Direct primary care without an actual physical office


(Matthew Haden) #21

@cjs56http://community.hint.com/u/cjs56

Stephen,

You can start very basic or splurge on equipment and supplies. I don’t have itemized prices, but I can send you a link to my Amazon list if you want. I purchased from Amazon, Andameds and McKesson.

Essentials are a functional bag to stay organized, laptop or tablet (excluded from $500 total since most have this already), your equipment for vital signs, rapid strep, urine dip and cups, otoscope, stethoscope, portable weight scale, Rx pads, measuring tape, suture kits, gloves, local anesthetic, alcohol swabs, betadyne swabs, syringes, needles, bandages, suture, scalpels, sharps container, ACE wraps, tetracaine eye drops, fluorosceine strips, a can of freeze spray for warts etc,.

Emergency meds-- Aspirin, epinephrine, Benadryl.

Snelling chart, hearing screening device if you do school physicals.

I keep non-temperature-sensitive items in my primary bag, and anything sensitive in the secondary/procedural bag, which is never is left in my car.

You can add EKG but that’s not first line; it has rarely been needed or helpful since we serve mostly young families. If you plan on doing a lot of geriatrics, you’ll want one, but Medicare covers home health services for truly home-bound, so you can have them do the EKG for you.

I do have a neb machine and albuterol and ipratropium but have yet to use them. My glucometer and strips went unused for several years so I didn’t restock after expiration.

I use a fair amount of ceftriaxone, never used Toradol, sometimes Zofran ODT. Rapid flu test is expensive and not used much…but it came in handy for use on myself and wife. Wound glue is appreciated by families, but expensive. I only recently ordered that. Basic splints for fingers etc are dirt cheap.

We don’t draw blood, but you could, it just complicates your logistics. We have mobile 3rd parties do it or the patients go to a local lab service center when it is convenient for them.

I pack for a lot of contingencies but most visits only use a few things that can fit in an old school doctor’s bag. Hope that helps.

Matt

Live well,

Dr. Haden

Matthew Haden, MD, MPH, MBA

Physician/Owner

www.ModernMobileMedicine.comhttp://www.ModernMobileMedicine.com

P 888.765.1444 x2

F 866.895.6753

Review us on Facebookhttps://www.facebook.com/housecalldoctors and Googlehttps://www.google.com/#q=Modern+Mobile+Medicine&spf=1496526658629


(cjs56) #22

thanks Matt.


(sujata kumar) #23

I have a question about mobile care. what kind of business license do you need to provide mobile care or does the city/county license cover this aspect of care as well?


(Matthew Haden) #24

Sujata,
There’s not typically a separate kind of business license for being mobile per say, it should be the same as any other in your local jurisdiction for your legal entity. You still have to declare a location for your business license, so you may have to list your home if you do not have an office. Most cities will not allow you to use a UPS store box for a business license, but they will allow a shared office location like Regus or WeWork. You should research your area though and talk to a local lawyer. The SCORE network might be helpful as well for advice specific to your city.
Matt


(sujata kumar) #25

Dr. Haden,
Thank you. I haven’t been active on Hint community for some time ,hence the delayed response.
I did open my pediatric clinic in Wesley Chapel( in Tampa Bay Area) FL in May 2018. I am struggling with patient enrollment. So I am considering if adding the mobile aspect would be beneficial.

My concern is also about the practical issues as I am solo at this time.
Kids + Winter = increased illnesses - should I be restricting this based on
Geographical boundaries / illness severity/ special needs.
Should this be offered as part of membership program vs extra service with discount to members.

In your practice do you encounter more children Vs adults utilizing your services?
I would appreciate if you can share some of the experiences and practical aspects about mobile clinic as well as about ways to enroll more members.

would like to also hear from any pediatricians and other family physicians who deal with children and if they are doing mobile care.

Sujata Kumar MD
Novel Pediatric center LLC
P 813-371-0388


(cjs56) #26

I thought seriously about it…and still do. There is a market for it. Places like California and Long Island…maybe less so because they are so entrenched with the typical ways they do things…which is not house calls.

PERFECT EXAMPLE: Rich area like “The Hamptons” a perfect place for house calls…correct? I mean the wealth and the opportunity to “serve the rich” as a doctor in their “McMansion homes.” And, not really anybody doing it.

ANSWER: No. Because you must think of the “traffic.” The place …although ideal for house calls…is a stream of traffic for much of the year because “others” are also serving the rich like pool cleaners, landscapers and the like.

A physician would be constantly delayed in traffic for much of the day (more so in the summer).

Still, these are things that one does not think of unless actual time is spent in the area.

TRAFFIC.

Get a book or two from Amazon regarding home visits or house calls. There is a physician in Wisconsin named Jackie Bristow (I think) who is doing house calls.

Lots of Medicare restrictions…must be “home bound” and a so-called 99214 in CA and NY pays about 120.00 dollars.

Physicians that do it bunch up their visits in nursing homes and the like because they can see more patients at the same time in the same place.

I am not a big fan of nursing homes or “board and care” facilities because not too much of the benefit goes to the patient.

More benefit to the family who does not have to care for “Mom or Dad.”

And, benefit to the facility.

Hope that helps.


(sujata kumar) #27

Thanks. Traffic is a big concern in this area.
I am peds so not a lot of kids in nursing homes and usually we see more medicaid than medicare patients.
Any recommendations about author for house call books?


(cjs56) #28

an African American nurse practitioner in Louisiana.

Can’t remember her name offhand.

But, I will try to look it up.

Check Amazon web site…and you may find her there…under…

house call medicine or home care medicine.