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House calls return

Two pediatricians have revived a venerable medical procedure: taking their medical expertise and technology to the patient.

By STEPHANIE HAYES
Published May 19, 2006

His mom was there, too. So was his aunt. And the family cocker spaniel named Taz. And Noah's toys.

The clan wasn't crammed into a tiny, fluorescent-lit doctor's office. They were in Noah's grandma's spacious Westchase home. Dr. Maria Ortiz-Tweed and Dr. Yim Lam had arrived to give him a checkup, medical supplies in tow.

It's a new business fashioned from an old premise. Instead of seeing patients in an office, pediatricians Ortiz-Tweed and Lam, who call their practice One to One Pediatrics, visit patients' homes in Northwest Hillsborough, South Tampa and downtown Tampa.

House calls wipe out the scene that anyone who has been to a doctor's office knows all too well.

"You already have a sick child, you're already up all night and you're miserable in the waiting room," said Lam, 38.

The women, who had practiced in the same Citrus Park office until November, were tired of seeing as many as 40 patients a day. But they say they needed that volume to pay rent, insurance and employees.

"People don't realize doctors don't want to see that many patients," Lam said. "It's just the environment right now."

Ortiz-Tweed hit the Internet to research alternatives and came across a Web site for a doctor in Pittsburgh who did house calls.

"I looked at her Web site and said, 'Oh, we can do this,' " said Ortiz-Tweed, 35. "The excitement came back."

Most people probably think "house call" and picture an old-timey, bespectacled doctor toting a black leather bag.

Until almost the mid 20th century, it was traditional for a family doctor (spectacles optional) to come to a home and care for the entire family there.

Then, the advent of nursing care and operating rooms compelled family doctors to start sending patients to hospitals for better care. House calls began to fade.

Modern house calls are most popular with elderly patients who receive Medicare benefits. In 2004, there were more than two million Medicare-paid house calls in the United States.

It's different for Ortiz-Tweed and Lam, who care for patients through age 18. They do not accept insurance. Instead, parents pay in yearly retainer fees that start at $1,500 for one child. After that, it's $60 a visit.

Ileana Liss, Noah's mother, uses money from a flexible spending insurance account she has through her job as a physical therapist for the Pinellas County School District.

"I have the means to kind of at least think about it," Liss said. "Some people may not. I go for convenience even if it costs me a little more money."

Ortiz-Tweed and Lam say their practice is the only one of its kind in the area, but they expect others to pop up soon.

Dr. Russell Libby, a pediatrician from Virginia and medical director of a pediatric home care agency, sees potential for pediatric house calls to become a cottage industry.

"The evolving opportunities are very real and I do think that there is a significant future for not only primary care but subspecialized care in those more cutting-edge marketplaces," he said.

But, he said, not if people don't have money to spare.

"That will only happen if people are willing to pay significant dollars to have it happen."

That would explain the women's target market: Northwest Hillsborough, South Tampa and downtown Tampa, all brimming with young families and professionals.

And you get what you pay for. The women work from 8 a.m to 5 p.m. Monday through Friday, doing healthy and sick child visits, prenatal visits, tests and vaccinations. They'll also answer calls at night, they say, spending as much time as is needed treating a child.

"It's more intimate. It's more comfortable. The child feels at ease in his own environment," Ortiz-Tweed said. "The main thing is not to be rushed. The main thing is to do the exam, and when we're done, we're done."

While the practice is in its infancy, Ortiz-Tweed and Lam do not expect to see more than five or six patients a day, a far cry from the number they saw before.

"The bottom line is to have a better doctor-patient relationship," Ortiz-Tweed said. "A lot of people miss that. That's what we're trying to get back. We hope people will value that."

Stephanie Hayes can be reached at (813) 269-5303 or shayes@sptimes.com.

[Last modified May 18, 2006, 13:11:52]