House Calls Program at NewYork-Presbyterian/Weill Cornell Helps City's Elderly
Dec 16, 2003
Run by the Wright Medical Center on Aging at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, House Calls is a program that brings physicians to the homes of elderly patients and provides care for those unable to visit the doctor. It began in 1997 as an idealistic venture by several NewYork-Presbyterian/Weill Cornell medical residents and has evolved into a formal program that continues to meet the needs of the community.
"There's a lot we can do," says Dr. Veronica LoFaso, the Program's founder and now the director of House Calls. "A team can perform EKG testing, draw blood, and conduct thorough physical exams right in the home." If the building has an elevator, a portable x-ray machine can be brought in, and services can be expanded when other medical staff—such as ophthalmologists, dermatologists, and dentists, among others—are willing to step in and offer their help.
There are many reasons that keep the elderly from visiting a physician. For some, struggles with dementia or depression are to blame. For others, it is the physical problems of navigating walk-up buildings or chaotic city streets. Many have been healthy all their lives and are in denial about the problems later life has brought them, or they fear the doctor will deliver bad news.
House Calls is staffed by four NewYork-Presbyterian/Weill Cornell physicians and a nurse practitioner who is the case manager. The physicians rotate, each taking different days to visit patients, and are often accompanied by medical students from Weill Cornell Medical College, nurse practitioner students, medical residents and geriatric fellows in post-graduate programs. They shadow the attending physicians and also participate in the geriatric team care.
The program serves about 70 households in the neighborhoods around NewYork-Presbyterian/Weill Cornell and is kept intentionally small. This allows for familiarity—physicians actually know each patient—and can spend time with them. It also ensures that students become well-versed in what it is like to grow old. "We're not necessarily trying to convince all of our students to go into Geriatrics," mentions Dr. LoFaso, "but the program will ensure that a new generation knows how to properly treat older adults."
Of the four physicians, the newest addition is Dr. Taryn Lee. She handles Monday morning visits and heads out with a team of students in tow. "I wanted to be like an old-fashioned doctor," she says. "Of course, now with so much specialization and technology this isn't always possible, but House Calls gives me the chance to spend more time with my patients."
Regular visits help maintain a "healthy balance" (as Dr. Lee puts it) that is often difficult to keep with the elderly. But while House Calls thwarts illness from developing or becoming out of control, it also helps prevent loneliness and depression, problems that are frequently high among the elderly, and it can eliminate expensive (and traumatic) visits to the emergency room.
"Often on the phone, problems seem worse than they really are," mentions Dr. Lee. "Another doctor might insist on an ER visit, but I know these patients. I can prevent an unnecessary visit that might become a 12 hour ordeal."
House Calls partners with city agencies to make sure those who need medical help have a good chance of finding their way to the Program.
Admittedly, it is work that is not always easy or immediately rewarding. "Many of our House Calls patients may have problems without solutions," admits Dr. LoFaso, "but we pride ourselves on keeping long-term relationships with our patients and being a caring presence in their lives."
"Yes," says Dr. Lee, "it's something we really need to do."
Dr. Veronica LoFaso is Director of House Calls. She is also an Assistant Professor of Medicine at Weill Cornell Medical College and an Assistant Attending Physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Dr. Taryn Lee is an Assistant Professor of Medicine at Weill Cornell Medical College. She is also an Assistant Attending Physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Director of the Consult Service for its Geriatrics Division.
For more information on House Calls, please see their website.
The NewYork Weill Cornell Medical Center, located in Manhattan on the Upper East Side at York Avenue and 68th Street, comprises NewYork-Presbyterian Hospital and Weill Cornell Medical College.