We believe that everyone is on a different journey in life. Our goal is to meet you where you are and help you customize your care plan. We believe that we all have a responsibility to take care of ourselves. We want to give you the tools and encouragement to be successful, but it also takes effort on your part. We want you to see yourself as equal partners with your medical provider in the health process. We want you to be informed, empowered, and savvy about your health. With new discoveries and a rapid change in information, we realize that patients have resources readily available. There are over 2000 researched health articles that are published daily (not including the popular media). We also realize that we learn from you and that you can become an expert on your illness due to the information that is available. We are open to listening to your discoveries and we facilitate a trusting relationship in which we can both share our knowledge and reason together, as partners.

A Nurse practitioner (NP) is an advanced practice registered nurse (APRN) who can assess, diagnose, treat and manage acute episodic and chronic illnesses. NPs are experts in health promotion and disease prevention. They order, conduct, supervise, and interpret diagnostic and laboratory tests; prescribe pharmacological agents and non-pharmacologic therapies; and teach and counsel patients, among other services. NPs start out as baccalaureate prepared RNs and are typically required to gain 2 years or more of experience as full time RNs before they can apply to a NP graduate school. For most NPs, this process takes 8-10 years of full time training. In Oregon, nurse practitioners have full practice authority and autonomy. What sets NPs apart from other clinicians is their school of thought: o They are PATIENT FOCUSED and take the time to listen to concerns, including the patient in the plan of care. o They have a unique emphasis on the health and well-being of the WHOLE PERSON o They use EVIDENCED BASED treatment/healing approaches that include pharmacological, non-pharmacological, and alternative/natural treatments. o They are passionate about PREVENTATIVE MEDICINE and educating/ encouraging their patients to live healthier lifestyles.

When you establish as a new patient with Voda, your first medical appointment is generally around 45 min. This time is variable based off the reason for the visit, the intake process, and checkout process. For the first appointment, you will do a lot of the talking and answering of medical questions. It's a chance to tell your story, be listened to, and discuss your health goals. Our goal is to create a road map to address your concerns. At this appointment, we will review your medical history and pertinent records, and determine if we would be an appropriate fit for your care team. Together we can then develop a plan. Please sign up for our portal before coming in and fill out the necessary paperwork electronically. This saves valuable time so that we can focus more on you and maximize our appointment time. Please come to your appointment early.

All prescriptions need monitoring for therapeutic effectiveness and potential side effects. This is part of the treatment. If you don’t have refills, you are most likely due for your follow-up appointment. This is purposeful to prompt you to review our treatment goals. Please make an appointment before you run out as we do not typically fill refills in between appointments. It is the patient's responsibility to make sure they have appointments well before they run out of refills. Refills require time, evaluation and management, so please respect the process. We will review notes and deny scripts because of lack of follow-up. This policy allows us to spend more time focusing on you and giving you the time that you deserve in appointments. When you are establishing and transferring scripts for the first time, we may recommend that you have you pharmacy fax us a request so that we can see the exact prescription. Then notify us that you are transferring your scripts under our care. It may be possible that certain scripts require separate appointments to monitor effectiveness and develop our own assessment of the diagnosis and treatment plan.

Yes. To get to achieve health goals, we often have to tackle multiple problems. However, separate appointments will be required when addressing hormones and other issues. Just as you would have a separate appointment if you were seeing another specialist, hormone consultations are individualized appointments that cannot be grouped with "problem visits" or annual exams. During a hormone consultation, a very thorough assessment and health history are taken. A lot of information is gathered and shared. During the appointment, we will also evaluate if you are a candidate for further testing. At that point, testing will be ordered and a follow-up appointment will be scheduled to review these labs in person and then discuss treatment options that are best for you. Depending on your health goals and problems, it is possible that you will require multiple appointments until you reach a therapeutic treatment plan and are stable. Every individual is unique. Preventative visits and annual exams are only for preventative measures and not problem visits. It is possible that upon examination further testing would be warranted. We can talk more about this if this arises. For more information on annual exams, please refer to the annual exam FAQ.

This is up to the individual, depending on the complexity and depth of your health concerns, and ultimately your motivation and goals to get better. When treating chronic health problems, our visits should generally be more frequent so that we can attack the root cause and get you feeling better faster. The following is a GENERAL guide for the frequency of visits. Each patient's needs are unique. o ONCE YEARLY: Annual exams, no health problems, no new health goals, taking no medications, have no changes in health over the past 1 year, yearly lab work, preventative vistis, etc. Voda recommends that all patients are up to date on annual exams, mammograms, prostate exams, colonoscopies and other preventative services. We would be happy to assist you in meeting these needs and answer questions that you have during your appointments. o TWICE YEARLY: If you are stable but on medications requiring monitoring or refills, to assess the effectiveness of current therapies, to ensure there are no major changes resulting from a chronic health condition, etc. o EVERY 3-6 MONTHS: Monitoring of therapeutic treatments or prescriptions o HORMONE REPLACEMENT THERAPY: Patients typically notice a difference in 4-8 weeks after initiating HRT, but adjustments and follow-ups may be needed initially in order to help you achieve optimal results. To ensure safety and effectiveness, an initial HRT consult appointment will be scheduled. After this appointment, baseline labs may be ordered. In the first year, labs are re-drawn anytime adjustments are made. This is up to the discretion of the medical provider, but they are typically redrawn at 6-12 weeks after therapy, 6 months, 9 months, and then 12 months. Once a therapeutic dose is established, we can lengthen treatment intervals. There is no "one size fits all" approach to HRT, so this schedule may fluctuate. Voda recommends that all patients stay up to date on annual exams, mammograms, prostate exams, colonoscopies, and other preventative services. We would be happy to assist you with these and answer more questions. o NUTRITION/WEIGHT LOSS: Voda incorporates nutrition into every appointment that we can. We believe that food is medicine. Voda offers nutritional programs and weight loss programs that may be covered by insurance, depending on comorbidities and your insurance plan. These programs usually require monthly visits until goals are met, or the disease process has improved. o ACUTE VISITS: You can call for same or next day acute visit availability. Voda tries to be available for acute visits such as potential urinary infections, laceration repair, minor burn care, splinter removal, sore throat/cough, and more. We are not an urgent care, but we strive to be available for our patients and help them save the cost of an urgent care visit when possible. If you have a medical emergency, please call 911.

Functional Medicine addresses the underlying causes of disease and engages both patient and practitioner in a therapeutic partnership. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental and lifestyle factors that can influence long-term health and complex, chronic disease. Integrative Medicine is healing-oriented medicine that takes account of the whole person (body-mind-spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. Integrative practitioners also believe that collaboration with other medical professionals is important for optimal healing (specialists, physical therapists, chiropractors, massage therapists, rehab specialists, counselors, and more). They believe that there is no "one size fits all" approach to medicine. The principles of integrative medicine include: o A partnership between patient and practitioner in the healing process o Appropriate use of conventional and alternative methods to facilitate the body’s innate healing response o Consideration of all factors that influence health, wellness and disease, including mind, spirit and community, as well as body o A philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically. They use evidence-based medicine. o Use of natural, effective, less-invasive interventions whenever possible o Use of the broader concepts of promotion of health and the prevention of illness as well as the treatment of disease o Training of practitioners to be models of health and healing, committed to the process of self-exploration and self-development

Absolutely! Voda strongly believes in integrative medicine. This means that we utilize other healthcare disciplines and collaborate with other providers. Sometimes patients see us for primary care, and sometimes they only see us for hormones or women's health. You are in charge of your health care team. We can send records at your request and we can request medical records from other facilities as well.

In Voda's ideal model, we strive to utilize technology to maximize our visit with you. Phone tag, phone trees, and messages are cumbersome for everyone and communication often gets lost or misinterpreted. In today's world of social media and screens, we strive to be different and give you the face-face interaction that you deserve. Our time is spent being 100% present with our patients in the office. This is where the best care happens. To keep the office a healing space, we asking you to please: o Log on to your patient portal, fill out the required paperwork, and schedule an appointment. o Schedule your next appt before you leave, especially if we know you already need a follow-up appointment. Plan ahead now and prevent that panicky feeling when you can’t get an appointment later. o Show up for your appointments on time. We want to maximize our time together and give you the time that you deserve. We will not run into the next patient's appointment time because we believe that every person deserves to be respected and they deserve every minute scheduled. o Treat our staff with kindness

Life happens, but we ask that you do this as early as possible. We respectfully ask for at least 24 hours for regular apt, and 1 week for lab f/u appointments to avoid missed appointment fees. We want to serve you and the community of Newberg. Canceling an appointment last minute, or failing to show up for an appointment prevents someone else from being served who could have taken your place. There is also a lot of prep work involved for staff and this creates an increased workload for them.

In person! Labs provide us crucial information about your health. Resuts are not always black and white. Your provider is specially trained to identify and understand lab trends and imbalances that often are not black or white answers. We want you to become informed and understand what the labs mean and how they contribute to your health. We use this information to create a treatment plan and discuss this in person so that your questions are answered and so that you can be actively involved in your care.

The Voda patient portal is an online tool that helps streamline the process and provides a high rate of satisfaction for users. The whole idea is to have open access to some of your health data quicker. We review labs, imaging results and other medical reports and post them to your portal. These results are printable and are always available, in case you need to share the info with someone else. In general, the portal is used for: scheduling, bill view/pay, patient education, and more. Please do not expect health questions and medical advice to be given through the portal. To give you the high-quality care that you deserve, come see us in person. All you need to create an account is a simple log-in/password combination.

Yes, we currently accept insurance! We live in a world that is constantly changing. We will continue to accept insurance as long as we are able to provide the high quality care that we believe in and as long as the patient-provider relationship is not harmed due to insurance regulations. We hope that we will be able to accept insurance for the foreseeable future. Our insurance list is ever-changing so we already recommend checking with your plan to determine network coverage. You can call our front office staff for assistance with this, but it is always the patient's responsibility to know and understand their coverage. Examples of Insurance companies we may be network with: o Regence BlueCross BlueShield o Providence o PacificSource o Cigna o United Health Care o Moda o First Choice Health Network o Aetna o and more. We do not currently accept Tricare or Workers' Comp. It is your responsibility to understand your plan and what is allowable, including co-pays and deductibles. It is the patient's responsibility to know the types of services covered under their unique insurance plan. Patient balances will preclude you from making future appointments.

We will be sad. We want to see you, but understand that life happens. If you contact our office within a reasonable time and explain your situation, we may consider waiving the no-show or missed appointment fee for the first occurrence. The second time, we charge a missed appointment fee and expect chocolates 😉. The third time, we feel disrespected and understand you are not vested in your health or a professional relationship and we are not a good fit. We want to help you but can’t if you don’t show up. It is a missed opportunity for other patients who want to be seen. Our system gives you reminders: text, email, phone. Sign up for them.

Yes! This is all part of being a board certified family nurse practitioner. We recommend a wellness exam annually. It is a full head-to-toe exam. Questions on guidelines/recommendations are discuss individually. We do not preform DOT physicals at this time.

Referrals require that we assess you and document why we think a certain therapy is necessary for your health condition. We need to evaluate you in person in order to send a proper referral. Referrals often expire, while PT and medical massage need to be reevaluated for necessity and documented. This is required by insurance. Please make an appointment.

It’s a cumbersome paper trail, along with phone calls and denial letters. It’s a method that your insurance company uses to avoid paying for medications, imaging, or services unless you meet their specific criteria. This is more frequently seen by insurance companies and can create a significant barrier to care. Sometimes there is a computer system with a specific algorithm they want to be used with drug therapy or a specific code to cover it. To help you, we fill out forms, send chart notes and our rationale for care. Although it would be nice, we do not have magical powers over your insurance to convince them to pay for things. We encourage you to speak to them about denials and find out about appeals. You pay for your plan and have the choice to choose another if you are not happy with the coverage they provide.

Yes. For acute visits, please call and see if there are any same-day openings on the schedule. Let us know it’s acute and the reason you want to be seen. We are not an urgent care, but we try to accommodate acute visits to save you an expensive urgent care visit. Typical acute cases that we see include sore throat/cough, cold symptoms, UTI, yeast infection, letter due to missed work/school, laceration repair, etc. If you have a medical emergency please call 911.

This is something that we recommend annually. This could include a prostate exam, GYN exam, sports physical, etc. Most plans cover a yearly preventative exam. The goal is to prevent disease by having visits with your health care provider – including a physical exam and usually labs – to ensure your body is healthy. These visits are not to review worsening chronic health problems, discuss new problems, or write new prescriptions. They are for disease prevention and health promotion. This stipulation is universal with insurance. Insurance companies will not cover preventative/screening exams that are billed on the same day as "problem visits".

Yes, but these medications require frequent monitoring and we are very careful when choosing to prescribe them. The goal is to use these sparingly due to side effects. If your prescription expires you need to come in for an appt. We will not automatically refill controlled substances. Narcotics, ADD medications, testosterone for men and women, and certain sleep aids are controlled substances. They are classified by the DEA and have strict rules for prescribing. Some are mandated to have hard-copy prescriptions. Testosterone expires in 6 months. Narcotics and stimulants are only good for 30 days. Sometimes it is necessary to prescribe acute pain medications, but we do not manage chronic pain with prescriptions. We are happy to refer you to a specialist who is an expert in the pharmaceutical management of chronic pain.

Schedule an office visit. Paperwork is cumbersome and we need your help with the answers. Often it requires assessments, exams, labs, vitals etc., documentation of necessity, as well as time. Medical paperwork presented outside of an office visit or forms that cannot be completed during the time constraints of a medical appointment will be subjected to a fee.

Voda has a zero harassment and violence policy. Most workplaces do, but the difference is that we actually enforce it! If you bully, yell, threaten, or harass any staff member, our therapeutic relationship will be immediately terminated and you will not be allowed back at the office. If a staff member bullies, yells, threatens, or harasses you...please notify the office manager as soon as possible and we will handle the situation. Voda exists to serve both patients and its staff members. We believe in creating a supportive work environment where staff love their job and feel empowered to use their talents to heal others. Because we start by investing in our staff, our patients reap the benefits. None of us are perfect, we all make mistakes, but please treat us with respect and we will love you even more :)