Forty-six-year-old Maria Martin of Schenectady can’t leave her home to get to the doctor’s office because of her chronic medical condition. So for regular medical care, the doctor’s office comes to her.
Practitioners from Homedical Associates, PC visit Martin monthly to monitor her health status, perform routine blood work, renew her prescriptions, arrange for in-home physical therapy, and order durable medical equipment when needed.
Recently, Martin experienced a severe internal hemorrhage. Unable to be moved from her home by ambulance, Martin urgently needed blood transfusions and medical monitoring. Homedical Associates arranged for these transfusions and attended Martin over the eight hours during which the blood was administered.
“I consider my Homedical Associates health care providers as friends and partners with me in my regular health regimen,” Martin says. “Together, we have taken my life from one with virtually no health care whatsoever to a life with proper health monitoring. I am still homebound, but my life now has quality to it, whereas before quality was severely lacking.”
Homedical Associates, PC is a primary and consultative medical practice whose staff members believe that the days of the house call are back.
“We care for those individuals who cannot leave their homes due to chronic physical, emotional, or cognitive disabilities,” says Dr. Roberta N. Miller, a founding partner of Schenectady-based Homedical Associates. Some of those patients include:
• An 85-year-old woman who suffered from unrelenting pain related to osteoporosis and possible bone metastasis from recently diagnosed breast cancer. Her Homedical Associates physician visits her to evaluate her and to prescribe medication that relieves her pain and allows her to sleep.
• A 54-year-old man who lost his left lower leg in a work-related accident. His Homedical Associates physician visits him to monitor his use of his new artificial limb and manage his diabetes and medication regimen.
• A 28-year-old woman who was discharged from the hospital after a two-month stay in the intensive care unit (ICU) for treatment of a severe systemic infection and respiratory failure. She was transferred from the ICU directly to her home because Homedical Associates was available to provide continuity of medical care for management of her tube feedings and tracheostomy.
Statistics from the American Academy of Home Care Physicians demonstrate the growing need for home care:
• About 1 in 20 individuals over age 65 is functionally or cognitively disabled to the extent that office-based medical care is inaccessible. An equal number but smaller percentage of people under age 65 is also homebound.
• The fastest growing population segment consists of people over age 85, of which 40 percent cannot perform at least one activity of daily living.
• There are approximately 68,000 people over age 100. This number is expected to grow to more than one million within 40 years.
• All patients, regardless of age, prefer to be cared for in their own homes. Physician house calls not only respect this preference but can also improve overall care and patient outcomes.
• The cost of homecare is significantly lower when compared to the total cost of hospitalization, emergency room visits, and ambulance transportation.
Recognizing home care as the new frontier of medicine prompted Homedical Associates to establish their practice. The physicians and nurse practitioner bring their expertise and caring directly to their patients and family members and deliver high-quality medical care in the comfort and security of each patient’s home. Homedical Associates offer primary care, consultative care, home ventilator care, comprehensive geriatric assessment, and chronic long-term care services. The practitioners work in collaboration with community Visiting Nurses, Hospice agencies, other chronic care providers, and social service agencies.
The members of the Homedical Associates staff are:
• Kevin Costello, M.D., F.R.C.P.(C.)
• Doctor of Medicine, Columbia University, 1988
• Medicine residency, Royal Victoria Hospital, Montreal, 1988-1991
• Geriatric Fellowship, McGill University, Montreal, 1991-1993
• Fellow, Royal College of Physicians (Canada), 1991-present
• Board Certified in Internal Medicine, 1991; recertified 2001
• Added Qualifications in Geriatric Medicine certificate (ABIM), 1996
• Assistant Professor of Medicine, Albany Medical College, 1994 to present
• Member: American Academy of Home Care Physicians and American Geriatrics Society
• David Hornick, M.D. , M.P.H
• Doctor of Medicine, University of Pennsylvania School of Medicine, 1969
• Masters of Public Health, SUNY at Albany, 1993
• Board Certified in Emergency Medicine and Fellowship trained in Geriatrics and Public Health
• Past President of The Capital Area Consortium on Aging and Disability and former member of the board of directors of the American Academy of Home Care Physicians
• Founder of Homedical Associates, PC
• Roberta Miller, M.D.
• Doctor of Medicine, UMDNJ, Rutgers Medical School, 1986
• Internal Medicine Residency, Albany Medical Center, 1987-1991
• Board Certified Internal Medicine, 1991; recertified 2001
• Additional Certifications in Home Care and Hospice and Palliative Care
• Assistant Professor of Medicine, Albany Medical College, 1992 to present
• Member: American Academy of Home Care Physicians and American Geriatric Society
• Michael Welch, M.D.
• Shaker High School, 1967
• Dartmouth College, 1971, BA in Physics
• Doctor of Medicine, The Albany Medical College of Union University, 1976
• Family Practice Residency, SUNY at Buffalo College of Medicine, 1979
• Board Certified in Family Practice and Orthopedic Medicine
• Currently practices part time in homecare and part time in an office-based practice
• Loretta Ciraulo, FNP,C
• Graduate of Sage Graduate School with Master’s Degree in Nursing, Family Nurse Practitioner, December 2000
• Bachelor’s Degree in Nursing, SUNY College at Plattsburgh, 1978
• Board Certified as a Family Nurse Practitioner
• Member: The Nurse Practitioner Association of New York State since 1998; current President of the Capital Chapter
• More than 20 years’ experience in home care with geriatric, chronic disease management, and palliative care
Another component of the Homedical Associates practice is education. Their recently launched Web site (www.homedicalassociates.com) provides a virtual library of information for patients, family members, and the general public about organizations and government agencies that deal with homecare, geriatrics, disability and end-of-life issues. The Web site includes a downloadable referral form and a referral form that can be completed on line.
A special section, “Friends of the Homebound,” enables those who believe in home care to support developing new approaches to community long-term care. Donations made through PayPal, a third-party payment processing company, go directly to Alliance for the Homebound, the non-profit corporation established by Homedical Associates in November 2004 to facilitate fundraising.
“In many ways, the medical care provided to homebound people resembles that provided in Third World countries,” says Dr. David Hornick, a founding partner of Homedical Associates. “Alliance for the Homebound allows people to become medical missionaries in their own communities.”
More than 5,000 people in the Capital District’s four counties are homebound individuals.
Contributions to Alliance for the Homebound made through the Web site (www.homedicalassociates.com) can be designated as a gift in memory or in recognition of others or to mark personal events (i.e., Honorary Gifts); as part of a community-service project or fundraiser (i.e., Event Giving); as part of retirement or estate planning (i.e., Planned Giving); or as corporate philanthropy (i.e., Corporate).
Homedical Associates serves Albany, Columbia, Greene, Rensselaer, Saratoga, and Schenectady Counties and participates with all Capital District hospitals. Referrals to Homedical Associates come from primary or sub-specialty care providers, individuals, family, friends, Capital District homecare agencies, hospital discharge planners, emergency room providers, social workers, adult protective staff, clergy, and other patient advocates.
To arrange for an appointment or to refer a patient, contact Homedical Associates at (518) 346-3100
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