House Call MD

A house call MD, or Physician house call, is an act of customer service where the doctors goes to the consumers home, rather than the consumer visiting the suppliers place of business. House calls are most often associated with doctor house calls. There are still doctors making house calls. A physician-led multidisciplinary team provides comprehensive, patient-centered care for any condition, from the simple problems to the very complex, in the patient’s own environment. Thanks to modern technology and our sophisticated, multi-faceted delivery system, we can do more tests and procedures in our patient’s home or place of business than other primary care physicians do in their office. House call MDs are equipped to perform most procedures normally performed in a medical office. House call doctors utilize electronic medical records and will coordinate home health and hospice services, mobile imaging services, durable medical equipment services, laboratory services, and specialist referral services. House call doctors acts as the primary care physician or as augmentation to or as an interim physician to the patients’ present medial team. Doctor’s House calls provide post hospital stabilization service to physicians, insurance plans, and hospitals to mitigate hospital re-admissions. Some concierge practices do not accept insurance of any kind. These are as cash-only or direct primary care practices. By refusing to deal with insurance companies, these practices can keep overhead and administrative costs low, thereby providing affordable healthcare to patients. They become concierge only if the practice assesses an annual or monthly fee instead of or in addition to a fee for each medical service. Other concierge practices do take insurance, even Medicare, but ask for an annual fee for additional services exclusive of insurance plans. This annual fee is not a substitute for medical insurance, and generally does not cover consultations outside the practice, laboratory procedures, medicines, hospitalizations, or emergency care from other providers.

Dermatology

Dermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails. Dermatologists have been leaders in the field of cosmetic surgery. Some dermatologists complete fellowships in surgical dermatology. Many train in their residency on the use of Botox, fillers, and laser surgery. Some dermatologists perform cosmetic procedures including liposuction, blepharoplasty, and face-lifts. Most dermatologists limit their cosmetic practice to minimally invasive procedures. Mohs surgery, developed in the 1930'a y Dr. Frederic E. Mohs, focuses on the excision of skin cancers using a tissue-sparing technique that allows intraoperative assessment of 100% of the peripheral and deep tumor margins . Physicians trained in this technique must be comfortable with both pathology and surgery, and dermatologists receive extensive training in both during their residency. Physicians who perform Mohs surgery can receive training in this specialized technique during their dermatology residency, but many will seek additional training either through preceptorships to join the American Society for Mohs Surgery or through formal one- to two-year Mohs surgery fellowship training programs administered by the American College of Mohs Surgery. Procedural Dermatology is concerned with the study, diagnosis, and surgical treatment of diseases of the skin and adjacent mucous membranes, cutaneous appendages, hair, nails, and subcutaneous tissue. Dermatologic surgical procedures are minimally invasive and may be performed safely in outpatient settings without general anesthesia or other intravascular physiologic alteration. An especially important technique is Mohs micrographic surgical excision, which treats cancers of the skin and incorporates training in clinical dermatology and dermatopathology as they apply to dermatologic surgery. Laser resurfacing is a technique used during laser surgery wherein dissolution of molecular bonds is by laser. It is for the treatment of wrinkles, solar lentigenes, sun damage, scars, stretch marks, actinic keratosis and telangiectasias or "spider veins". It can be with liposuction to remove excess fat from the chin and jaw area. Laser resurfacing can help tighten and smooth over the new contours.

Cosmetic Treatments

Being a grown-up does not have to be as difficult as it used to be. All adults long for the flawless skin they took for granted as a youth. As we age, the elements of our environment including the sun and air pollution affect the skin. The collagen fibers in the skin break down and lose their elasticity. Over time, the skin essentially becomes thin, dry, uneven in color or tone, wrinkled, and more sensitive. Based on years of research in scar formation and the effects of aging on skin, doctors have developed a unique multidisciplinary approach to treat aging skin. Each patient has different skin and a doctor evaluates its thickness, pigmentation, complexion, pore size, degree of sun damage, and hair density, among other variables. Doctors design individualized treatments based on general skin type and the anatomical area of concern. Treatments are best suited for individuals who seek a refreshed complexion without the recovery time associated with more extensive skin-resurfacing procedures.

Phototherapy Acne Treatment

Sunlight can improve skin care in the short-term. However, recent studies have shown that exposure to sunlight worsens acne in the long-term [citation needed]. More recently, visible light treatments (phototherapy) have successfully treated mild acne--in particular intense violet light (405-420nm) generated by purpose-built fluorescent lighting, dichroic bulbs, LEDs or lasers. Used twice weekly, this procedure resulted in a reduction of the number of acne lesions by about 64 percent. Studies show that this treatment is even more effective when applied daily. Scientifically speaking, the method of violet light treatment is effective because porphyrin (Coproporphyrin III), produced within P. acnes, generates free radicals when irradiated by 420nm and shorter wavelengths of light. Over the course of a few days, these free radicals ultimately kill the bacteria they spawned from. Since porphyrins are not otherwise present in skin, and the UV light applied is safe in its spectrum, this treatment is safe and licensed by the United States Food and Drug Administration (FDA). The ultra violet treatment works even better with red visible light (660nm) resulting in a 76 percent reduction of lesions after three months of daily treatment for 80 percent of patients. The overall skin clearing was similar or better than benzoyl peroxide. Unlike most of the other treatments, there are few if any negative side effects to this treatment and a development of bacterial resistance seems very unlikely. After treatment, a patient can achieve clear skin with topical or oral antibiotic treatments. The equipment or treatment, however, is relatively new and expensive, although the total cost of ownership may outweigh other costs (such as the total cost of benzoyl peroxide, moisturizer, and washes) over a couple of years.