Q: Are you a primary care doctor?
A: Yes, as a geriatric physician, acting as the coordinating physician for the overall care of an older homebound person is what I do best.
Q: What does homebound mean?
A: Medicare defines homebound to mean that leaving the home requires a considerable and taxing effort, such as needing crutches, a walker, wheelchair, or help from another person. Clearly people who cannot get out of bed are homebound, but so are those who live where there are environmental obstacles to getting out or for whom a trip to the doctor followed by a wait in an office would be a burden. These people might have the effects of a stroke, Parkinson's disease, advanced heart failure or severe arthritis.
Q: Do you have an office?
A: No, I see my patients in their homes. I make home visits which can be regularly scheduled planned like a check up in a doctor's office or when a patient or caregiver calls with an urgent problem, I can make a house call the same-day or next-day.
Q: Do you see patients in assisted living or nursing homes?
A: Yes, a home visit can be arranged in independent senior living, assisted living and nursing homes. In most cases I can be the primary care physician in an senior independent living residence and in a licensed assisted living. A nursing home will require that I submit documents for "credentialing" in order to be a consultant and have access to the medical records. As an outside physician at a nursing home I would provide a consult to the patient and the nursing home. The nursing home administration and physicians there have no obligation to follow my recommendations.
Q: Do you accept insurance?
A: No, I have "opted-out" of participating in Medicare. My services are provided by a contract between the patient or their legal representative and Comprehensive Geriatric Care. A copy of the contract is available on the terms & services page.
Q: Do you make emergency visits?
A: No, my evaluation in the home cannot provide the level of evaluation and support that an emergency room can. For patients with whom I have an established relationship with whom I have established goals of care, I try to prevent the need to go to an emergency room. I can advise by phone if an emergency room is the best option to meet health goals. Broken bones and hemorrhage are situations which are best managed in an emergency room. Even conditions such as pneumonia and stroke can be treated at home depending on the goals of care. I can make same-day and next-day visits for the type of new symptoms which can be evaluated and treated by a physical exam and simple testing. In an established doctor-patient relationship, I can prevent an emergency room visit.
Q: Do you take care of patients in the hospital?
A: Yes, but only at Montefiore Medical Center in the Bronx. I have made special arrangements to have the geriatric specialists at Beth Israel Medical Center take care of my patients there so that I can stay closely involved. In the future I may take care of my own patients at additional hospitals. I can provide coordination of care during hospitalizations .
Q: Are you available for questions at all times?
A: Yes, established patients who have contracted for services and their caregivers will be able to call me at any time for urgent questions. When possible I answer calls directly and if this is not possible, I return calls within three hours. I answer all emails by the end of each day.
Q: Do you send nurse practitioners or physicians assistants to make home visits?
A: No. All care is delivered in the context of a committed doctor-patient relationship.
Q: What neighborhoods do you service?
A: The Upper East Side, Upper West Side, Chelsea, Gramercy Park, Midtown, Hell's Kitchen, Lower East Side, East Village, Greenwich Village, Tribeca, Battery Park, Inwood, Washington Heights, Harlem, Riverdale, Bedford Park, Park Slope, Brooklyn Heights. For other parts of New York City, we should have a conversation.