New Practice Article - mostly good.....

[ventana]

So I am starting a new house call practice...... in todays (SUNDAY) local paper is this article :-) - - - thoughts?? (few miss statements so I am looking for thoughts on how to handle them...)

 

 

 

‘ Mobile medicine’ Physicians assistant to offer in- home medical services to patients

 

It used to be standard practice, but physicians usually don’t make house calls anymore. Visiting patients at home is mostly a quaint, but fond, memory that dates back to the days before HMOs, rising health insurance premiums and crippling health care costs.

 

But home medical visits haven’t completely gone away. One Berkshire physician is even reviving the practice.

 

Jeff Kellogg, a physicians assistant who lives in Lanesborough, formed Berkshire Mobile Medicine this fall. He uses his two Hondas to travel up and down the Berkshires to visit his patients, most of whom are elderly, in the places where they live.

 

“I do not have a physical office to see people in,” said Kellogg, who also works full time in a family practice on Elm Street.

 

“The single most overriding thing that I am trying to do is put the humanity back in medicine,” Kellogg said.

 

According to Kellogg, a physicians assistant receives the same training as a doctor, but instead of fulfilling a residency requirement, opts for on-the-job training in their field of choice. Kellogg operates Berkshire Mobile Medicine in collaboration with Dr. Charles D’Agostino.

 

The 43-year-old Kellogg, who grew up in Dalton, graduated from Wahconah Regional High School, and attended Albany, N.Y., Medical School, said he decided to establish a mobile practice because he saw an “enormous need” for one in this area.

 

“You see these elderly people who are frail and really can’t get out of the house so they often can’t get the care that they need because they can’t access it,” Kellogg said. “So their minor medical problems turn out to be major medical problems.”

 

The struggles his grandmother went through were also a factor.

 

“ In the last five or 10 years of her life to go to a primary care appointment was a week of planning,” he said. “ It totally exhausted her and took her a week to recover.

 

“It was a combination of seeing her struggle, this huge unmet need, and the ability to control my own destiny in the future,” he said. “To be able to slow down and talk to patients and practice medicine the way I feel it should be practiced which is the personal touch.”

 

Visiting patients is also less expensive than maintaining an office.

 

“One reason that I chose housecalls was to minimize my overhead,” he said.

 

According to Kellogg, physicians stopped making house calls purely for financial reasons. According to websites on the Internet, the practice began to taper off in the 1980s.

 

“Many years ago the insurance companies made the reimbursement for seeing someone in their house the exact same as seeing them in the office, which obviously makes no sense,” Kellogg said. “You can see 20 or 30 patients in the office a day. A full-booking for me [now] is eight patients. So it made it impossible to do and make a living.”

 

According to an article in USA Today, there are about 4,000 doctors who still make house calls in the United States. Kellogg said the practice became more economically feasible when studies performed by the U. S. Veteran’s Administration caused Medicare to slightly increase the reimbursement for house calls in 2009.

 

“It’s not a great reimbursement,” he said. “But it’s enough to put gas in the car and pay a salary.”

 

In order to qualify for a house call visit from Berkshire Mobile Medicine, patients must either need a device to walk, be unable to drive, have either a visual impairment or memory disorder, be bedridden, be restricted to limited activity following recent surgery, or cannot leave home without a “ considerable or taxing effort.”

 

“ I’m the one who determines if you qualify,” Kellogg said.

 

Initial appointments by Berkshire Mobile Medicine are 90 minutes, followed by monthly half-hour follow up sessions.

 

“That’s the industry standard,” he said.

 

Although he’s based in Central Berkshire, Kellogg said he will see patients who live anywhere in the Berkshires, although he said geography could make it difficult for him to see patients on opposite ends of the Berkshires in the same day.

 

He isn’t sure how the wear and tear will affect his two vehicles, a Honda CRV and Accord.

 

“To be determined,” Kellogg said. “I’m only a month into it.”

[mkrumm]

According to websites on the Internet...

I can't help giggling at that.

 

Aside from the dreaded S, I think this is great PR. Good luck!

[jmj11]

I will have to say that if this ran as a newspaper story, you scored a real coup d'etat. This type of advertising can be very expensive and a story like this is free. I've tried to accomplish this and so far haven't succeeded (getting a article written about us).

 

Have you had any physician response (might be too early) with letters saying that "PAs don't have the same type of training as a physician!?"

 

Good luck on your venture and a great score with a great article.

[bgdog]

 

According to Kellogg, a physicians assistant receives the same training as a doctor, but instead of fulfilling a residency requirement, opts for on-the-job training in their field of choice.

 

 

It's a good article and good idea and I hope you succeed.

 

The PA training description seems a little skewed though.

 

Good Luck, let us know how it goes.

[zepoPA]

I read the article twice. The first time as if I'm not in the medical field just interested in such article for my aging parent or relative. We all know how many of our patients don't keep appts. bc the person "in charge" could not miss work the day of the appt. Well, I almost called you to get details and refer people over to you. Wait, never mind. I'm in California.

 

The second time I read the article, I was the PA reading it. And my opinion is this: you probably will hear some noise from your local Medical Assoc regarding the PA training, but whatever they say, will pale next to the incredible exposure you will get in town. Make sure EVERY senior gets a copy of this TODAY. I would ask to post the article wherever seniors hang out (diners, churches, volunteer groups, etc). I think you got something cooking here, and it SMELLS MIGHTY GOOD.

 

Great luck to you.

[ventana]

yeah the training part is what got me concerned

 

I was clearly trying to explain that we have SIMILIAR training with mine being just under 3 years where as the doc's do 4 years THEN a residency. Even went on to talk about the fact about OJT and the whole "dependent practitioner" aspect of a PA - well none of that made it into the paper - just "we do the same training"

 

It is better to have an error in this direction as the common lay person with have a better understanding of what a PA is, but I am concerned 1) of the local doc response, (have already emailed my SP that I did not say that nor think it) and 2) if the local hospital system gets frustrated with it....

 

 

Now the biggest reason to post here

 

WHAT DO I DO ABOUT IT?

 

It was GREAT advertising that I did not have a pay a penny for but I don't want to come across as something that I am not.

 

choices?

 

1) letter to the editor

2) communicate with the writer and ask/request a correction

3) something else

4) do nothing...

 

 

it is a complex issue and I am looking for ideas......

 

 

 

 

 

As for the physicians assistant - I actually made sure that he did not put an 'S on the end, and I joked "we are not the possession of the physician" but didn't get the whole meaning across. that one I am not concerned with as it is trival in the eyes of the general public...

[rcdavis]

The Damage is done. Cannot unring the bell.

I think the best course is to sit back and watch what happens.

 

There will ge several letters to the letter by the local MDs, I am sure. Ride out he storm.

 

Writing a disclaiming letter to the editor, at this point, would create more doubt in the community about the level of education you do have (" we'll, just how far away from a physician does he have! And why then do I want him? " ). don't forget, the readers who are interested at also your potential customers.

 

You have lucked out with a pretty positive article .. First impression Everything hat follows will never be as effective as the article.. Even an outright retraction would not influence the folks as much as the original article.

 

If anything, call the writer and ask him to do a follow up article on "Physician Assistants in new Hampshire".. The positive impact that they are having, and, in the course of the article, let him exp,sin the AAPA/PATF descriptors of what a PA is, the education model, etc.. Kills two birds with one stone... Tell him there is a lot of community interest ( especially if the docs do send lettersto the editor ).

 

dropping a line to the hospital's CEO and telling him about the incomplete quotes, and distancing yourself a little from the education equivalency statements may go a long way to keeping them in your corner.

 

Good luck

 

Davis

[discogenic]

Perhaps the reporter just screwed up.

 

But perhaps this harkens back to a topic of discussion here a month or so ago regarding the issue of "medical school". I can see how this reporter could have easily gotten confused and written what he did if he'd thought he heard you say you attended medical school, in this case Albany NY Medical School. In his mind: physicians go to medical school + you as a PA also went to medical school = PAs do the same schooling as MDs. It may not be that much different than any other layperson getting confused, except this guy happens to be a journalist and got his confused perceptions published in a newspaper.

 

I'm not saying you intentionally misled the guy or anything, so please don't misunderstand my point. But the reporter's train of thought on this might not be that hard to understand. He got the part about the difference post-schooling (OJT vs. residency) but he mistakenly conflated PA and MD schooling because he heard "medical school".

 

Just a hunch.

 

In terms of dealing with any blowback, it may depend on how widely this paper is read. It's likely you'll get a comment from at least one rankled MD, at which point a brief written clarification might be in order. I wouldn't submit an unprovoked clarification though; let it go if nobody criticizes you in print. A few phone calls to colleagues you respect wouldn't be a bad idea, however, just to let them know this was a simple misunderstanding (and to plug your new venture while you're at it! :=D:).

[physasst]

Pretty cool man...congrats

[ventana]

thanks all

 

decided that I really needed to straighten it out with the reporter so at least the truth was addressed..... not going to attract any more attention to unless needed, but certainly wanted the truth to be known so that I am not accused of saying something that I did not, and never would say.

 

As to the medical school thoughts...... I was VERY AWARE of that whole post and was very careful to say that I attended PA school not medical school as I did not want there to be any confusion - it was nice that he did not put in medical school to confuse it even more (was likely because I avoided that phrase)

 

Hopefully nobody really gets in a dander about it.

 

At least the 26,000 subscribers at bare minimum know that the house call service now exists.....