The return of the house call

George Hensley climbs aboard the white van emblazoned with the vibrant turquoise letters that say Bayfront Call Doc and eases out of one of Bayfront Medical Center's parking lots.

Hensley, who is a medical technician, and a doctor will be on a mission for the next eight hours, piloting the van to homes, condos and hotels where non-emergency medical assistance has been requested.

Call Doc has been rolling in the Tampa Bay area since September 1995, when Bayfront Medical Center put two vans in operation for patients in Hillsborough and Pinellas counties. The mobile units and their teams of medical professionals provide medical care but do not respond to emergencies. If callers need emergency care, operators direct them to call 911.

The concept is the brainchild of San Diego doctor C. Gresham Bayne, 50. As an emergency room physician, he said, he saw many patients come to the ER for minor medical problems that a doctor could have treated in their homes. But most doctors no longer make house calls.

Bayne created the prototype for the first Call Doc van in his garage. In 1987, Call Doc Medical Group Inc. was formed, and the first van was ready to roll. Today, Bayne and four other doctors staff the Call Doc operation in the San Diego area. There also are units in Palm Springs, Calif., and Naperville, Ill.

"True emergencies represent only 15 percent of the 100-million emergency room visits a year in this country," Bayne said during a phone interview from his San Diego office. "A large part of the other 85 percent of patients can't access conventional care because they can't walk or have some other condition."

By preventing unnecessary emergency care, Call Doc reduces costs, he said. "A visit from Bayfront Call Doc is one-third the cost of an emergency room visit," added Diane Ross, a former home health nurse who directs Bayfront's Call Doc program.

Charges vary among cities where Call Docs operate, but Ross said the average charge per patient in the Tampa Bay area is $200. Medicare pays 80 percent of the cost, the patient the remaining 20 percent. Medicaid patients also are covered, and Cigna, too, approves medical care from Bayfront Call Doc. Other medical plans do not cover the service at this time.

Low overhead helps to keep costs down. A medical technician and a doctor travel in each van. The technician is responsible for everything from running lab tests to gassing up the van.

Hensley, 49, a 20-year veteran of the Gulfport Fire Department, is driver, medical technician, liaison and friend to the some 120 patients Bayfront Call Doc serves throughout the month. The vans in Tampa Bay operate from 8 a.m. to 6 p.m. Monday through Friday.

The first stop on Hensley's schedule this day is to pick up the physician who makes rounds with him. Dr. Stanley Eidinger, a veteran physician climbs aboard. Like Eidinger, many of the other doctors who staff Bayfront Call Doc in the Tampa Bay area are former full-time physicians who now do a 20-hour part-time weekly stint with the service.

Hensley hands Eidinger the case load for the day, and the two do a run-through of the patients they will see. They get to specifics as they approach the first home.

"She'll be waiting for us," Hensley says as he knocks on the door.

"Come in," calls a voice from the inside the house.

Eidinger carries his little black bag, and Hensley lugs in a case that holds everything from syringes to minor surgical equipment to an electrocardiograph that can be attached to the printer inside the van.

There are a few bright spots in the small room that has become the world for 71-year-old Catherine Weed: An autographed poster of Cal Ripken Jr. at Orioles Park at Camden Yards hangs on the paneled wall, along with pictures drawn by some of her six grandchildren.

Weed was Bayfront Call Doc's first patient. In fact, she moved to Florida because of the services it offers. A secretary at the University of Maryland for 25 years and a credit manager for Hecht's for another 15, Weed has been bedridden since she suffered a stroke in 1991. Because of her weight (385 pounds) and the nature of her medical problems, an ambulance was her only transportation to receive medical care away from home.

After Weed's daughter Mary Jacobs saw a television feature about Bayfront Call Doc last fall, she called to find out whether it could provide home care for her mother. The answer was yes, and Jacobs and her husband, Roy, got in their van, drove to Silver Spring, Md., and brought Weed to their Largo home.

While the doctor discusses her concerns, Weed receives a B-12 shot from Hensley. She fills him in on the medication she has been taking, and tells him what prescriptions need to be refilled.

The van's next stop is in downtown St. Petersburg, where Betty Canady waits in her yard to open the gate. The team has come to make a house call on her 96-year-old mother, Josephine Tracy.

"Call Doc is a miracle from heaven," Canady said. "They come to her like they did in the olden days."

At the sound of her daughter's voice, Tracy's eyes flutter. Most of her days now are spent in sleep. She receives nourishment through a feeding tube.

As the doctor checks Tracy's vital signs, Canady recalls a time when "Mama" was the caregiver.

"She raised 30 children," her daughter said proudly. "Mama supported herself and her children by running a boarding house. She was "Mama' to everyone. They knew at her house they could get a clean bed to sleep in and a good meal."

Mama also served as one of the midwives in the Withlacoochee area for 40 years.

Canady moved her mother to St. Petersburg 20 years ago, after Tracy began using a wheelchair. Getting her to and from medical appointments was stressful. In recent years, after Tracy became bedridden, Canady had to arrange for special transportation, which proved costly and hard on her mother physically. Canady also likes getting a direct medical diagnosis from the doctor.

The Bayfront Call Doc van is stocked with microscopes, a portable X-ray machine, a film developer, oxygen and IV supplies.

"We can do over 20 blood chemistry tests; urine is even simpler," Hensley said. The van also is equipped for casting and splints as well as suture and wound care.

"We can fax the results of an EKG into a cardiologist from the van," Hensley said.

"Earlier this year, a guest at the Renaissance Vinoy Resort sprained his ankle while playing tennis," said Ross, the Bayfront Call Doc director. "He called Bayfront Call Doc rather than go to an outpatient clinic or to the emergency room."

Some doctors in the Tampa Bay area make house calls, but no other service brings as much sophisticated equipment to the patient.

"We're not in business to replace primary-care doctors," said Sumner, the Bayfront spokesman. "All results of tests and visits are sent to the patient's personal doctor. If the patient does not have a doctor, Bayfront's Call Doc has a list of referrals."

To make an appointment for a visit from Call Doc, call (800) CALL-DOC, or (800) 225-5362.