In The News

In modern medicine, house calls make a return

In his 15 years providing home health care services mostly to seniors, David Maymon constantly saw clients who needed to see a doctor but for one reason or another couldn’t get to one.

What would happen, Maymon says, is that many of those clients – suffering from a worsening of underlying conditions such as diabetes-related issues or COPD – would end up going to an emergency room, often by ambulance after calling 911.

“This was not the exception, it was the rule,” Maymon says. “It’s an incredible drain on taxpayers, on patients and on the whole system.”

Recognizing there might be a better way to handle the situation, Maymon started Red Tree Health, one of a small number of services that arranges house calls for those who can’t or don’t want to leave their home.  

In creating Red Tree Health, a Fort Lauderdale-based company serving mainly Broward and Palm Beach counties, Maymon developed a model that focuses largely on providing medical care to individuals recently discharged from a hospital or nursing home.

A nurse practitioner from the company visits patients the day after they’ve been released from a facility. Then he or she will follow up to help ensure the patient’s recovery progresses without incident.

Red Tree’s nurse practitioners also are available to visit patients who cannot get to a doctor for a variety of reasons.

Mobile Doctor Services, a West Palm Beach company directly serving Broward, Palm Beach and Miami-Dade counties but with doctors available internationally, takes house calls to another level.

Started in January, Mobile Doctor Services arranges for its contracted physicians to visit patients in their homes.

“When I say we have doctors who make house calls, people don’t believe it,” says Seth Levy, a health-care industry veteran with more than 15 years experience who started the business. “They think it’s a thing of the past or they think it’s a scam.”

Levy says his service’s average patient is between 70 and 90 years old and takes between eight and 12 medications a day.

“These are patients who for one reason or another have difficulty getting to a doctor’s office,” he says, adding that reasons range from lack of transportation to being bedridden.

Mobile Doctor Services also provides doctors who will make house calls to others who prefer not to go to a doctor’s office, such as celebrities or business executives who don’t have time to leave their own offices.

To provide the service, Levy has enlisted the aid of two to four doctors in each of the three main counties he serves. He also has a network of doctors throughout the United States and around the globe. Doctors usually come with a physician’s assistant who can help with taking vital signs and other basic procedures. The company also can provide a variety of diagnostic tests including lab work, x-rays and EKGs – but is not emergency services.

In many cases, patients with traditional Medicare, not Medicare HMOs, can have the at-home services provided by both Red Tree and Mobile Doctor Services covered, as long as they meet certain requirements. Levy says that other patients may be eligible for reimbursement from their insurance providers.

Both Levy and Maymon say that one advantage of having a doctor or a nurse practitioner visit a home is that they see patients in their daily environment, for a better understanding of lifestyle conditions that may impact an individual’s health.

“There’s no doctor in an office who knows what we know about a patient,” Levy said.

In addition to the services offered by firms such as Red Tree and Mobile Doctor Services, some primary care-physicians and concierge medical practices also make house calls.

For many, however, taking time away from seeing patients in the office can be a challenge.

“It’s a matter of time management,” says Dr. Jack Zeltzer, a vascular surgeon and member of the board of directors of the Palm Beach County Medical Society.

Zeltzer says that as a surgeon he needs to personally see patients soon after an operation to ensure that a wound is healing properly and that there are no complications. Most patients, he said, are able to get to the office but for a small number, the only option is a private ambulance service, which can be costly.

While in many cases it’s imperative that patients see a physician, evolving technology and telemedicine is having a positive impact on where medical care takes place.

“The advances in telemedicine are growing by leaps and bounds,” says Bart Delsing, chief operating officer of FirstLantic Healthcare, which provides a broad range of home health care services to clients in South Florida.

Delsing says that today nurses can leave equipment in a client’s home that will make it possible for them to remotely check everything from vital signs to fluid levels in lungs. “People want to be treated at home.”

Copyright © 2016, Sun Sentinel


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