A Lowcountry Practice Brings Care Home to its Patients with a Team of Doctors Making House Calls
by Dr. Stela Pavic
A Call to a Service
When it is time for 87 years old patient named G.L. to see her primary care physician the doctor comes to her. The patient requested to have her visit outside in the courtyard garden at a local Assisted Living Community. Dr. Stela Pavic wheels her suitcase style medical bag into the beautiful garden to meet the patient. Dr. Pavic takes a seat in the chair next to the patient and flips open her laptop, giving modern twist to old time medical services, house calls.
Most HouseCalls patients are elderly and live in a retirement community while others live in private residents and have condition which makes travel difficult. The visiting doctors do exams including; blood pressure check, temperature, give shots, swab throats and do pap smears if needed. Some doctors do biopsy’s and sutures. They send in other medical service groups to gather blood and urine samples do sonograms, electrocardiograms, and take x-rays.
A patient who needs more sophisticated test are referred to hospitals and imaging centers. We refer to specialist just like any other office based physician group. Some of the homecare physicians in the Lowcountry are doing partial house call visits and still have office based practice. It appears that HouseCalls MD is unique and is the one of the only practices doing exclusively all home visits in the Lowcountry. The need for home care remains very high. There are reports of some of the geriatric divisions of local hospitals doing home visits on a very rare basis, mostly to very frail patients. This type of approach can decrease emergency room and urgent care visits which may be unnecessary.
Doctors benefit greatly from seeing patients in their home. Example, last year we visited a patient that had uncontrolled high blood pressure and the woman insisted she used no salt in her food. Upon visiting the patient in her home we discovered that she was using a seasoning that contained monosodium glutamate which is much more potent salt in raising blood pressure. It is very beneficial so to do home visit when things do not seem right.
The Business of Care
The business of HouseCalls MD was based on the idea of a company in North Carolina’s Doctors Making House Calls. The owner of HouseCalls MD was a pupil, for a few years, with this company so she could learn and be able to transfer such a model of care to the Charleston area. Most of the practice calls are made to retirement communities, Independent or Assisted Living Facilities. Most communities agree to let HouseCalls MD clinician staff to come once per week. If a visit is needed outside the visit date the patient is charged a trip fee of $50 which is not covered by health insurance. Medicare and Medicaid cover medical services as they would for any provider. And for many patients supplemental insurance normally covers the remainder of the charges.
Sometimes we have patients move to a community in which we do not have an agreement with however if the patient is requesting for us to follow them we are more than happy to do this. Particularly with a patient that we have a strong relationship with and have become very attached to. We continue doing exams, keeping medications in check and taking care of other chronic issues. We do encourage our patients to participate in exercise classes, physical therapy and occupational therapy when the need arises as we believe this keeps our patients in the best of health for much longer.
Additionally, HouseCalls also visits people in their homes that are too busy at work to leave the office during the day. In this area we have many tourist visits. HouseCalls MD also visits people in hotels or condos when needed. In this case we are working as a concierge service and the cost for this is $150 and the patient then submits their bills to their health insurance when they return to their home state.
Dr. Pavic worked as a resident at the Chapel Hill hospital system. Working in the office environment was very stressful to her. Most of the time she was pressured by the number of people in the waiting room. Having experience with Doctors Making Housecalls in North Carolina she decided to bring this concept to South Carolina. This is more fulfilling not only for the Physician but also to the patient. The job requires a lot of communication between the staff and family members and we strive every day to improve that flow. We try to spend 30 minutes to one hour with our patients as they normally have a lot to tell us. We are here to be a true benefit to all our patients.