Live from the Summit: Doctor or dinosaur?


"I didn't know a thing about homecare," says Dr. Steve Landers. "But the patients were so grateful."

Dr. Landers is the opening speaker at the HME Business Summit. A family doctor and geriatrician at the Cleveland Clinic, where he directs the Center for Home Care and Community Rehabilitation. He does something I didn't realize physicians do anymore.

He makes house calls.

"I was sort of the dinosaur."

During his medical training, he didn't learn much about in-home care, but in practice, he soon learned about the value it offers, to patients, to their families and to the healthcare system.

In-home care can be safer than facility care. It is more effective and less costly. In medical literature, there is a preference for care at home, whether long-term, end of life or rehab.

"Another thing happened, with house calls, it started out as my throwback practice, a nice thing to do. Over time, I started to recognize things happening in my practice, and in the healthcare system."

His belief in the importance of in-home care, and the healthcare industry's slow shift toward it was confirmed recently, Dr. Landers, said, when a colleague announced at a meeting:

"The home is the healthcare venue of the future."

That wasn't part of the commentary when I started, said Dr. Landers.

Several key trends are driving the increase of in-home care: demographics, technology, consumerism. The healthcare industry needs to harness these trends, especially technology, in order to increase care in the home.

Fun fact: Physician house calls increased 14% from 2004 to 2009.

Not so fun fact: About 20% of Medicare beneficiaries are readmitted to the hospital within 30 days, at a cost of $17 billion.

"We've got some hard work to do, but this is where we are headed," said Dr. Landers.

Theresa Flaherty