Attention: Retirement Communities!

-Independent and Assisted Living Communities-

A physician dedicated to your Retirement Community!

Every Community wants it…No Community has it…

Ask yourself:

“What dedicated physician services does my community have NOW?

(List all physician services here)

Unless you change something, what will be different about tomorrow?


Here’s what a small, low risk investment in House Calls gets you:

  • Regularly scheduled on-site physician clinics in the residents’ rooms
  • YOUR physician who will accept any new patient requested
  • YOUR physician who will sign all appropriate Home Health orders the same day as requested, allowing all Home Health services to begin within 24-48 hours of request
  • YOUR physician who will perform either single visits for residents OR become the resident’s primary care physician
  • YOUR physician who will respond promptly when notified about a resident’s medical needs
  • Physician directed healthcare coordination where all who participate in a resident’s healthcare are now led by a physician and unified as a TEAM rather than acting as separate individual services who don’t communicate with one another
  • Memory Care residents and their families and your staff who are spared the stress and inconvenience of transporting these fragile individuals off-site for routine doctor visits
  • A Marketing and Promotional advantage that identifies YOUR COMMUNITY as a LEADER by offering a service that ALL RESIDENTS WANT, WITHOUT EXCEPTION – easy and convenient access to a physician-led team of healthcare professionals
  • Stabilization of your census by reducing health related attrition through pro-active, early, physician-led intervention in a resident’s declining health
  • Growing of your census by capturing prospective residents who choose YOUR FACILITY because of its unparalleled healthcare support

 There is a way to get what every community wants.

But to get it…a community must be willing to do something different!

House Calls ( is the ONLY healthcare service in Idaho

that brings Physician clinics to Retirement Communities.

Invest a Little…Get a LOT!


Change Nothing…Invest Nothing…Get Nothing…

But what about the Elderly? Part 3 of 3.

Where do we begin?

I’ve been discussing how enhancements in communications through the adaptation of new technology can be seductive amid the use of apps, social media, and telephone outreach, even though there are no data to support their effectiveness.  In contrast, the popularization of wellness programs is also enticing with a very appropriate focus on issues such as weight control, smoking cessation, cholesterol and blood sugar management, and exercise.  These latter programs are promising with their emphasis on prevention of the chronic illnesses seen in older age groups but are met with the daunting task of trying to affect people’s behavior.

These approaches to reaching out and engaging patients in their healthcare and that dominate the medical literature all have one thing in common – they are aimed at the relatively young patient.  So again I ask, “But what about the elderly?”  They are the current highest consumer of our healthcare dollars, yet today’s medical literature is almost silent when it comes to new approaches to treating them and the diseases they’ve acquired and that are slowly taking their lives.

I believe that perhaps one of the best “new” approaches in healthcare in the elderly lies not so much in the ‘treating of illnesses’ but rather in the ‘delivery’ of their healthcare.  And this approach is, in fact, something quite old…that is, the old fashioned ‘house call’.  A ‘house call’ is bringing the physician to the elderly, where they live, rather than waiting for the elderly to decline to the point where they are forced into the emergency room, hospital, and then nursing home.  The reason why this simple and old fashioned approach can be so effective is because it increases the access to healthcare that the elderly so desperately need but yet so often ignore.  If a physician is visible and easily accessible, then the elderly will get the timely care they need to manage their chronic illnesses.

And now finally – “Where do we begin?”  We begin in Retirement Communities – Independent and Assisted Living.  Why do we begin in these communities?  We begin here because this is where larger numbers of the elderly live in a community setting.  It is in this setting where healthcare can be delivered efficiently and proactively with other community health services that are already available and waiting for proactive physician engagement and leadership – home health, hospice, pharmacy, durable medical equipment, and a host of others.  We can make a remarkable difference in these communities now that the final member of the team, physicians, can be encouraged to perform this essential community outreach and still maintain a profitable medical practice.

House Calls offers a business model that merges the old fashioned ‘house call’ with modern healthcare delivery.  It allows interested physicians to enhance their office practice with a profitable outreach in retirement communities.  It makes physicians more accessible and available to lead the team of community health services and make a difference in the health of the elderly.  And the elderly will engage too, because this model is based on an essential feature that the elderly insist on but that modern technology ignores…RELATIONSHIPS.

But what about the Elderly? Part 2 of 3.

What Works and What Doesn’t?

A prominent topic in healthcare discussions these days is physician – patient engagement.  That is, encouraging physicians to reach out to their patients with reminders and health advice that inspires them to keep their appointments and engage in good health behaviors.  Multiple surveys show that younger patients give lip service to wanting a variety of medical apps or be engaged with their physician via text messages, automated voice messages, or e-mail.  The underlying assumption is that patients will change their health behavior and do what their doctor advises them to do.  But literature demonstrating that this type of remote “connection” translates into changing health behavior is glaringly absent.  There is no conclusive evidence in the literature that having an app on your iPhone or a computer that’s connected to the Internet 24 hours a day reduces your hemoglobin A1c, gets your blood pressure under better control, or makes it easier for you to breathe when your emphysema starts acting up.  This type of remote connection, although interesting, just hasn’t yet been shown to improve health.

Do you know what else doesn’t work?  Phone calls don’t work.  There are those who believe that trying to engage patients by calling them on the telephone and speaking with them about their health condition may cause them to be more compliant with health advice and therefore be healthier.  But this also DOESN’T WORK!  This was shown convincingly by Medicare’s Demonstration Projects on Disease Management, Care Coordination, and Value-Based Payment published by the Congressional Budget Office in 2012.  Patients acknowledged that they were called and given encouragement and health advice, but they still didn’t change their behavior.  This is ESPECIALLY true for the elderly, many of whom have at least some degree of hearing loss and find it difficult or even objectionable to assimilate instructions from a stranger over the telephone.

So what DOES work?  What IS effective in reaching elderly patients to help them remain as healthy and independent as possible for as long as possible? The answer lies in 3 parts:

  1. Visibility and Accessibility.  The elderly often neglect their healthcare because our medical system is so cumbersome and difficult for them to find and access.  If healthcare professionals are more visible, and physicians are more readily accessible, the elderly will get care – it’s as simple as that.
  2. Face-To-Face encounters.  Like it or not, the elderly won’t let you into their lives until you build a relationship with them.  And until then, you will usually have little influence over their health behavior until it’s too late (they fall and break a hip or get pneumonia or have a stroke from uncontrolled hypertension, etc.).  Face-To-Face encounters build relationships and therefore get results.  This has been proven conclusively in the field of Transitional Care Medicine which describes the care patients receive when they are recovering from an illness and transitioning from the hospital to home.  The common thread that is integral to all successful protocols that improve a patient’s health behavior and reduces hospital readmission rates is…Face-To-Face encounters.  In other words, RELATIONSHIPS.
  3. Technology.  New communications technology is making vast improvements in the way healthcare professionals interact with each other through Electronic Medical Records, through efficiencies in healthcare delivery, and in the coordination of patient care between hospitals and healthcare and residential facilities.  Younger patients are showing an increasing interest in engaging with their doctors using various modes of technology.   But when it comes to the elderly, meaningful and effective healthcare communication depends almost solely on Face-to-Face interactions and RELATIONSHIPS.

So these are 3 characteristics of healthcare delivery that get the best results with the elderly.  In Part 3 we discuss, “Where Do We Begin?”  If we have a disciplined, targeted, and focused approach in delivering healthcare to the elderly, we can and will make a difference.  And this is also where the fun begins, because to make a difference in this crazy and complex healthcare system, we need a simplified approach that is creative and innovative.  And the answer is found where the old merges with the new!

But what about the Elderly? Part 1 of 3.

The Forgotten

Technology is a wonderful thing…for some people, that is.  Electronic medical records, the Internet and e-mail, smart phones and health apps, automated voicemail, and social media inundate our lives.  Doctors and their patients have either leaped forward or been dragged kicking and screaming into this age of high paced, rapidly changing technology.  Prominent in today’s health literature are articles authored by young technology enthusiasts who promote hi-tech devices and apps that encourage doctors and their patients to relate in a way that’s different than what they’re accustomed to – not in person, not face-to-face, but rather electronically, with promises of benefits that have yet to be proven.  Whether we like it or not, we’re all part of this, and maybe some good will even come of it, eventually.

But there’s an emptiness in these discussions about technology, because something is missing.  You know what it is?  It’s the elderly.  When reading the literature and all the hype and excitement, I can’t help asking myself, “But what about the elderly?”  What about these wonderful, stubborn, cantankerous, and often fragile yet essential creatures who just can’t keep up with these advancements?  I’ll tell you what’s become of them regarding their healthcare:  they’ve been left behind…forgotten.  The nice young people who invent and promote all this wonderful technology and new ways of communicating have done so primarily for the benefit of other younger people.  The elderly, the very people who are the highest consumers of our healthcare dollars, are the least able to access these marvelous inventions.  They have literally been forgotten!  The figures below illustrate this paradox.

Figure 1.

Figure 2.

They show that as we age, our healthcare spending rises dramatically (Figure 1), but we have less access to the technology that may potentially benefit us (Figure 2)!  Most of the elderly simply don’t or can’t use computers or smart phones and could care less about text messages, Twitter, Facebook, and You Tube.

So, what are we to do for the elderly, the demographic that has the most need with the highest number of chronic medical conditions and that by 2030 will comprise 20% of our population?  Where do we go from here?

Part 2 of this 3 part series offers some ideas and describes what works for the elderly and what doesn’t.  Finally, in part 3 you’ll discover how and where WE can make a difference.  Hint…the old and the new will come together.