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(HealthNewsDigest.com) – It’s a fact that Americans are living longer than ever before. Statically speaking, the average American will, according of the Center for Disease Control, live to the age of 78.5 on average. The increasing advanced age of the elder care patient, combined with adult children living farther away from their aging parents then in generations past, have created a niche market for some eldercare practitioners-the home-bound patient practice.
Home-bound patients, by definition, have a significant degree of disability that cause lack of mobility. Most home-bound patients are of a geriatric age; however younger patients with severe physical and/or neurological impairments (like accident victims that are paralyzed or patients with cerebral palsy) are also classified as home-bound.
The South Florida market is critically underserved, due to patients’ longer lifespans, limited mobility and the lack of public transportation in many cities. Elder care physicians who maintain a home-bound patient practice have many significant advantages over doctors who see patients in an office.
Home visits give the primary care physician a window into a patient’s life in a way that standard office visits cannot. The physician can immediately establish a network of persons that have direct access to the doctor and to the patient. This is especially important in which the patient cannot directly communicate with the doctor, due to speech difficulties, neurological problems or other obstacles. The doctor can establish a strong bond of trust with family and friends who can act as a link between doctor and patient. Additionally, the doctor can observe patient-caregiver relations, assuring that the patient is being looked after by compassionate and able caregivers and ensuring that the patient is not suffering from elder abuse or neglect.
When I first visit a newly referred home-bound patient, one of the first things I notice is that in many instances they do not remember the last time they saw their primary care physician. This is easily explained by their degree of immobility, and the logistics necessary to mobilize a bed-bound patient to a doctor’s office. By providing regularly scheduled home visits to these patients, the patient can avoid unnecessary emergency room visits or hospitalizations.
The economics of a medical practice based on home visits are interesting. A medical office where patients are seen is not necessary, but there does have to be a place to maintain records, receive calls, billing, etc. When a practice grows, the need for clerical assistance arises, but an expensive medical/business real estate or rental is not a necessity. Some doctors may be able to run a practice out of their home or less expensive locations, such as a small office that does not require special access for physically challenged patients, parking etc.
Establishing a good relationship with hospitals in the community is essential, especially when following patients through the hospitalization process. When a physician gets to know their home-bound patients over time a trusting relationship is built. Should that patient ever be hospitalized, the patient, friends and families are more comforted by the fact that they are seeing a doctor they know and not an unknown hospitalist.
Dr. Reinaldo Carvajal specializes in internal medicine at Hialeah Hospital in Miami.
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