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Mobile doctors a godsend to the homebound

Two months ago, Anna Runge's leg was so swollen and painful the 92-year-old couldn't walk.

So the doctor came to her home, not once, but several times to diagnose the problem, prescribe medication and check on her progress.

By Monday, when Dr. Karen Mutter knocked on the door, Runge could get up to answer. Her leg, she told Mutter, felt much better.

Runge is one of dozens of patients seen every week by Call Doc, a mobile physician service operated by Bayfront Medical Center.

"They were an absolute godsend," said Genevieve Poteat, Runge's daughter, who said her mother refused to be hospitalized for treatment.

Heralded as the return of the house call when it was started two years ago, the Call Doc service was slow to get off the ground. Eleven months after it was launched, Call Doc was visiting 100 patients a month, according to Diane Ross, a registered nurse and Call Doc director.

Now, another year later, that number has doubled and the two Call Doc vans are kept running seven days a week, 12 hours a day.

They visit people like Runge, who may be temporarily confined to the house by a medical problem, or people who are more permanently homebound. They are people who have great difficulty getting to a physician's office.

One patient, 72-year-old Walter Patterson, has a chronic lung disease and is confined to a wheelchair. His condition cannot be cured, but regular treatment helps him stay as healthy as possible.

"Getting to a doctor's office is expensive," the St. Petersburg resident said. "It costs $150 one way with wheelchair transport, or $300 one way by ambulance. Call Doc is paid for by Medicare and helps me stay in my own home for the long run."

Providing such standard treatment saves money for the entire health care system, since a visit by Call Doc costs only about one-third as much as an emergency room visit. Only about 15 percent of visits by Call Doc are emergency calls, Ross said.

When Call Doc got off the ground, the vans were on their own in the field. Doctors had to rely on information in patient charts they brought with them for the day. If a patient was added to their schedule, they often had to return to Bayfront to pick up the chart. And since they cover all of Pinellas, and now Hillsborough, the detour could be a long one.

Now, with the help of donated equipment from GTE, the Call Doc vans can be instantly connected to the hospital. Using laptop computers in the vans, the traveling physicians can dial up Bayfront via a wireless modem.

The connection allows physicians and technicians in the field to read the results of laboratory tests and X-ray reports from afar. That's helpful because recent results or tests done in the emergency room or by other physicians often aren't in the patients' charts, Mutter said. Call Doc physicians also can get up-to-date information about an unexpected patient added to the schedule.

Sometimes, the connection just helps physicians confirm which tests a patient has had recently.

"Some of these elderly people aren't very good historians. Sometimes they can't remember what they have had done," Mutter said.

GTE provided the technology to Bayfront to help demonstrate its capabilities, said GTE spokeswoman Cristina Coffin.

The technology will help as Call Doc extends its reach. Currently, about 98 percent of Call Doc patients are on Medicare.

In hopes of making the service more profitable, Call Doc has marketed its service to hotels and motels along the beach and is beginning to get calls to provide medical help to tourists. The visit costs $119 with additional charges for certain treatments, she said.

Most of the calls are for problems like colds, earaches and minor injuries, she said. One of the first calls, though, was a German woman complaining about stomach pains, Ross said. The woman ended up at Bayfront Medical Center having emergency surgery for appendicitis.