Do in home doctor visits still exist? Are any doctors making house calls like they did years ago? Believe it or not, a few are and it is becoming more and more popular among physicians. There is even an association called the American Academy of Home Care Physicians to support those who make in home doctor visits. Some have a practice dedicated to home visits while others offer it as a part of an office practice.

I have been making house calls to homebound elderly for about the past 25 years, initially in St. Louis where I had my practice and more recently in Denver where I opened a practice just last year. It provides joy beyond measure for me and hopefully provides a useful service to those I care for. One of my most memorable patients is a lady named Ruth, who had not been to see a doctor in over 10 years. She was developing memory loss, and was resistant to leaving her home. A concerned nephew called me to see if I could come to her. If you can’t move the mountain…, you know the rest. This lovely 81 year old lady was not functioning well at all. She had bottles upon bottles of old prescriptions and had those all mixed up. She was eating poorly, mostly TV dinners, but saving the aluminum tray they came in; she must have had over 100 of them stacked to the ceiling. Her clothes were soiled and her hygiene poor. She was very welcoming, however, and after some time she grew to trust me. We (my nurse and I) set up some home services; personal care aids, nurses, physical therapy, housekeeping, etc. and succeeded in allowing her to remain in her home. We helped her nephew set up guardianship and evaluated the cause of her memory loss, which turned out to be Alzheimer’s disease. She was able to stay in her home for about another year before she required more care and supervision, but that year was a safe and happy one. I can still picture the stacks of colorful hairnets she was wearing when I first met her because she hadn’t been able to dye her hair in a while.

Not all of my patients are as colorful as Ruth. Some need me because they are dying and I help facilitate hospice. Some need only temporary house calls while they recover from surgery or a fracture. Most, however, have numerous complicated medical problems that need the kind of diagnostic skill and oversight that only a professional can accomplish with home visits that allow enough time for listening and observing.

One of my older patients tells me the last time a doctor came to her house she was eight years old. My patient’s memories are not so different from what they experience now. I arrive with a large doctor’s bag (though mine is on wheels), visit for a while and do the same kind of examination and tests they would get in the office (for the most part). I am always amazed at the stamina and attitude of the people I visit. I learn a lesson from each and every one of them.

So if you think house calls are a thing of the past, think again. You just might be surprised to find how many physicians are (still) making in home doctor visits.

Nancy Wilcox Hooyman, MD

Phone: 303-757-0012

For more information, visit http://www.aahcp.org (American Academy of Home Care Physicians) or www.paradigmcare.com.

One of the most difficult tasks facing people today is decision-making about their own healthcare or that of a family member. While the current trends in health care toward patient empowerment, personal health records, patient advocacy, internet research and resources, electronic medical records, and other such tools have brought about much needed change in health care, these concepts also bring about much confusion.

When enough understandable information is made available, people can usually see their way very clearly toward a course of action. This process eliminates the anxiety, fear, and turmoil around complicated problems and complicated decisions.

The process we use at Lynxcare to assist people with their medical decision-making most often begins with a gathering of the person’s entire historical medical record. This is easily accomplished by a signed Medical Release of Information and can be collected by the person themselves, or by Lynx.

The records are then reviewed by the Lynx physician consultant on the case, and are then sent to a registered nurse trained in records abstraction. This Review-By-Two method assures that, as much as possible, errors, inconsistencies, omissions, dangling tasks and unanswered questions are recognized and resolved in the process of creating a very comprehensive, detailed, yet brief and efficient Health Record Summary.

The beauty of this process is that is allows for an ongoing “virtual” case management process to begin that is inclusive of the patient, all their practitioners, the Lynxcare medical consultants, and any other specialists, practitioners, or subspecialists whose expertise may be necessary, but whose time is too short to allow a thorough review of the original records.

Using this method of medical advocacy, Lynx has enabled participants to:
•access the wisdom of renowned medical experts to clarify questions about diagnoses
•qualify for specialized treatment previously considered inappropriate due to sufficient historical information
•have more effective and well-understood communication with their doctors, practitioners, and specialists
•successfully appeal health insurance denials
•move through complex health conditions and difficult times with clarity and peace of mind

As a personalized medical advocacy service, Lynx uses our solid foundations of medical practice, health care systems management, and personal experience to help fill the gaps in individuals’ health care experiences.

Sharon Feder
President, CEO, and Founder of Lynxcare

www.lynxcare.net