Anyone have experience with a doctor that comes to your home?

I'm not in Michigan, sorry, I'm in NY. My mother's team is affiliated with Northwell Healthcare system. Maybe there's a healthcare system company in Michigan that offers similar services. Other places I would check with: Visiting Nurse Services - they might be able to refer you to someone, social workers who specialize in elder care, local hospitals. Your own doctor might have some ideas, or know of a doctor who makes house calls to the elderly housebound.

Good advice above.

For the last four years my mother has been under the care of a MD and NP Team; two MDs and two NPs. The NP visits us once a month; she orders home health, in-home labs, x-rays, ultrasounds as needed. In-home labs are done by smaller companies/phlebotomists that just drop off the samples at the larger labs, like Sonora Quest or Lab Corp who actually run the labs and send the results back to the doctor. The in-home x-rays and ultrasounds are done by a mobile radiology tech team; the tech takes the images and emails them to the radiology MD at the office for review who then sends the results to the doctor's office. The actual x-rays and ultrasounds are done on my mother while she's in the comfort of her bed. If I need something, I just call the office. They have an on-call service provider after hours. I've never seen the doctor but I've been told if there is an urgent matter then he'll come by. They work only as primary care providers and will coordinate care with any specialist so my mother has options for advanced diagnostics not provided by this team.

My mother is housebound permanently due to her complications of vascular dementia. She's immobile, permanently. If there was no doctor (who takes Medicare) to service homebound seniors, then I would have to put my mother in a nursing home. She's only on thyroid medication. Thank goodness I found a reliable medical team to care for Mom in the comfort of our home.

There are NP-only based services in our area (that also order labs, in-home x-rays, ultrasounds, write scripts) but I'm not comfortable with an NP being the sole primary care provider of my mother.

Our MD-NP team has a palliative care and hospice division so when the time comes for me to put Mom on hospice, I don't have to reinvent the wheel with a different hospice provider as Mom's now medical team already know us so the transition will be much easier for everyone.

MissingStuff, if you're in Michigan, would you PM me with the name of this visiting physician service?

I got a house calls doctor for my bedbound mother several years ago. He had his own practice, with a nurse practitioner who came every month for a check in. When he needed lab work done he contacted a lab who would send a technician to the house to draw blood. The first year was fine, but then his NP stopped visiting. When my mother developed dementia with out of control behaviors (she would scream non-stop for 8 hours straight) I found out from his office manager that he could not prescribe certain types of medication that might have helped her. My brother, who used to be a sales rep for a pharmaceutical, told me there was something wrong with the doctor's license if he can't prescribe things like mood stabilizers and sleeping pills. Not long after I found that out, my mother ended up in the hospital, diagnosed with a UTI that her doctor - who had tested her a week earlier - had missed. I canceled his services after that.

I had no one to refer me to another visiting doctor, so I searched online (yeah, I did that). I found a practice in my area that was affiliated with a local hospital. They turned out to be awesome. Two years later, we're still with them. They have an emergency hotline that will send community or hospital EMS, and a consultation line manned with NPs and an on-call doctor who will answer health questions and write prescriptions when necessary. They have the hospital's lab techs visit to do blood draws, other hospital techs will come over to do x-rays, and when a urine sample needs to be collected they'll send someone out to collect it (in my mother's case, she's incontinent, so has to be catheterized for urine sample collection).

My mother takes a lot of maintenance meds. The current doctor wrote all of the prescriptions and submitted them to the pharmacy for us. After that, I had the pharmacy put everything on auto-refill. When a prescription expires, the pharmacy contacts the doctor for a prescription renewal.

If you look around for a visiting doctor, my advice is:
- look at hospital affiliations
- look for practices with multiple doctors
- ask them how lab work and x-rays are done (who makes the arrangements, what lab do they use)
- ask if the doctor has one or more NPs on staff
- Look for reviews online of the doctor
- ask them how often they'll visit for checkups

The first doctor my mother was with gave her a checkup every 6 months. The doctor she's with now started visiting every two months for checkups, but since my mother's health is basically good/stable now, the doctor visits every 3 1/2 months.

Before I got her a visiting doctor, my mother was in and out of the hospital a few times. I could no longer get her into/out of my car, so the last two times she came home I used a private transport/ambulance service. The first time, she was still able to sit, so she rode in her wheelchair, and the driver got her on and off the van (and even helped me get her into the house). The second time she came home on a gurney. The driver and his partner took care of everything - they got her up our front steps and back in her own bed in ten minutes. It was surprisingly cheap. I think both times the trip was less than $100, but that was two years ago, prices may have changed since then. I was given the name of the the transport service by the hospital.

Having a visiting doctor is a relief. My mother is at the point where she'd have to go into a nursing home if I hadn't been able to find a good visiting doctor. We lucked out with my little google search...you should probably use that as a last resort. See if your community has elder care assistance services - they might be able to provide you with a list of local visiting doctors.

Good luck

My limited knowledge is that there are companies of visiting physicians, some of which "affiliate" with home are agencies to get referrals for patients just out of rehab and getting home health care and rehab at home.

It's my understanding that either a doctor or nurse practitioner will come, can draw blood and send it to a lab of the company's choice. Interpretation would be done by an NP or doctor. Scripts are written the same way.

I also questioned the issue of x-rays and was told that portable machines could be brought in. I've never seen any, have no idea if the quality is comparable to those in x-ray labs, or if x-ray techs read them or the visiting doctor or NP does.

If you go this route, investigate the company as much as you can. I ran into a situation in which a home care company wanted to bring in their visiting physician. Doing a background check on that company, and reading their contract beforehand raised a lot of issues with which I wasn't comfortable. I was even more so when two of them showed up after I had cancelled the appointment with the home health care agency, which allegedly told the visiting service not to come.

Of the two alleged NPs who came, one had to have been a marketer. His sales pitch was more aggressive than a used car salesman's (with apologies to any used care salesmen). More unsettling, his behavior was nothing like any medical professional I've encountered.

You might ask one of your mother's consulting doctors if there's a visiting physician service he/she would recommend. I'd feel more comfortable with that than a recommendation from a home care agency. I've discovered that some of these agencies are involved in business to business relationships that benefit them, but not necessarily the patient.

As to the wheelchair, I know that challenge; did it for some time over a decade ago. Puts a lot of stress on the back.

Do you have a ramp from the house to your car, a low threshold in the trunk (such as that of an SUV vs. a sedan), and a ramp to push the wheelchair up into the cargo area? I saw this being done with much ease one day at Home Depot when a mother rolled out a wheelchair for her daughter. I asked her about the ramp, which was collapsible; I don't remember where she got it.

If you have a van, you might be able to get a lift put in so the wheelchair could be raised up on the lift and you don't have to pick it up to put it in the car. That's got to be a recipe for short and long term back problems.

My friend had a doctor that came to her home. Also, someone came to do bloodwork. When my mom was in Assisted living, a mobile xray machine arrived (via van) and was wheeled in when they suspected pneumonia. I suspect that most things can be done at the home. As to prescriptions, they all seem to be sent in by the medical practitioner. I haven't received a paper script in quite some time.