Doctors Keeler, Young, McLurg and Miller Family Practice

05/05/2026

🎗️ Screening vs. Diagnostic Mammograms — what’s the difference?

We often hear: “Do I need a requisition for a mammogram?”
The answer depends on why the test is being done.

🔍 Screening Mammogram
This is for people without breast symptoms — routine checks to look for early signs of breast cancer.

✔️ You can book this yourself through the screening program
✔️ No requisition needed
✔️ You do need a family doctor listed to receive and act on your results
✔️ If anything abnormal is found, you’ll be contacted for further testing

👉 Think of this as preventive care — looking for problems before you notice anything.

🩺 Diagnostic Mammogram
This is for people who have symptoms or specific concerns, such as:

* A new lump
* Breast pain in one area
* Ni**le discharge
* Skin changes
* Breast implants
* History of breast cancer (survivors requiring annual follow-up exams)

✔️ Requires a requisition from your physician
✔️ Done in a more targeted way, focusing on the area of concern
✔️ May include ultrasound at the same visit
✔️ If something suspicious is seen, the radiologist may arrange a biopsy

👉 This is problem-focused care — investigating something that needs a closer look.

📌 Why this matters:
Screening and diagnostic mammograms are booked and performed differently because they serve different purposes. Using the right pathway helps ensure timely, appropriate care.

📅 What should you do?

* No symptoms? You can book your screening mammogram directly
* New concern or history of breast cancer? Book an appointment with your family doctor so we can assess and order the right tests

Early detection matters — and so does getting the *right* test for the *right* reason.

05/04/2026

Join the May Pride Swim at Crystal Pool 🌈

Enjoy a fun, inclusive swim night for 2SLGBTQIA+ community and allies! Whether you float or swim laps, this is your space to show up exactly as you are. All bodies, identities and swim styles are welcome. Cool off, connect and celebrate community at this all ages event.

Saturday, May 23
6:30-9 p.m. (last entry at 8:30 p.m.)
Crystal Pool and Fitness Centre

No pre-registration required. Public drop-in rates apply. Membership passes accepted

05/03/2026

Our understanding of depression is evolving thanks to science.

So called “lifestyle” strategies are expanding and explained here. Diet and exercise play bigger roles, as do sleep and psychotherapy.

This link to the latest Lancet article has the details: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00201-1/fulltext?fbclid=IwVERDUARkbLJleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEen4uGdjhYj7T06WiteK-0IVga1dlgo1JBIJdrhRFTaQ9fTaf0FgV4TMTmPo0_aem_IJukFWI8Qcw3LM3y9ruv2g.

Depression is a common illness that affects people within every society around the world. It afflicts the young and the old and everyone in between, and as such poses an immense global burden. New interventions and a deeper understanding of this illness are emerging, but improving the use of existin...

05/02/2026

It’s never too late to strengthen your bones! Start today.

05/02/2026

Walking is great but check out these tips for strengthening your bones 😊

05/02/2026

Thinking that your daily walking program is key to longevity?

Well, it’s better than not walking, but as far as bone health, agility, and being able to get up off the floor as you get older, walking isn’t the best option.

Have a look at these tips for strong bones from

It’s never too late!

Start today, with sit to stand repeats from your favourite chair. Try 🔟 in a row. You can do it! 💪🏼😊

05/02/2026

Do you have one or more young kids? 😊

Victoria psychiatrists Dr. Melissa Gansner, and Dr Jasmina Kobiljski are running a zoom CBT skills group for New Parents through Mind Space starting Wednesday June 3rd, 2026. There are still spaces available.

Here is more info about the group:

This 10-week 105 min group is for participants with young children (4 years old and younger).

It provides support and teaches skills to manage symptoms of postpartum anxiety and depression, such as learning distress tolerance skills, mindfulness skills, and exploring how our thoughts and behaviors affect our mental health.

Ask your family doctor about it if you’re interested. It’s covered by MSP 😊

Mind Space: mental health skills education for BC residents, offering groups to learn practical skills for managing anxiety, depression, ADHD and parenting.

05/01/2026

Are you a cancer survivor?

Do you have questions about your follow up, and what regular surveillance is needed?

Have a look at this great tool for patients:

04/29/2026

This great summary about viruses comes from the Durham County Public Health but applies everywhere.

Swipe for a brief guide to everything we want you to know about viruses today, put together by our social media manager who has not yet taken the time to plan this week's content or make good graphics so put these together very quickly because every day we are reminded of the importance of sharing these facts.

04/21/2026

💊 “It’s just a refill” — not quite. Here’s why.

When you request a prescription refill, there’s more going on than simply clicking “renew.”

Every medication we prescribe is part of an ongoing plan that needs regular reassessment:
✔️ Is it still working as intended?
✔️ Is this still the right dose for you?
✔️ Are there any side effects or long-term risks developing?
✔️ Has anything in your health changed that should shift our approach?

Good care means booking in, not coasting.

Prescriptions are written for a specific duration on purpose — they are meant to last until it’s time to reassess your condition together. That reassessment is a key part of safe, effective care.

🤝 This is also where shared decision-making happens:

* Continue as is
* Adjust the dose
* Try a different medication
* Or sometimes, stop altogether

📅 Your role matters too:
Please book a follow-up appointment *before* your medication runs out. This helps avoid gaps in treatment and ensures we’re making thoughtful, informed decisions — not rushed ones.

Bottom line:
There’s no such thing as “just a refill.” There’s only ongoing care.

Thank you for being an active partner in your health.

04/15/2026

Just today, I was asked by several perimenopausal patients if they should "have their hormones checked"?

I often refer patients to Dr. Jen Gunter's book, "The Menopause Manifesto" as an excellent resource for evidence based information.

Key insights on "hormone testing" from Dr. Gunter:

No Testing Needed: For women over 45, reproductive hormone tests are not recommended to diagnose menopause or manage symptoms.

Why Not Test? Hormone levels change constantly during perimenopause and cannot help determine the correct hormone dosage.

Symptoms Rule: Decisions on hormone therapy (type and dose) are based on clinical symptoms like hot flashes and vaginal dryness, not lab results.

Exception for Under 45: Testing FSH and estradiol is only recommended to evaluate for premature menopause (POI) or if someone has signs of excess testosterone (like high hair growth).

The Problem with Testing: She argues that testing often leads to incorrect dose adjustments (like excessive doses) that cause side effects, and some practitioners use these tests to charge patients more money.

The primary goal of hormone therapy is symptom relief, which is best assessed clinically rather than biochemically.

Salivary and urinary testing are particularly unreliable and have no FDA-approved assays for steroid hormone measurement.

I start with a menopause symptom questionnaire, and we go from there. The approach needs to be tailored to the individual, and their symptoms.

There is no one size fits all, and, when it comes to what's on the "MHT(Menopausal Hormone Therapy) Menu", there are many excellent , safe, evidence based choices, and now, in BC, many of them are "on the house", covered by pharmacare for all.

04/03/2026

🚗 Driver’s Medical Exams at Age 80 & 85 – How to Prepare

If you’ve received a RoadSafeBC Driver’s Medical Examination form, here’s how to make the process smoother and set yourself up for success:

✅ Before your appointment:

* Consider booking a refresher driving lesson with a local driving school
→ You’ll get expert feedback, updated road rules, and tips to stay safe

🧠 What to expect at your visit:

* A review of your medical history and medications
* Cognitive and memory screening (a routine part of driver safety assessment)
* Vision and general health review as it relates to driving

💬 Important to know:

* This exam is not covered by MSP
→ Fees may be up to $253 for assessment and form completion
* Your doctor may ask about your plans for eventually stopping driving
→ This is to help you stay in control of the decision, not to take it away from you

⚠️ A note on safety:

* No physician wants to report unsafe drivers
* However, we are legally obligated to do so if safety is a concern

❤️ Our goal:
To help you keep driving safely for as long as possible, while ensuring our roads remain safe for everyone.

If you have questions about the process, feel free to contact the clinic—we’re here to help.

This post was inspired by Celine, who came in yesterday for her driver's medical (turning 85 soon) exam and form, and reported her driving instructor from her refresher lesson had given her the thumbs up. I was so impressed by her insight and planning!