Medicare’s annual check-up includes many important health concerns, but does not usually include a comprehensive physical examination.

We can supplement your annual Medicare check-up with a comprehensive preventive examination including a

• complete head-to-toe skin examination
• top to bottom physical evaluation
• prostate check for men
• gyn exam for women, if desired
• any other disease oriented physical examination you request

Medicare does not pay for this detailed preventive examination.

Your license to operate a commercial motor vehicle requires periodic physical examinations from a physician who meets the standards of the National Registry of Certified Medical Examiners.

Most of the time, we can generally perform your examination within a couple of days of your call. Assuming you meet the Federal guidelines, you will receive a written certificate on the day of the examination, in most cases valid for two years.

Please come for your examination several weeks before your license expires so you have time to correct high blood pressure or any health issues that may delay renewal.

Please Bring to Your Examination

• Your current commercial driver’s license or picture ID.
• Appropriate medical records if you have sleep apnea, cardiac disease, a recent back injury, any work-related injury, high blood pressure, recent major surgery or a serious medical condition.
• Laboratory forms if your company requires a urine drug test.
• Credit/debit card, check, or other means of payment. If your insurance company reimburses you for preventive examinations, we will give you a billing form so you can submit a claim for reimbursement.

• Vision correctable to 20/40 in each eye. Glasses or contact lenses are permitted.
• Adequate hearing.  Hearing aids are permitted.
• If you have high blood pressure, you are required to be conscientious about treatment.  In the case of new onset high blood pressure, you will usually be allowed to drive while medication is begun and adjusted.
• Not using drugs that impair alertness or performance, such as alcohol, amphetamines, narcotics, or tranquilizers.
• Not subject to seizures.
• Be fit enough to install and remove tire chains, couple and uncouple the trailer, safely secure a load, etc.
• Space allows only this brief survey of the requirements.  The guidelines are lengthy. As a driver gets older, the medical examiner must evaluate all aspects of the driver’s health to ensure safe operation of a commercial motor vehicle.

Waivers

• Certain drivers who require insulin for treatment of diabetes may qualify to operate a commercial motor vehicle under special monitoring programs.
• Drivers with missing limbs may qualify in certain circumstances to operate a commercial motor vehicle. Special evaluation is required.

Hazards Associated with Commercial Motor Vehicle Operation

Dr. Rienstra (and the Federal Motor Carrier Safety Administration) understands that there are many stresses unique to commercial motor vehicle drivers. These can include

• Long and irregular work hours
• Rotating work schedules
• Irregular sleep patterns
• Fatigue associated with extended work hours without breaks
• Nutritional challenges that go with restaurant food
• Emotional stress due to extended time away from a driver’s social support system
• Physical and psychological stress from tight pickup and delivery schedules
• Adverse road, weather, and traffic conditions
• Exposure to temperature extremes, vibration, and noise
• In the case of passenger carriers, stress from passenger interactions

This is why we recommend our drivers maintain positive health habits even while away from home to prevent weight gain, de-conditioning, and all the health problems that come with it. Your career as a commercial motor vehicle driver depends upon maintenance of your health.

We want you to be able to continue driving and do so safely!

We perform new and renewal examinations for your US Coast Guard license.  If your employer requires a urine drug test, please come ready to give us a sample.

Please Bring to Your Examination

• Your picture ID.
• Appropriate medical records if you have sleep apnea, cardiac disease, a recent back injury, any work-related injury, high blood pressure, recent major surgery or a serious medical condition.
• Laboratory forms if your company requires a urine drug test.
• Credit/debit card, check, or other means of payment. If your insurance company reimburses you for preventive examinations, we will give you a billing form so you can submit a claim for reimbursement.

• Vision correctable to 20/50 in each eye. Glasses or contact lenses are permitted.
• Adequate hearing.  Hearing aids are permitted.
• For a renewal, your blood pressure must be 150/90 or less.
• Not using drugs that impair alertness or performance, such as alcohol, amphetamines, narcotics, or tranquilizers.

Suboxone® is a medication used by people with opiate addiction to help maintain sobriety.  It does not cause the mental clouding of methadone.  Suboxone also blocks the rush produced by heroine, oxycodone, and similar opiate drugs.   So in two ways, by blocking the craving and by preventing the high, Suboxone in conjunction with outpatient treatment helps people get clean and stay clean.

Dr. Rienstra is certified per the Drug Addiction Treatment Act of 2000 (DATA 2000) to prescribe and monitor treatment with Suboxone.

What You Need to Know

Sixty miles

Successful addiction treatment requires an on-going relationship between you and Dr Rienstra, so you must live within 60 miles of our Port Townsend clinic or within Jefferson or Clallam County. 

Medical Records

• We must have records from previous clinics and doctors prior to your first visit. 
• You must bring your photo identification.
• You must be prepared to release copies of all previous medical records to the clinic.
• You cannot be in withdrawal at the first visit.
• You must agree to urine drug testing during your treatment. 
• You must provide proof of continued active participation in a recovery program.
• You must agree to lifestyle homework as worked out by you and Dr Rienstra.

Requirements for Treatment

Detoxification

Switching to Suboxone requires that you go through a few hours of withdrawal from heroin, methadone, oxycodone, or your other drug of choice. We usually do this on your second visit to the clinic, and only if you are taking no more than 60 milligrams of methadone or its equivalent.  If you are already taking Suboxone and we have reviewed your records before the visit, detoxification is not necessary.

No Drugs in Clinic

• We do not store in the clinic, nor do we dispense, Suboxone or any other scheduled drugs.
• We do not prescribe methadone.

Individual Care 

We tailor treatment to each individual. To reduce your costs here at the clinic, you may wish to give Dr Rienstra a written summary of your health, your past and current drug abuse history, your current social situation, and other aspects of your life which seem important to your care here.   If you send this before your first visit, we can be sure that we will be a good match for your needs.

Payment Policies

 We require payment at the time of each visit.

 Are you having difficulty finding relief from your symptoms? 

Do you wonder if there might be better treatment options?

When you’re not getting the help you need, or if you are experiencing unusual or complex medical symptoms that seem to escape solution, come to us for an in-depth evaluation. Dr Rienstra can be your medical detective.  He takes the time necessary to listen, to question, to examine, to explain his findings thoroughly, and to formulate solutions.

When you and Dr Rienstra collaborate on your treatment plan, he’ll offer you choices from the best of pharmaceutical and alternative treatments.

Whether you need a 2^nd opinion or are starting with a clean slate, the Rienstra Clinic can provide the time, effort, and resources you need to get to feeling better.

How it works:

1. Contact our office receptionist.  She will help you obtain medical records from your previous physicians.
2. Write out a summary of the medical problems you need solved. Include a time line of symptoms and medical tests.
3. Dr Rienstra will briefly review all this so we can be sure we have everything on hand for an effective consultation. (If he thinks you are unlikely to benefit, our receptionist will let you know and will return your medical records to you.)
4. Our receptionist will then call you and arrange for an appointment.
5. Following your evaluation, Dr Rienstra will send a full report to you and, if you permit, to your primary care doctor.

The fine print:

• While we wish we could guarantee a solution to every problem, of course we can’t.  We do guarantee you that everyone in this office will give you total and complete attention and effort.
• In some cases, including cancer, Dr Rienstra can support and help you only in collaboration with your specialist provider.

House Calls

We offer house calls if physician schedule allows. Please phone our office at 360-385-5658 to inquire about availability.

After Hours House Calls

On evenings, nights and weekends, telephone Doctor Rienstra at home, 360-712-7149, if you have an urgent need. Leave a message on the telephone. If he does not return your call promptly, he is not available, and you need to take other action as appropriate. Depending upon what your needs and desires are, he will see you at your home or his office, give advice over the telephone, or suggest that you to go to the emergency department.

We do special testing for digestive function, hormone levels, cardiac risk, vitamin and nutrient levels, celiac disease, allergies and many more.

If you need to know more about one of these issues, then collect your previous medical records, write out your symptoms and thoughts, and make an appointment with Dr Rienstra to decide what tests are best for you.

If you are in a fix and need someone to cut the red tape, or get you out of the nursing home, or find a solution to a diagnostic dilemma or treatment predicament, call us.  We’ve helped people improve and extend their life, and we’ve helped them bring it to an end when the time came.  If you need someone to expedite your care, we’ll do it.

New Patients

We can provide telephone service to new patients only in the state of Washington.

Established Patients

We can provide telephone service no matter your location.  Regarding prescriptions, we can authorize those only to United States pharmacies.  Controlled substances like narcotics or sleeping pills require an office visit and written prescription.

Insurance Coverage

Your insurance may not pay for a phone consult.

I cannot overstate my gratitude to Dr. Rienstra for being instrumental in saving my life a few years ago. Although the blood test for cancer was negative, Dr Rienstra did his usual careful annual physical exam. When he finished, he surprised me by saying “I don’t think that PSA test is correct. You need to see the surgeon for confirmation of my physical findings.” The surgeon verified Dr Rienstra’s concerns; now I’m well.

I completely appreciate Dr. Rienstra’s intuitive, comprehensive and unequaled fostering of my well-being over the years… Here’s my heartfelt thanks to Dr. Rienstra for sculpting the Monroe Street Medical Clinic!

Vern Garrison

Thanks Dr. Rienstra for the phone consultation today about my bone fracture and upcoming surgery. Your words “you might need this surgery, but you don’t need it tomorrow morning” were positively liberating. Right after talking to you, I called to cancel the surgery and then talked to the orthopedist.

He confirmed that yes, fractures like this could indeed heal on their own. Yes, the pin would stabilize the joint, but was not crucial to a good mend. Yes, no pain means the bone is fine and probably knitting away. I made an appointment to get another xray and consult in 1 month to make sure it is healing. I promised to call him instantly if it started to hurt.

So I will lie around and read, soak in epsom salt baths, and move around with crutches and let nature do its beautiful work.

I was so relieved, I burst into tears.

Thanks again. You rock.

Marian R

Douwe-

Hello and many thanks for the recommendation of Bos Welya Plus on your newsletter. When it made an impact on my hand/finger joint pain, it was suddenly and significantly effective.

Not only has it alleviated morning soreness in the joints, but it also has a significant impact on pain reduction following exertion or physical labor – where in the past I could count on pain after yard work, now it’s either non existent or so greatly reduced that I don’t even notice it. In fact, not noticing pain is the biggest impact of taking this med.

VERY NICE!

Thanks again,

John W. Bickley, Port Townsend

Dr. Rienstra,

I am so impressed with the level of research you must go through to provide the monthly newsletters Medicine-for-People. It is obvious you have a passion to provide medical information to the general public for which no strings are attached. How refreshing is this!

In this day, we are marketed beyond belief. We read and watch only to find that the underlying reason for most information is to sell something. Sometimes I feel we are in the Twilight Zone, with only a few left who can give us information that we need to prevent illness and lead a better quality life. This is not to say that doctors and those in the medical field are trying to take that away from us. I think they are in a survival mode as regulation, insurance and drug companies squeeze every bit of common sense out of them.

What you are offering via these newsletters is a service, and your expertise, experience and willingness to spend huge amounts of time in ongoing research should be compensated. I would be the first paying subscriber.

Thanks again and again,

Judy Peterson
Port Hadlock, WA

My son and I are resistant to Doctor visits. Neither of us have had positive experiences with health care facilities in the past. My ex-wife suggested that Dr. Rienstra’s clinic was different, far better than the norm. It turned out she was correct. Since beginning to go to the Rienstra Clinic, I now find I have no qualms about going in and having physicals, and checking out what seem to be serious health issues. In every case, Dr. Rienstra has a calming effect combined with exceptionally straightforward opinions and scientifically based recommendations. With each health issue, his recommendations have led to solutions and his bedside manner is nothing short of amazing. I would have to say, he solves not only the physical, but leaves one feeling an emotional well-being too. After my experiences, I convinced my son to have, what seemed a serious health issue, checked out with Dr. Rienstra, he had the same experience as I, and now also is willing to visit the clinic when necessary. I can’t stress enough, how effective Dr. Rienstra is at addressing both the physical issues we humans face with health problems, but also the psychological fallout that results.

 CP, Port Townsend