Q. My mom is 82. Her mobility has become limited in the past year, and it has become difficult to take her to appointments with her doctor, who doesn't make house calls. Do you have a list of physicians who specialize in geriatric care and that make house calls? Perhaps you have other suggestions?
Sonia F., Miami
A. Getting an immobile parent to an appointment can be an exhausting outing. Certainly one solution to your problem would be to find, as you suggested, a physician who does make house calls. These doctors tend to have “concierge’’ practices that offer a higher level of attention and personal service with the patient and their family caregivers. If your mother can manage the fees, which typically range from $600 to as much as $25,000 annually (often paid in monthly installments), this could be a great solution for both of you.
To find a concierge physician in your community, start your search with The American Academy of Private Physicians (AAPP) (www.aapp.org), an organization that provides a directory of 80 percent of individual and groups of concierge physicians in the U.S. I spoke with Tom Blue, chief strategy officer of AAPP, who said, “Only a minority of private physicians (less than 10 percent) specialize in making house calls. However, the majority of private physicians, will, when medically needed, make house calls for routine examinations.”
If you choose to use a concierge physician, I suggest that you set up an appointment to visit the office, meet the staff as well as the physician, and confirm that they treat geriatric patients and provide the services your mother needs.
If your mother lives in either Miami-Dade or Broward Counties, there is a new option called the Physicians at Home Visiting Program (www.physicianshomevisit.com), a physician-owned medical house-call practice that only treats patients in their own home, even if it’s at an assisted living facility.
What I like about this solution is that the patient does not have to say goodbye to their regular, longtime doctor, although they can choose to designate them as their primary care provider. The medical house-call practice told me in an email that “patients who ... are not able to get to their regular doctor due to an acute illness such as a stroke or hip fracture can be followed by our group until they are well enough to transition back to their primary physician.”
Also, “providers are available for telephone triage 24/7 and appointments usually have no more than a 24-48 hour wait time for established patients.” The house-call group is a Medicare provider so there would be no additional cost to your mother other than her usual co-pay.
Another solution would be to hire a licensed and trained companion to help you take your mother to the doctor. Their hourly rate is usually between $16 and $20 and that extra set of hands (and muscle) might be all you need to move your mother in and out of the car and into a wheelchair or walker once you arrive at the doctor's office.
Alternatively, both county-based and private special-needs transportation services use vans that accommodate any medical equipment that your mother might already be using.
Finally, if the purpose of your mother's regularly scheduled doctor visit is for monitoring her vitals — such as blood pressure and lab work, it may be possible for your doctor to arrange for home visits by the local Visiting Nurse Association (www.vnaa.org), whose staff of highly experienced nurses communicate directly with your doctor.
Nancy Stein, Ph.D., is the founder of SeniorityMatters.com, a local caregiver advisory and referral service for South Florida seniors and their families. You can contact her at firstname.lastname@example.org.