fee. Please confirm with Méd Ass de Sainte-Croix if you have questions about specific services or potential fees.

Méd Ass de Sainte-Croix
6350 rue Principale
Sainte-Croix, QC, G0S 2H0

Phone: (418) 926-3260

Dr. Nancy Shink 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: 88014

Verify registration with The Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=88014

Family doctors like Dr Shink 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.