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From ER to ‘country doctors’
(by Maggie Fazeli Fard - February 06, 2008)
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Fast Facts
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Drs. John Hallenbeck, with 12 years of ER experience, and Ken Cartaxo, with 23 years of ER experience, will treat minor emergencies in
Pascack
Valley and surrounding areas.
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As the region waits with bated breath on the fate of the former Pascack Valley Hospital (PVH), two former PVH emergency room physicians have embarked on a new medical venture: treating everything from sprained ankles to food poisoning in the comfort of a patient’s home.
“We saw a need,” said Dr. John Hallenbeck, who along with Dr. Ken Cartaxo launched Urgent Care House Calls last Thursday.
The doctors, who have 35 years of ER experience between them, now make house calls to treat minor emergencies that are too serious to be handled in primary care doctors’ offices but that don’t warrant a trip to – or a long wait in – the emergency room.
“The reality of the matter is the other hospitals are not located in a reasonable distance,” said Hallenbeck. “What’s a reasonable amount of time to wait when your kid has a cut and is in pain?”
Hallenbeck and Cartaxo found themselves haunted by questions like this as PVH stood on its last legs in 2007. In the weeks before the hospital closed, the physicians began diverting patients to other hospitals.
“Just hearing people accept calls, they were inundated,” recalled Cartaxo, who has worked in emergency rooms for 23 years and was at PVH from 1988 to 2007. “The waiting times were unreasonable. The need was there for these acute medical needs.”
Cartaxo met Hallenbeck about one year ago when the 12-year ER veteran joined the PVH team after his former employer, Passaic Beth Israel, closed.
“We just seemed to click,” said Hallenbeck, who lives in Montvale. “We both knew we wanted to do something. We just didn’t know what.”
They briefly considered opening an urgent care center, but it didn’t take long before Cartaxo recalled a newspaper article about house calls that he had read several years earlier.
The more the pair looked into starting the service, the more it seemed like a viable option.
“The majority of emergency room patients came in with minor emergencies,” but they would sometimes have to wait several hours before they could be seen, Cartaxo said, noting that serious emergencies take precedence over minor ones like lacerations or flu symptoms. PVH’s closing, he added, has aggravated the situation, as more stress is put on the ERs of other area hospitals.
“If you cut your hand while making breakfast, do you want to spend the whole day in the ER?” he asked. “We can decompress some of the emergency rooms.”
In addition to lacerations, Cartaxo and Hallenbeck will treat simple infections, sprains and vomiting, and can administer medications and IV hydration. They will be on call 24 hours a day, seven days a week at 1-888-DRHC247, which they hope people will remember by memorizing “1-888-DR House Call 24/7.” Blood work and x-rays are not currently available, but the pair is confident that they will be able to offer portable tests in the future.
Cartaxo also hopes to incorporate nutritional medicine. “I think the pendulum is swinging back from high technology to more natural treatments,” he said. His first call on Thursday, Jan. 31, involved dispensing a vitamin cocktail through an IV.
“The country doctor,” Hallenbeck said, jokingly nodding towards his business partner.
Cartaxo agreed that people think that house calls are “a thing of the past.”
“It’s a losing proposition for primary care physicians,” Cartaxo said. “We don’t have any office or staff. In private practice your biggest expense is your staff. Our overhead is much less.”
The cost of a basic house call is $250; a follow-up costs $195. Hallenbeck said that the cost of an evaluation by a physician in an emergency room runs about $300, excluding hospital and treatment fees. “The ER is the most expensive care being offered. The fees are steep.”
Hallenbeck added that while it’s cheaper than going to the emergency room, the waiting times for doctor’s appointments can be two or three days and the doctor’s practice is not always equipped to handle minor emergencies. Doctors very often instruct patients, especially those who call at odd hours, to go to the emergency room. “We’re basically going to take people with minor emergencies that small doctor’s offices can’t handle,” said Hallenbeck. “And it’s one-on-one while in the ER it could be one-on-20.”
The doctors plan to work with local doctors, giving them an alternative to sending people to the ER while giving detailed follow-up reports on treatment provided during the house call. They also plan to contact visiting nurses who care for homebound patients as well as local hotels, where guests may be far from their home physicians and need assistance with issues such as minor food poisoning.
They stress, however, that they are not aiming to take the place of primary care physicians nor that of emergency room care. If anyone calls them complaining of labor pains, chest pains, numbness or uncontrollable bleeding, they will instruct the caller to hang up and call 911.
Similarly, they have no qualms about calling paramedics if they arrive on a scene and deem the situation needs emergency care. “A non-life-threatening emergency could become life threatening,” admitted Cartaxo.
In the end, the house call service boils down to two energetic doctors with time on their hands and the desire to help their community.
“I enjoy seeing people and really helping them. Now that the ER is gone, we can do it in a way that is satisfying to the patient and to us; to provide care the way we’d want to be cared for.”
To contact Dr. John Hallenbeck or Dr. Ken Cartaxo at Urgent Care House Calls, call 1-888-DRHC-247 (1-888-374-2247).
Maggie Fazeli Fard's e-mail address is fazelifard@northjersey.com.
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