Old isn't always old-fashioned. The good old days have that name for a reason. When my grandparents were children, which isn't that long ago in the grand scheme of things, they had a doctor who came to their house when they were sick. He knew them well. He knew the whole family, knew everyone's ailments and preferences, and he knew just what to do to help them heal and provide reassurance. Where did he go?
This day and age, we rely on the dictates of third party payers (aka the health insurance company) to tell us what we as doctors can and cannot do. They cost us so much (in the way of a billing company, secretarial staff, paperwork manager) that in order to get paid we have to see more patients. When we see more patients - think 25 per day - there is certainly no free time to see patients at home. So, when the opportunity arose for me and my physician partner to do things differently - to turn back time - we jumped at it.
When my elderly patient with Alzheimers started taking a turn for the worst, her sons called me and within a day we arranged for hospice to help her at home. Instead of the burden being on the sons, we were able to alleviate the medical concerns and allow them to cherish their last weeks with their mother. When my disabled patient developed a respiratory infection, I swung by on my way home and checked her vital signs, listened to her lungs - I was able to judge that she could stay at home on her portable oxygen machine and ordered breathing treatments through her nebulizer. I checked back in on her the next week and continued to monitor her over phone and email communication with her husband. When a new patient's family called, desperate because their mother's pills were running out and the old doctor couldn't fill them because she hadn't made it into the office in over a year, I alleviated their concerns and spent two hours listening to the story of their mother.
These things aren't possible in a traditional practice, but they are the norm in our practice. When we don't bill insurance (we don't collect copays, we don't send bills to the insurance company, and our patients don't get bills for co-insurance sent back to them), we free up our time & energy and we lower our costs so much so that we can spend more time with patients. When we have more time, we can see patients at home. We can spend hours on an introductory visit. We can meet a newborn for the first time without her parents having to trek her through the snow to our office. We can prevent elderly and young babies from exposure to sick patients coughing around them in the waiting room. Everyone is better off for it. Everyone appreciates it.
Home visits aren't a thing of the past - they are a necessity of the present. We have chosen an alternative model of care that allows us to care for our most at-need community members in their own homes. We have helped patients have dignity in dying in their own homes with their family by their sides; we have welcomed newborns into their parents' lives without exposing them to illness; we have worked with families to prevent un-needed re-hospitalizations; and we have been allowed the privilege of entry into patients' sacred spaces so that we may help them heal where they can heal best.
Dr. Mark Turshen MD and Dr. Lauren Hedde DO are accepting new patients at their Direct Doctors family practice in North Kingstown (Wickford), Rhode Island. Direct Doctors is an innovative primary care practice emphasizing an improved doctor-patient relationship. Drs. Hedde and Turshen offer 24/7 access, no waiting, same day visits, home visits, and a doctor who knows YOU well! If you are frustrated with “fast-food”, “cookie-cutter” health care, Direct Doctors may be just the prescription for you. Check out the Direct Doctors difference at www.directdoctors.org, email firstname.lastname@example.org, or call 401-400-2699.
Lauren Hedde, DO and Mark Turshen, MD are Family Physicians and Founders of Direct Doctors, Inc. a Direct Primary Care Practice.