Specific services available include:
- Evaluation and recommendations for management of age-related medical concerns, such as:
- memory problems, including Alzheimer’s and other dementias
- integrated management of multiple chronic conditions
- declines in independence
- Treatment of chronic illness and geriatric problems, including prescription medication when appropriate, with prompt follow-up and revising of treatment plan
- Evaluation of overall health, physical function and mental function
- Assistance navigating a difficult medical decision
- Evaluation of past and ongoing medical management
- Coordination of care among multiple doctors, as well as coaching patient and family to improve care coordination
- Caregiver education, information, and support
- Medication review and recommendations for optimizing medication plan, with a special focus on identifying and minimizing the many drugs known to be risky for elders
- Advice on completing advance directives and living wills
- Assistance planning for future care and housing needs
- Completion of residential care facility for the elderly (RCFE) forms
- End-of-life care, including education about hospice and referral if appropriate and desired by patient
I am a solo practitioner who chooses to work without any staff; all care is provided by me directly. Visits take place in the patient’s home, whether that be a personal residence or a residential care facility. (In some circumstances, patients can also be seen in the nursing home or during a hospitalization.) Follow-up is easily and quickly available, via telephone, secure messaging, video, or in person. Phone calls will be returned within two hours during business hours (8am – 5pm, Monday-Friday).
Please note that my geriatric consulting practice is not at this time able to provide housecalls or phone follow-up after hours, unless special arrangements have been made beforehand. Patients will need to have a primary care physician or other usual source of medical care, for urgent care needs or after-hours concerns.
I use transparent time-based fees, with all services billed based on the time spent providing assistance. Because elderly patients vary widely in their medical needs, and communication needs, time-based billing empowers every patient and his or her family to decide how much of the doctor’s time is needed. Time-based fees also allow for frequent, efficient follow-up by phone and secure messaging — a system that’s often quite convenient for elders and families.
All time providing service is based on my rate of $200 per hour, billed in five-minute increments (5 minutes = $16.67; 15 minutes = $50).
Time includes phone consultation, secure messaging, video visits, and time spent reviewing records or coordinating care, as well as time traveling to a housecall. Phone consultations are generally available within two hours, and secure messages are responded to within one business day.
My transparent time-based billing means that a 15-minute phone consultation costs $50 , with no need for you to spend time traveling to a clinic, or waiting for your appointment.
Advance estimates of time needed to address a given situation can be provided on request.
There is no membership fee or recurring fee.
In order to keep overhead low and fees reasonable, I am unable to accept Medicare or any other insurance. Patients will be billed directly for the cost of my services. Please note that those with PPO insurance can often be reimbursed up to 80% for the expense of out-of-network providers such as myself.
Laboratory tests, radiology tests, prescriptions, and referrals are covered by Medicare when I order them.
Questions? Please check my FAQs or call 415-574-0545 and I’ll be happy to provide more information.