By: Sarah Terry-Cobo The Journal Record March 26, 2015
TUTTLE – On Wednesday, 95-year-old Helen Joslin had her routine doctor’s appointment at her kitchen table in Tuttle. Dr. Joe Witten took her blood pressure, and talked about her pain and mobility.
“I’m getting to the age that I prefer not to drive,” she said. “That leaves me without a way to get anywhere.”
Joslin’s experience hearkens back to the day when physicians routinely visited patients at home, but the appointment represents a growing trend in health care. Hank Ross, owner of Physician Housecalls, said there are many homebound people who need to see a doctor, but it is too difficult or expensive for them to leave their houses. As a result of the federal health care overhaul, federal officials are creating incentives to treat patients in their home, away from expensive care settings, Ross said.
Joslin drives only to the grocery store. She can’t make the trip to Chickasha or Oklahoma City on her own to visit a doctor or a specialist. Granddaughter Tandye Ryans said Joslin had a bad experience at the local medical facility and won’t return.
Physician Housecalls is the best option for her grandmother’s basic medical treatment, said Ryans, who works as operations manager for the company. Joslin can meet with the doctor in her own home, and Ryans doesn’t have to take a day off of work to take her grandmother to a clinic. That saves time and money, Ryans said. Ross estimated one in six adults take care of an elderly relative.
Administering health care at home isn’t necessarily a new phenomenon, nor is it a remnant from a pre-war culture. The American Academy of Home Care Medicine was established in 1984 and serves ill people who also receive Medicare, according to the organization’s website.
However, many physicians aren’t trained to administer care in the home, and Medicare reimbursement has been a challenge, according to the website. And home care services are more predominant on the coasts, Ross said.
Those phenomena are changing, Ross said. Sending a physician to a chronically ill patient’s home can help lower overall costs because it reduces the chance they will call an ambulance to take them to the ER. The University of Oklahoma Physicians is also incorporating home care training for its physicians in residence, though those rotations aren’t commonplace, he said.
He isn’t the only one who has found a business opportunity in providing health care to those who are homebound or live in rural areas. Mike McAuliffe, CEO and president of DoctorOnCall.com, established his business in 2003. In February, he bought out his former business partner and is now sole owner. The business is undergoing a reorganization, and is not currently active, but he expects it to be reactivated by this year, he said.
The service differed from Physician Housecalls. Patients called an (800) number and a physician somewhere in the U.S. would return the call, answering medical questions. His target audience was the low-income population: Medicaid patients. But he was also able to lower health care costs, he said.
In a pilot study among 10,000 Medicaid patients in South Carolina, those who used DoctorOnCall.com service reduced unnecessary visits to the emergency room by 22 percent, he said. That helps reduce overall health care costs.
Ross said he expects this segment of his business to continue to grow; he also owns Ross Health Care, a hospice and home health service. Physician Housecalls has about 200 patients in the Oklahoma City metro and in adjacent counties. There are 63,000 people in Oklahoma County and contiguous counties who are on Medicare and are homebound, which would qualify them for the service. He said he expects to grow to 500 patients by the summer.
The challenge he faces is finding another family practice physician. He is recruiting two nurse practitioners and two physician assistants to meet his expected patient growth.
Among the patients Witten serves for Physician Housecalls, Joslin is unique. She is the healthiest, even compared to patients younger than her, Witten said. Most of his patients are bed-bound and chronically ill. Regardless, the service provides an interesting opportunity he didn’t get at a traditional hospital setting.
“It is a unique way to see a patient in their own home environment,” he said. “They are more relaxed, more at ease with the doctor, plus you can potentially see more of their needs in this environment.”