Dr. Benjamin Mena wants a doctor's black bag, specifically the one his physician father carried. Maybe Dad will bring it on his next visit to Tampa. It would complete the picture — a picture from the past, one that Norman Rockwell might have painted. Dr. Mena, you see, makes house calls. They aren't a mainstay of Mena's newly launched internal medicine practice, and he restricts the visits to a few elderly patients within a short distance of his South Tampa office. But the 41-year-old physician says he plans to set aside one afternoon a week for house calls no matter how busy his schedule becomes.
"It's always been my dream to do this,'' says Mena, a native of Honduras who has been practicing in the United States for a decade. "My grandfather was a general practitioner in the '30s in a medium-sized city back in Honduras. So he was the guy who would go and deliver your baby, and then go see the baby next door, and go suture you. He did everything.''
Physician house calls, once common in America's farm communities and small towns, may seem as rare these days as phrenologists. But visits to elderly patients, at least, have been increasing each year, according to the American Academy of Home Care Physicians. In 2009, Medicare reimbursed physicians for more than 2.3 million house calls nationwide. In 2005, reimbursements totaled 2.1 million; in 2002, the figure was 1.7 million.
The need will increase as America ages, the academy notes. The population of Americans in their mid 80s — a time when many become homebound — is rapidly growing, says Constance Row, executive director of the physicians organization. At the same time, the number of general practitioners and geriatric specialists is shrinking, so Row says her colleagues hope more doctors start making house calls.
A few other Tampa Bay area physicians make house calls, among them Dr. Radley Griffin, also of South Tampa. Griffin says that some weeks, his practice takes him on as many as 20 house calls. He does not accept health insurance, charging $100 for office visits and $200 for house calls.
Dermatologist Seth Forman, who has offices in Carrollwood and downtown Tampa, visits people at assisted living centers. He brings a nurse along and sees up to 10 patients, he says.
Mena's home patients are all in their 90s, and all have difficulty getting around. Most found out about the service through their children or other relatives who visit Mena at his office. He does not charge extra for house calls.
"I think everybody's very appreciative, but mostly everybody's surprised. It's very unexpected.''
His most convenient call is at Jewish Central Towers on DeLeon Street, close to his office. On a recent sunny day, the doctor grabbed a blood pressure monitor, walked a block, rode the elevator up and knocked on the door of Prudence Breijo, 92, whom he recently treated for acid reflux disease.
"My stomach is so good,'' Breijo tells him. "The medicine you sent me is gold!''
Mena sits in Breijo's electric scooter while she settles into a big easy chair. She tells him how to set the controls to secure the scooter, suggesting it has a mind of its own.
"Anybody that touches it, it moves. It's a monster.''
Mena checks her blood pressure, listens to her heart, looks over her pills and checks her legs, noting that the swelling has gone down.
"The monster hit me,'' she says. When she got the scooter last year, she tried to back it up but sent it forward instead, smashing her legs into the coffee table. She spent four days in the hospital.
A doctor at the hospital recommended she call Mena. "He'll come to see you,'' he told her.
"So that's what I did.''
Walking back to his office, Mena says some old-school doctors applaud him for going to see his elderly patients. Other doctors question the business sense of it, as the time Mena spends traveling to house calls is time spent not making money.
To Mena, it's an emotional paycheck.
"I find it rewarding.''
Philip Morgan can be reached at (813) 226-3435 or firstname.lastname@example.org.