On the Revival of Individual House Call Doctors

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Re-Thinking a Popular Practice from the Past

By Dr. David Edward Marcinko; MBA, CMP™ [Publisher-in-Chief]

By Professor Hope Rachel Hetico; RN, MHA, CMP™ [Managing Editor]

More personal than a corporate home care medical business model, most people view house calls as a popular practice from the past.

Although only slightly less than 5% of the nation’s doctors regularly make house calls today, the medical house call industry is swiftly picking up momentum once again. It is a move that is greatly benefiting physicians and patients alike.

Why House Calls?

It’s because we live in a society that has become technology focused. While this emergence has benefited many in terms of medical advancements, there are a growing number of patients who are uncomfortable with next-generation medical practices. These people, particularly the rapidly aging elders of the nation, want to be cared for in a friendly, nurturing, and convenient way. As people age and fall ill, it becomes increasingly difficult to leave the home for office visits. Not to mention, there are many handicapped patients as well who have to arrange for wheelchair vans or ambulances just to visit the doctor.

Link: www.BusinessofMedicalPractice.com

Meeting a Niche Market Need

Thanks to the desire of physicians seeking to open their own medical house call practices, these patient needs are slowly being met. Many of these physicians are strictly open for house call visits only and have no physical office. They commonly take appointment requests via phone calls and emails with the overall goal to combine the service of an old-time, small town doctor with the latest technology designed to meet people’s emotional, and financial, needs. Patients are also able to save a considerable amount of time by not having to leave the house to go to the doctor’s office, and not having to fill prescriptions. After all, many medical house call physicians travel along with certain medications that can be dispensed on location. Narcotics, however, will likely need to be filled with a prescription.

While highly convenient for patients who wish to receive medical house call services, the reviving industry is fitting for physicians. In recent years, Medicare has increased its level or reimbursements for physicians who travel to patients. Just in the past few years alone, Medicare has been billed approximately $1.5 million annually for house calls. 

Enter the DNPs and NPs

Even nurse practitioners [NPs] and Doctors of Nursing Practice [DNPs] who make a small number of house calls are typically unaware that they can maximize profit potential with medical house calls. Some NPs have even offset operating expenses by offering house calls to make their office based practice more appealing to their patients.

Link: Front Matter BoMP – 3

Technology Enabled

Also, significant advances in technology have enabled popular medical equipment to be smaller and portable. Physicians are able to perform standard procedures, such as skin biopsies and blood draws while outside the office. They are also able to easily access patient medical records through usage of a laptop, as well as resources such as the Physicians’ Desk Reference [PDS] through usage of a hand-held personal digital assistant.

Assessment

For example, one firm – HouseCall Doctors – established since 1998, educates and supports physicians who are ready to make a transition from office-based positions to medical house call practices. There are no royalty or membership fees, and this is not a franchise. HouseCall Doctors helps transition to a reportedly more pleasing, profitable way to practice medicine today.

LINK: http://housecalldoctorsmedicalgroup.com/

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Is Primary Care Medicine Toxic?

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Requesting Real-Life Examples of Professional Despair

By Dr. David Edward Marcinko MBA CMP™

www.BusinessofMedicalPractice.com

[Editor-in-Chief]

As you’ve probably heard – and experienced or know from our books, journal and this ME-P – there’s a primary care medical shortage out-there!  Maybe you’ve even read or heard about the Physician’s Foundation study describing the overwhelming number of PCPs who want out of this toxic environment. On one hand, we have patients desperately searching for a PCP, while on the other hand we have good caring doctors being forced out of the profession. Of course, NPs, ANPs, DNPs and other ancillaries are part of the solution; but not entirely.

Link: http://www.physiciansfoundation.org/

Human Anguish

And humanely, as stated by our medical colleague L. Gordon Moore MD, these statistics miss the very real pain and anguish of people who entered primary care to help patients when they find the environment for primary care toxic to the ethical practice of medicine. Even to the point of suicide!

Assessment

These voices need to be heard. And so, we are asking doctors and providers of all stripes to post in the comments section below personal examples of medical practitioners leaving primary, solo or small group practice because they just can’t stand the toxic environment any longer.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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A Doctor – Economist’s Solution for Health Reform

My Laundry Wish List for all US Healthcare Stakeholders

By Dr. David Edward Marcinko; MBA, CMP™

[Publisher-in-Chief]Fox News

As President Obama speaks, prods and cajoles, and Congress returns to session to begin work again on HR 3200-3400 or similar, I believe that for any healthcare reform effort to work successfully for the American people – not necessarily be adopted – we need to consider the following in no particular prioritized order:

  • Insurance portability uncoupled from patient employment
  • Health insurance regional exchanges with inter-state purchase competition
  • Doctor, drug, DME and hospital pricing and payment transparency for HSAs, and all of us
  • Modifying or eliminating AMA owned CPT Codes®; a huge money maker for them
  • Abandoning ala’ carte medicine for values-based outcomes
  • Reduce JCAHO influence; encourage competition from Norwegian Det Norske Veritas [DNV]
  • Reduce big-pharma influence thru-out the entire medical education, career and care pipeline
  • End DTC advertising from big-pharma
  • Promote wholesale drug purchase competition, MC bidding and generic drugs
  • Encourage evidence-based medicine, not expert-based medicine
  • Less pay for medical specialists with a  re-evaluation of the hospitalist concept
  • Advance the dying art of physical diagnosis, teach and embrace Paretto’s 80/20 rule for clinic issues
  • Reduce lab test, diagnostic imaging and testing
  • Encourage private 24/7/365 medical offices and clinics; and on-site and retail clinics
  • Abandon P4P, medical homes and disease management ideas
  • Give more economic skin-in-game to patients relative to health benchmarks
  • Concretize the “never-event” prohibitions and include a list of patient health responsibilities
  • More pay for primary care docs and internists
  • Adopt digital records and cloud computing for patients
  • Phase in true eHRs incrementally; and abandon CCHIT for open source SaaS
  • Promote Health 2.0 social media.
  • Augmented scope of practice, numbers and pay for NPs and DNPs, etc
  • Reduce pay for CRNAs and increase it for staff RNs
  • Develop step down triage and treatment units to reduce the number of full service ERs
  • Increase medical, osteopathic, dental, optometric and podiatric medical school classes
  • Increased practice scope for dentists, podiatrists and optometrists
  • Make some sort of catastrophic HI mandatory, much like auto insurance for all
  • End pre-existing conditon health insurance contract clauses
  • More choice  and end of life control for the terminally ill patient
  • Increase marketplace competition with fewer political and financial “externalities”.
  • Teach basic healthcare topics in school and encourage physical exercise
  • Health and insurance education should be, but is not, the “answer” for Americans
  • Protect borders and discourage undocumented illegals
  • Adopt medical malpractice tort reform
  • Make all stakeholders fiduciaries 
  • No public “option” unless you like food stamps, Section 8 housing, public transportation and schools
  • Budget deficit neutrality
  • Joe Wilson is both a bright guy – and a jerk
  • Slow down!

Assessment

Recently, while in the Baltimore/Washing area, I was asked by several reporters to opine on the healthcare debate; which I did so freely having never been known as the shy type. And, regular readers will note that many of these items have been used as posts or comments on this ME-P. Unfortunately, my “laundry list” interview was pre-empted by two local but boisterous town-hall meetings with respective passionate politicians. It was redacted no doubt, but never broadcast. Thus, I missed the potential for my “five minutes” of fame. C’est la vive!

Conclusion

There you have it; direct and straight forward. And so, your thoughts and comments on this Medical Executive-Post are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com 

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

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Myths and Solutions for Healthcare Reform

Enter the Primary Care Docs, NPs, PAs and DNPs

Staff Reportersidea

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Would more family practitioners, and professional medical care extenders, help or hinder true healthcare reform?  

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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