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November 20, 2012 > Health care returns to the home

Health care returns to the home

By Julie Grabowski

The image of a doctor grabbing his black bag and heading out to his patients' homes has long been relegated to a bygone era. With advancements in treatment and technology it seemed to be an unarguable fact that in order to receive the best care, you needed to go to a physician's office or hospital. But the house call is making its way back into the mainstream as an effective alternative for elderly and chronically ill patients.

Home care serves to reduce time spent in hospitals and nursing homes while significantly lowering the cost to care for patients with multiple ongoing heath issues - a group that consumes over 50 percent of Medicare's budget. The Independence at Home Act was established to address these needs. It allows those with Medicare to receive in-home services from doctors and nurse practitioners, provided that the care results in a minimum savings of five percent to Medicare with improved patient outcomes and satisfaction for both physician and patient. As a result, house calls are now available in hundreds of locations across the country including those living in the Bay Area.

Based in Palo Alto, Bay Area House Call Physicians was begun in 2006 by Dr. David Jones in order to better serve elderly, disabled, and home-bound patients. A graduate of the University of Southern California's School of Medicine, Dr. Jones did his residency at Scripps-Mercy Hospital in San Diego and spent many years working in hospitals and providing hospice care. He has seen the difference taking care of people in their homes can make.

He says that 9-1-1 is called for everything, and many people are in a constant rotation between home and hospital. Providing house calls keeps patients healthy and comfortable at home without the disturbing trips and travails of the hospital. "It allows you to maintain a patient-centered approach," says Dr. Jones.

He believes the house call re-establishes the doctor/patient/family relationship and provides an intimate knowledge of the patient's environment. "It's doing medicine the way I think we should do it," is Dr. Jones' simple explanation. "It's like the bank robber: 'Why do you rob banks? That's where the money is.' Why are you doing house calls? That's where the sick people are," says Dr. Jones. "It was really what my vision of medicine was."

Bay Area House Call Physicians is comprised of Medical Director Dr. David Jones, MD; Sheila Nouchian, MD; Cecily FitzGerald, MD; and Nurse Practitioner Lily Lee. They have seen 2,200 patients and currently have about 400 active patients. Most visits are primary care, seeing patients every four to six weeks. Services include blood tests, changing pill boxes, flu vaccines, Vitamin B12 injections, wound care, mental status exams, home risk assessments, urine analysis, and joint injections, as well as testing with EKG, i-STAT, and CoaguChek. Bay Area House Call Physicians has expanded into Fremont, Newark, and Union City. Locations serviced are determined by the travel radius from the office; doctors need to be able to get to patients within 20 minutes. Appointments are available Monday through Friday from 8:30 a.m. to 5:00 p.m.

"We're out in the home and we're centered on what their needs are," says Dr. Jones. "The solution becomes much harder than writing a prescription or ordering a test. It's got to fit in their world, it's got to work. You're always trying to adapt your treatment strategy."

To learn more about Bay Area House Call Physicians, call (650) 384-0986 or visit www.bahcp.com.

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