House calls make a return

Syracuse medical practices respond to demand from aging population

SYRACUSE — As area health-care providers try to meet the growing demand for services from an aging population, house calls are making a comeback.

MobileMed and Upstate At Home are two house-call practices in the Syracuse area that started because each saw an increasing need for in-home visits, particularly from seniors with physical limitations to travel to a hospital or doctor’s office.

Upstate At Home  
Upstate At Home, a new health-care practice started by SUNY Upstate Medical University last fall, brings back the traditional style of medicine, the house call. It provides its patients with non-emergency medical care at their home for ailments ranging from flu and fever to concussions and minor burns, according to the Upstate Medical website. 

Offering house calls helps set the practice apart and helps the people who need it, says Dr. Christian C. Knutsen, assistant professor of emergency medicine at Upstate Medical University, who staffs Upstate At Home.

Knutsen says he first got the idea to offer house calls four years ago after speaking to the Fayetteville Fire Department. The department’s firefighters and EMS personnel recalled the numerous 911 calls they would receive for medical assistance for minor injuries. The fire department’s staff were spending more time assisting these people than getting to more serious calls, Knutsen notes.

Last September, Dr. Gary A. Johnson, chair of the Department of Emergency Medicine at Upstate Medical University, approved the formation of the Upstate At Home practice and set a trial period for 12 months to 16 months to see how it would perform. And every three months, the department reviews what has worked and what needs to be improved, according to Knutsen. 

Patients schedule house-call appointments like they would a visit to the doctor’s office. The patients call a number that connects them to a nurse who determines whether the patient’s ailment is appropriate for a house call. If a house call is necessary, the patient’s call is transferred for registration and the patient provides additional information about his/her insurance. 

Patients who might need a house call include those who don’t have a primary care physician or those whose doctor’s office is closed or has no appointments available on the day they’re sick, according to the Upstate At Home web page.

Upstate Medical University stresses that Upstate At Home is not a form of concierge medicine for well-to-do patients paying with cash. “We wanted to make it offered to the masses and not just to people who can afford it,” Knutsen says.

Most of the patients pay with Medicare or Medicaid or private insurance, with a co-payment usually required, ranging up to $40 a visit.

In addition to Knutsen, the newly formed practice has two other emergency room doctors and two nurse practitioners available as needed. As Upstate At Home grows, it expects to add more staff.

Knutsen says he sees 30-35 patients a week. “We want that number to be higher than that but that’s a good number for now,” he adds. 

Upstate At Home primarily services the eastern parts of the Syracuse area, including DeWitt, Fayetteville, Manlius, Minoa, Kirkville, Chittenango, and Cazenovia. Knutsen also visits long-term care facilities like Brookdale Senior Living, Loretto, and Menorah Park.

Knutsen says Upstate At Home primarily competes with urgent care centers and emergency departments. 

MobileMed
MobileMed — a home-based nurse-practitioner medical practice whose formal corporate name is Mobile NP Adult Health of CNY PC — says it offers the same basic care that patients would receive at any primary care office. That includes complete physical exams, diagnosis and treatment of chronic and acute illnesses, immunizations, diagnostic testing, coordinating home care after hospital or rehabilitation discharge, and dementia screening, according to the MobileMed website.

This focus on in-home visits sets MobileMed apart from other area health-care providers.

“There just isn’t any other practice that does just house calls,” says Desta Anthony, MobileMed’s owner, founder and a nurse practitioner. 

Patients contact MobileMed by messaging it through its website or calling the office number. They are connected to one of its three nurse practitioners. Kate DiDonato, who specializes in geriatrics, and Carol Anne Kozik, who is also a clinical assistant professor at the Upstate Medical University College of Nursing, are the other two nurse practitioners listed on the MobileMed website, besides Anthony.

MobileMed is not a form of concierge medicine, says Anthony, who is an associate member of the Academy of House Call Physicians and the American Academy of Nurse Practitioners.

The patients are billed in the same way as at a regular doctor’s office, she says. The majority of the patients use Medicare, Medicaid, or some form of private insurance like Aetna, Excellus BlueCross BlueShield, or Humana. 

MobileMed’s annual gross sales are currently a little over $200,000, says Anthony. She says the practice’s revenue has increased by about 3 percent to 4 percent annually since she founded it in 2007. 

The nurse practitioners at MobileMed typically see about five patients a day and leave open times on their schedule for new calls. They work from 9 a.m. to 5 p.m., Monday through Friday, and sometimes at later times if a patient needs urgent care. But they do not provide emergency medicine. Phone calls are answered from 7 a.m. to 7 p.m. on weekdays.

The practice serves all of Onondaga County and surrounding counties when needed.

MobileMed has access to X-rays, EKGs, and can conduct blood work and ultrasounds, using medical equipment provided by AJ Medical Products and sometimes Mohawk Medical Supply. 

It will make house calls to patients’ place of work as well as a residence.