Concierge Medical House Calls . 212-252-2305
I respond quickly to urgent medical problems. You can reach me by phone and I'm often available within a few hours. Guaranteed. But first I have to get to know you. If you'd like more information on starting care, give me a call or send me an email.
I make house calls, providing ethical, compassionate, high-quality care to medically fragile patients including the frail elderly and those at the end of life. Because palliative care benefits from a team approach, I help coordinate the efforts of everyone caring for the patient - family and hired caregivers, as well as a wide range of medical professionals. Seasoned and resourceful, I offer sound advice on medications, medical equipment, wound care, medical testing, nutrition, and other issues that arise as one is caring for someone at home.
I didn't learn home care medicine in school or in residency. I learned it in the field, caring for patient after patient and listening to the wisdom of my colleagues - especially home-based nurses, but also physical, occupational, and speech therapists and other members of the caregiving team. I like to solve problems and I do my research. Perhaps the folks I've learned the most from are family and other caregivers, because they tell me what works and what doesn't.
This practical knowledge can save you precious time and it can even save you money. I bring that knowledge to bear in every interaction with an aim to smooth the road you're traveling.
I am not a geriatrician by strict definition (which to me means Board Certification in Geriatrics). But between my knowledge of Family Medicine and adult primary care and the practice of palliative medicine and hospice there is a great deal of overlap with Geriatrics. If you're a geriatrician you know these fields and vice versa.
Although I hesitate to call myself a geriatrician the fact is that a good 80% of my practice is geriatrics and perhaps 20% involves the care of a younger adult with a devastating illness like multiple sclerosis, ALS, or an aggressive cancer.
So, most of my practice really is Geriatrics, folks in their 70's on up (to over 100 not too infrequently). So I have to know about all the problems of aging from health maintenance - and often health improvement - to the management of inevitable decline.
It's well-established that Palliative Care often extends a person's life. Why would that be? Well, it's because there's a good team providing care. And I will say that my care does often result in my patients living longer healthier lives, sometimes "graduating" from hospice. This isn't just because of me. It's because someone has cared enough to hire me, and together we make sure a team is in place that works to do everything required to take good care of my patient. That means:
- There's a social worker on tap.
- A visiting nurse comes when needed.
- Volunteers may visit.
- Home Health Aids are properly trained and supervised.
- You have all the medical equipment and supplies you need right there.
I carefully coordinate care from a wide range of other professionals:
- I take the time to talk to the pharmacist if there's any question about medications.
- I order home-based care from people and agencies I trust:
- Eye doctors
- Physical and Occupational Therapists
- "Alternative Therapists" for Reiki, massage, reflexology, music therapy and more.
Most important, I help you set up a system to keep track of everything. When circumstances change I'm tuned in and can respond quickly to address problems. You can reach me on the phone or by email. I stay in touch, making sure everything is going OK. When you have a good team, when you treat small problems before they get too big, a patient - no matter what their diagnosis - can often live for years in relative comfort and stability.
Though not a new concept, Palliative Care is a relatively new medical discipline, one that focuses on relieving and preventing suffering. In my practice I:
- provide thoughtful assessments and sensitive care to those dealing with difficult and life-limiting illness
- help patients and their families examine their goals of care
- prescribe therapies to prevent and alleviate suffering
- provide guidance to patients and their families as they confront difficult medical decisions
- identify and help plan for treatments that are consistent with my patients’ values and desires
- work with other specialists to help coordinate the medical care my patients receive at home
- help those confronting serious illness to improve the quality of their lives
I am skilled at ferrying patients and families through difficult circumstances. I work closely with families and caregivers and am honored to be present for people in the twilight and at the end of life.
House calls provide comfort and promote tranquility during times of stress. In many ways, a house call is like any other medical visit. I take vital signs, review problems, complete a comprehensive examination, and form or revise a plan of care. I make visits when necessary and provide telephone and email consultation in lieu of or in addition to face to face meetings.
Comprehensive review of goals and treatments
I help patients and families clarify their goals of care and align their medical treatment with those goals. When appropriate, we review and adjust treatments to bring them into alignment with those goals.
I regularly review all medications to determine their necessity, benefits and risks.
In home diagnostic services
Mobile laboratory services, x-rays, ultrasounds, and EKG’s are some of the things I can order.
I can advise on all sorts of practical interventions that might improve a patient’s situation at home. I can help you find caregivers and coach you on the right questions to ask when hiring. I prepare customized notebooks for family and caregivers to use to track daily schedules, patient symptoms, medications, and important events.
I help you access community resources, whether that is a support group, an online forum, a professional care manager, or a social worker to identify and navigate available programs.
Long-term or respite care placement
If for whatever reason care in the home is not possible, I can help you find long-term or short-term alternatives.
Choosing and ordering medical equipment
The right equipment can make all the difference in terms of comfort and safety. I advise on appropriate beds and chairs, cushions and lifts, even exercise equipment to maximize recovery and comfort. Even the smallest details can make a world of difference in the well-being of someone ill at home. When I don’t have a solution I seek out someone who does, to make sure you get the answers you need.
Coordination of care with visiting nurses and other health professionals
In between my visits I enlist the help that’s available in the field, coordinating care with visiting nurses and home health aides, with physical therapists and other medical professionals, including doctors you may have known for years.
Intensive medical treatment and symptom management
I manage a wide range of problems in the frail patient - from general geriatrics (adult internal medicine) to the management of very worrisome symptoms in a patient of any age - such as chronic pain, insomnia, or nausea. I help you understand the risks of proposed interventions, and act as a trusted advocate in navigating hospital stays or acute exacerbations of disease.
Caring for the geriatric patient may be especially difficult when complicated by dementia and other progressive neurologic problems like Parkinson's Disease, multiple sclerosis, or stroke. With my guidance I can help you optimally manage these and other problems.
When appropriate, I am available to meet with loved ones to discuss goals and treatments.
End of life care
At the end, I help people die with dignity, with, to whatever extent possible, their wishes answered. The wish to stay home. The wish to have loved ones nearby. The wish to be spared pain. I aim to relieve pain and other symptoms while at the same time honoring the patient’s right to consciousness, to connection with this world in as deep a way as possible before the end.