House calls: in-home health booming
By Deborah Jeanne Sergeant
During the pandemic, more people oriented their daily lives around home: home grocery delivery, virtual work, Zoom parties and remote school.
Some of these remain even after the quarantine was lifted.
The time period highlighted the need for more services at home for certain demographics, including people who struggle to leave home because of mobility and transportation issues.
J. Christopher Stringer, internal medicine physician in practice in Manlius, provides office visits and also sees patients in their homes once a week — on Thursdays — or as required.
“There are people who need it,” he said. “It’s not particularly available. Medicine is increasingly challenging for physicians and increasingly impersonal and institutional. There’s less time for patients with the doctor. From our point of view, we do it differently. Most doctors do volume; we don’t do volume. I did volume a long time and finally said ‘Uncle.’”
From 1980 through 2013, Stringer treated about 2,000 to 3,000 total patients seen in only 15-minute time periods at a time. He felt completely burned out and ready to quit medicine because he felt he was not providing the level of care that he wanted.
Now he sees only 300 patients, but “I can spend time with them,” he said. Visits may be as long as patients need, which helps the complicated cases often found among patients with limited mobility.
“It’s the way medicine should be, but it isn’t anymore,” Stringer said.
Patients pay a monthly membership for this personalized healthcare, ranging from $1,650 to $4,100, depending upon age. Services can include blood draws, EKGs, ultrasounds and even minor surgery at home for things like skin problems and treating ulcers. Stringer also bills insurance, but “if it weren’t for the membership fee, we couldn’t open our doors.”
He also cares for patients in the hospital, not relying on a hospitalist to provide their care during their stay. Stringer likes offering this level of continuity of care.
Alexander Talev, doctor of physical therapy, operates Home Stretch Physical Therapy in Syracuse in a similar fashion—treating patients at home.
Since mobility is an issue for most people undergoing physical therapy, he finds it an ideal way to treat patients. He can see them in their own environment and problem-solve with them about with any obstacles they encounter where they spend most of their time each day.
“We see people for various conditions after surgery, after an illness, after falls,” Talev said. “We can see them as an alternative to going out to a clinic. We can work with people in their homes, go to all of the senior living communities, including senior apartments and can go to people’s places of employment. We can also work with people in preventing falls and injuries.
“We see people post-surgical, after hospitalization, after stroke, neurological rehab, Parkinson’s multiple sclerosis, and various conditions like that. Or for general deconditioning after a weakness or people who have found they have more trouble walking and are more unsteady. We can help them regain strength and balance and be more active in the community.”
He also provides home safety assessments and maintenance for people who have become deconditioned because of an illness, surgery or injury.
Talev accepts insurance, Medicare and most Medicare Advantage plans, as well as self-pay options.
Although it can be hard for a physical therapist to do all the exercises needed in-home, Talev views this as an advantage.
“We can show them they don’t need any equipment to improve strength, balance and mobility,” he said.
He believes that healthcare in the home will only continue to grow as more people indicate they want more personalized service.
According to Market.us, the size of the home-based healthcare services segment is anticipated to grow by 8.2% between 2023 and 2032.
The Bureau of Labor statistics anticipates that the growth rate of jobs for workers performing this labor will increase by 34%, “much faster than the average of all occupations” between 2019 and 2029.
Some of this stems from the aging population, which comprises 80% of the consumers of home-based healthcare.
The COVID quarantine also played a role. During the pandemic, more people oriented their daily lives around home: home grocery delivery, virtual work, Zoom parties and remote school.