House Calls is proud to announce its association and membership in the Idaho Health Care Association-Idaho Center for Assisted Living. To commemorate our relationship, we now offer a 10% discount to all IHCA-ICAL members who partner with House Calls to provide primary care services in their Independent Living or Assisted Living Community. With House Calls, your residents don’t go to the doctor for routine primary care…the doctor comes to them! We also coordinate on-site blood work, plain x-rays, and EKGs. Your residents and their families will appreciate compassionate and timely care delivered by a physician in the comfort and convenience of the resident’s own room. Prospective residents and their baby boomer families will breathe a sigh of relief when they discover that if they choose YOU, they will not have to struggle with transportation for routine doctor visits because YOU bring the doctor to THEM. You can confidently ask them, “Why would you choose any place else to live?”
Our seniors are caught in a healthcare paradox. They have enormous healthcare challenges, and yet many have the least access to physicians because they have so much trouble getting to them. By 2030 seniors will represent 20% of our population, and they are the largest subgroup of our citizens. It would be logical to believe that they would be a major focus of attention of the medical community, but this is not happening. As a result, our seniors are underserved, overprescribed, and under-represented in healthcare delivery and research.
There are intriguing new developments in electronic access to healthcare, but most seniors don’t or can’t use electronic gizmos and are therefore left behind (http://housecalls-llc.com/articles/but-what-about-the-elderly-part-1-of-3/).
Physician medical practices seem to spring up everywhere, but the physicians themselves maintain their traditional business model and force seniors to either come to them for their care or do without. Too often our cumbersome medical system causes seniors to delay needed healthcare until it’s too late, resulting in an ER visit or hospitalization. And when they are discharged from the hospital, seniors are given a ream of paperwork with myriad vague and often conflicting instructions which they are then forced to try to disentangle and assimilate, all while they are still weakened and recovering from their illness.
Seniors have the highest number of chronic medical conditions, are the highest consumers of our healthcare dollars, and yet are at the point in their lives where they are least able to financially contribute to the cost of their healthcare. And yet approaching senior healthcare in the traditional manner does nothing to reduce their overall healthcare costs.
So, what is the solution? Well, there is no single solution that will solve this paradox, and looking for a magic bullet that doesn’t exist might explain why there has been such little progress in this arena. And it blinds us to creative approaches that can be identified that can have real and immediate, tangible benefits. If we make it our goal to “bite off a little chunk” of this problem rather than the impossible task of conquering the entire monstrosity, and if we get creative, we can make a difference in the lives of our seniors NOW…not a year from now, not 5 or 10 years from now, but NOW!
Here’s an example of a “new” and deceptively simple approach. A “House Call.” A simple, old fashioned House Call. A physician bringing full primary care to the home of a senior. This opens up a world unseen and unknown by most physicians, because what happens in a patient’s home is often VERY DIFFERENT from what the physician imagines from his remote perspective in the hospital or his office. And here’s the best part of this approach and where the benefit really lies: once the physician is in the senior’s home, this allows on-site, realistic physician leadership and management of the senior’s healthcare, where the physician sees things the way they really occur and not just the way he imagines they occur.
There are only a few working models of House Calls across the United States, and among the most successful are those providing care in Retirement Communities (Independent and Assisted Living) which are a popular alternative for many aging seniors. It is here where physicians can schedule a group of patients to be seen in a ½ day clinic, most closely imitating a ½ day in the doctor’s office.
But this approach needs the partnership and mutual support of both the physician and the Retirement Community. When this occurs, the benefits of an on-site House Call are just what you’d expect them to be: more appropriate care directed to the reality an individual patient faces at home, healthcare that is actually provided rather than avoided due to the difficulty or impossibility of accessing a physician, and adjusted expectations of achievable results resulting from a better knowledge of the patient and his preferences. Applied on a broad scale, the House Call would almost certainly contribute to reducing overall healthcare costs.
We must encourage and foster creative approaches to improving the healthcare of seniors. Everyone who interacts with seniors is a stakeholder. So I encourage you to think outside of the traditional healthcare box, think creatively, and then innovate by picking just a small “chunk” of this issue and applying your contribution TODAY!
Not one single Retirement Community in Idaho (Independent or Assisted Living) has regularly scheduled on-site doctor services offered to all their residents…not one! Despite the potential value of these services, not only to the residents but also to the Communities, until now there has been no focused dialogue between doctors and Community administrators to try to bridge this gap.
I’d like to explain, from the doctor’s point of view, why this service does not happen. I will then point to a solution that works for EVERYONE with the hope that we will all work together in partnership to help the elderly who need us.
The short answer? Going to Retirement Communities contradicts the doctor’s current business model. Even though many might desire to extend their practice to include these Communities, they simply can’t because doing so is 180 degrees in opposition to their business model and therefore prevents them from running a profitable medical practice.
Here’s the doctor’s perspective:
- I can either remain in my office with my entire support staff who has arranged a full afternoon schedule of patients waiting in exam rooms to see me, or
- I can spend the entire afternoon traveling to a Retirement Community where I have no support staff, have to hunt down my 1 or 2 low reimbursement Medicare patients wandering around the Community somewhere, find some place to examine them, and then somehow arrange follow-up testing and appointments.
Everyone simply accepts that if you need a doctor, you go to the doctor’s office, to a clinic, or to the hospital. The doctor does NOT come to you.
Here’s the dilemma
Healthcare is changing, and this means that doctors and Retirement Communities must adapt to new ways. In order to reduce overall healthcare costs, there is an increasing focus on delivering as much healthcare as possible OUT of institutions (e.g. hospitals) and in the Community.
Here’s how doctors must change
You must be more creative and develop a business model that encourages you to come out of your office and provide care in our Communities. There’s a HUGE need and desire for this, and it must be met. Especially for the elderly for whom scheduling appointments and arranging transportation is so difficult that they will often avoid essential medical care rather than go through all the hassle.
Here’s how Retirement Communities must change
Your market is extremely competitive, and in order to achieve a profitable census Communities must not only attract residents but maintain their loyalty by offering quality services. When available, on-site healthcare MUST be included. You must invest in this service just as you would invest in other valuable services you provide.
Here’s a solution
Doctors and Retirement Communities must come together as partners, not competitors. They must understand that neither is trying to take advantage of the other. Rather, both are working together, in partnership and to their mutual benefit, to care for the elderly.
Doctors in Boise, Idaho have ‘stepped up to the plate’ and met this challenge by developing a new business model that makes it possible to provide regularly scheduled services to all residents of a Community while maintaining a profitable medical practice.
But this new model requires that Retirement Communities must also ‘step up to the plate’ and invest in a service that their residents want and that will benefit them and make them more profitable by raising their census.
A partnership that includes Retirement Communities, their residents, and doctors, is one in which EVERYBODY WINS!