One dedicated urban doctor takes geriatric medical care to those who can't easily leave home. When support for her dream did not come from local hospitals, Dr. Andrea Fox convinced the Veterans’ Administration to fund a mobile medical unit. She was interviewed by Dale Bell.
We have to get out of the hospitals and go into these communities and learn what they need and what they're not getting. And the only way you know that, is to actually go there and see it. I didn't know what these patients were going to need the first day that we drove the mobile unit up there. I'm starting to learn to see the kinds of things, why they don't go to the hospital. You know, the waits are terrible, the buildings are scary. They're not treated well when they get there.
The guy that we saw today, he had a doctor at the VA, but that doctor didn't realize that he really wasn't getting it together to take his medicines and he was on 150 medications to try and control his blood pressure, but he couldn't remember to take it. So, he comes in every two weeks and he's become a part of our mobile unit community. And it's been extremely successful.
What really breaks my heart is that I can't see everybody in that community who comes to our van and wants care. We do have plans, maybe someday in the future, to have another van, that's from the university hospital, and then we can see everybody else, or the doctors down there could see everybody else. Now that we've proven it works.
Dr. Fox also makes house calls to elderly patients not covered under the Veterans program.
I just travel around Pittsburgh to all kinds of different neighborhoods, rich people, poor people. They're just these older adults who no one ever sees, these caregivers just struggling to do the best that they can and there's just so little out there to give them. This couple that we're seeing, she actually had a doctor who has an office, right here, and he wouldn't go the two blocks to see her in her house. It was just so silly to me.
My patients that I see at home, I know them better than all my other patients I see that I don't see at home. When something bad happens to them, if they are hospitalized, they're in and out of there really quickly. That's my goal. And I think that if patients are homebound and no one sees them, that things fester and people end up with worse problems.
It's not really that complex of a thing to do, to go to someone's house. Just to look, ask, you know, to try and figure out what's going on, just to avoid sending them to the hospital, which are horrible places. Yes, cure is one of our goals, but since most of the people who get sick and who suffer from illness, in our country, are older adults, that what we need to do is to start focusing on caring, as opposed to curing, and that just takes a whole different mindset, for young doctors to say, "Okay, I'm not going to march in there and save this person, but maybe, I'm going to try and make this person have the last, you know, years of their lives as comfortable, free from pain, and supported by me as they can be.
Now I, sometimes I see a new patient and I think I'm going to be there when they die. And that's not, anymore, a bad thing to me. But that actually, is one of my goals, is to be there when they die.
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