M.D. News Article

A Call Back to the Good Old Days

Doctors Making Housecalls Offers Benefits to Patients and Physicians An iconic image of American life, the physician with his black bag making housecalls, is as nostalgic as the memories of wooden bleachers at baseball fields, ice cream sundaes made by soda jerks and six-ounce Coca-Colas in green glass bottles. Today, thanks to two innovative pioneers, this image does not have to be something of the past for residents of the Triangle area. The “good old days” of doctors making housecalls are back, according to Dr. Shohreh Taavoni, who, along with Dr. Alan Kronhaus, started a practice by that very name. After practicing internal medicine in the Triangle for more than a decade, Dr. Taavoni saw a need for a new twist on an old type of patient care. “So many times I got phone calls from patients who said they were too sick to come in, or too busy to leave work, or their schedule just didn’t allow them to get there, or they didn’t have a ride.” Thus, Doctors Making Housecalls was created. A group of experienced, board-certified physicians, Doctors Making Housecalls is dedicated to providing medical care in the comfort and convenience of the patient’s home or office. Doctors Making Housecalls combines clinical excellence with uncommonly high levels of service and personalized attention, at a price patients can afford. Dr. Taavoni says Doctors Making Housecalls is a full-service practice. “Anything that primary care physicians can do in their office, we can do in the patient’s home or place of business.” The physicians bring their own portable medical equipment to do everything from blood work to an electrocardiogram. If patients need imaging or other specialized procedures, the physicians make the necessary referrals, just as their colleagues in mainstream offices would do. The benefits to patients are numerous. “You have the convenience of a physician coming to your home and meeting you personally and taking time,” said one satisfied patient, Perry Jenkins. However, the benefits of Doctors Making Housecalls go well beyond convenience. “The fact that the doctor can see where you live, how you live; can see things that can help you take care of yourself so you don’t fall. The obstacles in your home have a lot to do with your health.” Equally important, but perhaps not as obvious, are the benefits to other physicians. Dr. Kronhaus pointed out, “Colleagues can use our service to care for patients who are temporarily debilitated or homebound—after discharge from the hospital, for example. They can also call on us when they are overbooked or away from the office, and one of their patients has to be seen right away. We decided not to have an office, in part, because we wanted colleagues to see us as a complement to their practice, not a competitive threat.” A GROWING NEED FOR HOUSECALLS
When one thinks of who might use this service, the elderly come first to mind. According to the American Academy of Home Care Physicians, an estimated two million elderly nationwide will be chronically homebound, needing a doctor to pay them home visits, by the year 2020. People who are 85 years or older represent the fastest-growing segment of the U.S. population, and are perhaps most in need of a doctor’s visit. Treating these individuals in their own homes can reduce the number of hospitalizations and trips to the emergency room, and can prevent or delay nursing home placement. Physicians get a better sense of how a patient is really getting along. They can check on what medications he or she is actually taking, and whether they can navigate their living quarters. “In the home, physicians have the opportunity to speak with the patient’s relatives and other caregivers, and to coordinate care more effectively with the allied health professionals,” explained Dr. Kronhaus. “We’ve been impressed at how much useful clinical information we glean by going into the home. This is especially important in treating Alzheimer’s patients, who can become totally different people when they’re removed from their usual environment.” The elderly are certainly not the only patients who use Doctors Making Housecalls. VIPs and business executives also use the service, but more for reasons related to privacy, time and convenience. Many busy executives can’t imagine spending half a day going back and forth to see the doctor, and risk languishing in a waiting room. They prefer to schedule an appointment at a time and place of their convenience. They can even have the physician come right to their office. “Many busy executives haven’t seen a doctor in years because they can’t bring themselves to go,” said Dr. Kronhaus. “We lower the threshold by eliminating the excuses.” Travelers comprise another special patient population. “For tourists or business people who get sick on the road, nothing beats having a physician come right to your room,” said Dr. Kronhaus. “Being ill when you’re away from home is scary. You don’t know what to do or where to turn. Now, when a hotel guest calls the front desk or concierge and says, ‘I’m sick,’ the staff knows to call us.” Several hotels in the Triangle use Doctors Making Housecalls to provide urgent care to their guests. Making hotel calls to the The Carolina Inn, Sienna Hotel, The Sheratons, Hilton Garden Inn and Embassy Suites, to name a few, the group’s physicians can do whatever is required to diagnose and treat most medical conditions. “But we are careful to point out, whether to the hotels or our patients, that we are not an emergency service; if the problem is a medical emergency, we tell them to call 911,” said Dr. Taavoni. There are many reasons why a patient would call Doctors Making Housecalls; for example, one would use the service if he/she:

• Wanted to avoid sitting in a waiting room,
• Needed acute care, but wanted to avoid the ER,
• Needed an outstanding primary care doctor,
• Cannot get a timely appointment with his/her doctor,
• Cannot get out of the house, or feel too sick to drive,
• Wanted more privacy and personalized attention,
• Wanted to avoid exposure to other sick people. PHYSICIANS ALSO BENEFIT FROM DOCTORS MAKING HOUSECALLS

Doctors Making Housecalls views physicians as an important part of its referral base. “There are many ways we can complement a physician’s practice,” offered Dr. Kronhaus. “For example, physicians can use our service to help them provide ongoing care to their frail patients.” This reduces the burden on physicians, who may feel that close monitoring of a patient is warranted, but are wary of the dangers and discomfort of getting these patients to their facilities. Physicians may also use Doctors Making Housecalls to provide acute episodic care to patients who are “too sick to come into the office,” or to patients they can’t work into an already overloaded schedule. Physicians are usually not comfortable making a diagnosis without seeing the patient, especially considering the liability of treating a patient over the phone. In these cases, the physician may call on the service to see the patient at home, verify the physician’s diagnostic impression and initiate therapy. Some patients have medications that are regularly filled. Although the medications need to be monitored, the patient may not necessarily need an office appointment. Physicians can reduce their liability on medication refills for patients who are not regularly seen by using Doctors Making Housecalls to check on these patients. Similarly, the service can reduce the exposure from physicians who sign nursing orders for patients not regularly seen. “Our group represents an additional service physicians can offer selected patients. We can dramatically improve access to care and enhance the referring physician’s ability to effectively treat his patients,” explained Dr. Kronhaus. THE FOUNDING PHYSICIANS
The company was founded by Dr. Kronhaus and Dr. Taavoni, who developed the concept to answer a growing need they saw in the Triangle area. Dr. Kronhaus is well known for developing innovative ways of providing care to underserved populations. “Our housecall service can help people who just can’t, or don’t, get to the doctor,” said Dr. Kronhaus. “They are busy executives, overscheduled moms, and patients with physical limitations. They are people who don’t have good access to care, despite the resources available in the community.” The concept of providing physician services on a temporary basis, known as locum tenens, emerged from Dr. Kronhaus’s interest in providing care to underserved rural areas. It catapulted him to national prominence as the founder and CEO of KRON Medical, and the driving force behind the now-thriving locum tenens industry. Dr. Kronhaus sold KRON Medical in 1993 and retired two years later at the age of 46 to become a stay-at-home dad. His wife finally coaxed him out of retirement in the summer of 2002 to help implement her vision of a medical group practice devoted exclusively to making housecalls. In the summer of 2002, Dr. Taavoni started North Carolina’s first medical group practice dedicated exclusively to making housecalls. She believes that seeing patients in their home or office will become a compelling community service. “We can dramatically improve access to care for many individuals, from overworked businesspeople, to isolated elderly, and busy women pulled in all directions,” said Dr. Taavoni. “These people might not get the care they need if our service were not available. “We are proud of the fact that we provide comprehensive care for both acute and chronic medical problems,” she went on to say. “In fact, we provide the same range of services that specialists in adult medicine typically provide in their office. And we add value by offering same-day or next-day appointments seven days a week, and by seeing patients in their home or office—wherever is most convenient for them.” INCREASED ACCESS TO TOP QUALITY CARE

Doctors Making Housecalls provides an impressive array of services:

• Acute/Urgent Care—all appointments within 24 hours
• Preventive Medicine/ Annual Physical Exam, including EKGs, mammography, prostate screening, flu shots, tetanus vaccines, and blood cholesterol and sugar tests
• Blood drawing for whatever laboratory tests may be required
• Electrocardiograms (ECGs)
• X-ray and medical imaging studies, including traditional X-rays, mammography, CT, MRI, and ultrasonography.

Currently, Doctors Making Housecalls serves Chapel Hill, Carrboro, Durham, Morrisville, Apex, Cary, Raleigh, and north Raleigh. They have occasionally ranged as far as Wake Forest, Clayton, Pittsboro and Harris Lake. The practice accepts Medicare, takes Medicare assignment, and submits claims electronically to all commercial insurance carriers. Affordable fees, coupled with reimbursement from insurers, make this unique service available to almost everyone. For more information about Doctors Making Housecalls, please see their Web site, www.DoctorsMakingHousecalls.com, or call (919)932-5700.