Photo By: Eren Gknar/Special to the Town Crier
As baby boomers near retirement age, thousands daily qualify for Medicare.
An aging society results in more chronic health conditions, but fewer local doctors – approximately half, according to an El Camino Hospital survey – accept Medicare Part B patients. Even if they do, seniors on fixed incomes will often avoid seeing primary-care doctors because the co-pays and extra expenses add up quickly without gap coverage.
To fill the health-care void, El Camino Hospital quietly opened its doors in February to the outpatient Senior Health Center in the Cedar Pavilion at 2660 Grant Road in Mountain View.
Medical Director Patrick Kearns, M.D., and Clinical Manager Jodie Sugiyama, RN, touted the program’s innovative approach – the medical home model – to a lunchtime crowd at the Los Altos Senior Center April 19. Candace Bates, senior recreation coordinator, and the Community Services Agency provided healthful veggies and dips while El Camino’s Health Library distributed brochures.
iPads and house calls
It’s not a run-of-the-mill senior health center, although it provides one-stop shopping of sorts. Combining state-of-the-art technology, including iPads, with old-fashioned practices, like house calls, the center aims to address bugs in the system.
The current situation jeopardizes seniors’ health needs, as physicians slowly retire even long-term patients who turn 65 and join the Medicare rolls. Many physicians say they fear losing their practices if they take the government’s fee-for-service, historically low for California’s high cost-of-living, according to Kearns.
In an email to the Town Crier, Kearns noted that many seniors move to the area to be closer to their adult children, but they can’t find a doctor to take a new Medicare patient. Medicare reimbursements, he wrote, are too low to cover “local high office rents and salaries,” because it’s based on national living costs, which “remain extremely prejudicial” to Northern Californian doctors.
Senior Health Center patients can use their Medicare benefits and not have to purchase extra Part C coverage for $500-$700 a month.
A graduate of the UCLA School of Medicine, Kearns, who specializes in geriatrics, moved his practice from Santa Clara Valley Medical Center to the new Senior Health Center.
Addressing the Los Altos Senior Center crowd, Kearns said the hospital program provides a change from the traditional model, which “focuses on the failures, the diseases,” not on success. For example, falling is often a harbinger of poor senior health, but losing one’s balance comes before the fall.
“So we try to improve your balance, we try to involve you with tai chi just enough so you’re not stumbling when Curly, your poodle, runs by you,” he said. “I want to prevent the stumbling that causes the fall.”
Senior health, the doctor said, means “maximum function so you can enjoy sunny days.” The Senior Health Center’s mission is to give patients the information they need “to make life longer, but also more fun.”
The 8,000-square-foot outpatient center hopes to manage up to approximately 5,000 seniors’ diet, nutrition, pharmaceutical, social service, physical therapy and medical needs. Currently, an orthopedic surgeon is available for appointments one day a week.
Patients can walk in and talk with nurses, who use iPads to enter data and can even perform an exam with the doctor monitoring electronically with special medical software.
Senior-oriented touches abound. For example, most of the chairs are high enough that those having trouble bending can just slide into them – the reverse of the child-focused pediatrician’s office, where all the furniture is pint-sized.
Kearns spoke proudly of having decreased “unanticipated emergency room visits” by 15-20 percent in his previous practice.
“Since I’ve been a resident, I’ve told people, ‘You don’t want to be in a hospital (overnight), because they’re dangerous places,’” he said.
Kearns encourages drop-in visits.
“You will be able to see your doctor that day,” he said. “We will have a talk about whether or not you need the ER.”
The center can accommodate an additional 500 seniors who already have primary-care doctors but require adjunct services for dementia, falls, depression, delirium or incontinence that those practices can’t handle.
“The purpose is not to break relationships (between doctors and patients),” Kearns said. “It takes any doctor weeks, months, years, to get to know you, and they have a lot of medical knowledge that they’re losing when you turn 65.”
A holistic approach
Sugiyama, who is studying for a master’s degree in divinity, promoted the Senior Health Center’s holistic approach, in contrast to the current “fragmented health-care system … which is in disequilibrium.”
Sugiyama said the program is unique because it is:
• Person-centered, enabling the patient to email or call a nurse or doctor with symptoms and drop by that day. Kearns said he has time blocked off daily for such last-minute visits.
• Preventive and self-managed, offering risk assessment and wellness planning as well as disease-specific health education.
• Relationship-based, so multiple care managers can get to know each patient.
• Able to provide primary-care doctors with a caring, supportive team.
• Coordinated, with comprehensive care across such disciplines as social services, nutrition and pharmacology.
The center will involve extended family members, according to Kearns, with plans to sponsor facilitated support groups for caregivers.
“In these groups, people will be able to share their stories and find out that they’re not alone, that maybe something worked for someone else,” he said.
The center also partners with agencies like Meals on Wheels, the Community Services Agency and RoadRunners, making referrals and educating patients.
“We’re going to help people find additional resources in the community,” said Kearns, noting that the staff will search for “the underserved or reclusive elderly” who don’t leave their homes, for example.
For more information, visit www.elcaminohospital.org/Programs_and_Services/Senior_Services/Senior_Health_Center.