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House Calls 

5 ways to receive medical care at home

A doctor knocks on your door, conducts an hourlong medical exam, takes samples for laboratory tests and checks your house for potential safety issues. This is not 1930, when 40 percent of patient visits occurred at home. This scene happens regularly in the greater New Orleans area, where independent physicians, home care organizations and the Department of Veterans Affairs deliver medical services to people of all ages at their homes.

  According to the American Academy of Family Physicians, only 1 percent of doctors made house calls in 1980, but that rate jumped to 13 percent in 2013. Pediatrician Dr. William Lister, who offers in-home doctor visits through his House Call Pediatrics (504-373-8480; www.hcpeds.com), thinks this resurgence is partially due to the Affordable Care Act. That law offered incentives for health practitioners to adopt electronic medical records, giving Lister "the ability to have an office and charts on an iPad," he says. With an online office, a house call doctor can spend less money on overhead and has more time with patients.

  House Call Pediatrics and NOLA Doc (504-383-3828; www.noladoc.com) are among the independent, individual home-service practices in New Orleans. Both provide routine medical care, including diagnostic tests, wellness visits and treating sick patients. The doctors visit homes in select neighborhoods in New Orleans and have no physical offices.

  Lister, who also is a former emergency room physician at Tulane Medical Center, founded House Call Pediatrics in 2013 to serve patients from birth to 18 years old. The practice blends a rustic throwback with modern technology: Lister rides his bike to patients' homes, communicates by text any time of the night or day, and uses an online patient portal, where parents can view electronic medical records and pay bills. He can admit patients to Tulane Medical Center if necessary, and he accepts private insurance and Medicaid.

  Family physician and former emergency room doctor Dr. Mark Berenson launched his private house call practice, NOLA Doc, in 2013. The medical practice offers around-the-clock urgent care services, IV therapy, Suboxone treatment, counseling and routine examinations at patients' residences. His patients can be admitted to Touro Infirmary. Patients are responsible for submitting paperwork to their insurance companies.

Whether used for convenience, to preserve privacy, safety or hospital beds, house calls provide comfortable care to patients outside a clinic setting, and allow doctors to assess living conditions that could contribute to or aggravate chronic illnesses.

  While Lister and Berenson see patients who could visit a clinic, several local home care organizations offer medical services, often covered by Medicaid or Medicare, to patients of all ages who are homebound. These organizations offer physical, occupational and speech therapies; nursing care; social services; and home health aids. They often treat patients with congestive heart failure, pneumonia, diabetes and chronic obstructive pulmonary disease, because those conditions have portable treatments. The two agencies below offer all of those services and received high ratings for their quality of patient care by Medicare.gov, the government's official Medicare website.

  Founded in 1993 by a team of local nurses, Family Homecare (3636 S. I-10 Service Road, Suite 310, Metarie, 504-835-0934; www.familyhomecare.net) specializes in orthopedic programs and palliative care. It serves patients in a 50-mile radius of Metairie.

  Ochsner Home Health (www.ochsner.org/services/home-health) delivers the hospital to homebound residents on the West Bank from its Gretna location (200 Lapalco Blvd., Gretna, 504-394-0102) and on the East Bank from its Kenner office (200 W. Esplanade Ave., Suite 601, Kenner, 504-842-5585). The group's medical staff specializes in treatment of hypertension, stroke, cancer, angina and aneurysms.

  As a result of limited bed capacity at its hospital (scheduled to move to a new facility in 2016), the Southeast Louisiana Veterans Health Care System created Hospital at Home (1601 Perdido St., 504-412-3700; www.neworleans.va.gov/Hospital_at_Home.asp) to provide home-based medical services to patients with specific conditions. Registered nurses, under physician oversight, deliver 24-hour care to adult veterans within a 25- to 30-mile radius of the service's home base.

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