New way to treat geriatric patients

New way to treat geriatric patients

The Westerly Sun


Dr. Michael Feltes has devoted half his life to caring for the elderly and is now embarking on “a novel approach to the practice of medicine” in an area within a fairly short driving distance of his base in Mystic.

The medical practice, Mystic Geriatrics LLC, officially opened Tuesday and has two offices, at 107 Wilcox Road, Stonington, in the Quiambaug Cove Professional Center, and at 186 Jerry Brown Road, Mystic, in the StoneRidge senior living community. Feltes has been joined in the practice by Karen Terwilliger, an advanced practice registered nurse and nurse practitioner in geriatrics, and manager June Fliri, who has a master’s degree in social work and an MBA.

It will be a concierge practice with the goal of attracting, over next the next five years, about 500 senior patients, 65 and older, who would pay a monthly fee for the evaluation, guidance and monitoring of a primary care team that has “a focus on medical care in the home with 24/7 availability.”

As Feltes noted, a conventional private medical office might have 3,000 patients, and at a time when many physicians have quit individual practices, Mystic Geriatrics aims to be something of a throwback, complete with house calls.

In fact, the doctor stated in an interview, “If I can’t visit the home, it’s not going to work.”

Walking into the dwelling of an 80-year-old and making observations of “a lot of little things,” he said, is an important part of assessing nutrition, medical issues, potential safety hazards, and other factors that weigh on a person’s well-being. It’s not something than can be done in a 10-minute office visit every four months, he said.

Some of the key aspects of the practice, listed in a press release, include advanced care planning, medication and pain management, preventive care, coordinating care with specialists, treatment of memory loss and dementia, “maintaining quality of life and dignity,” and palliative care consultation.

Feltes quoted a fee of $150 to $175 per month and remarked that the cost would be cheaper than some cable plans, or long-term care premiums.

And how could it work that two people, himself and Terwilliger, could deliver 24/7 service?

The doctor said many problems could be solved over the phone. And for those that required home visits, Feltes suggested that a 20-minute house call could be much more effective and less expensive than an emergency room visit. He said he was confident, too, that patients in this age group, who tend to be respectful of a physician’s time, might reserve most of their calls “for 9 o’clock in the morning.”

This “new model” of medicine, he added, could appeal to the patient’s family because it would spare children in some instances from having to take off work to transport the parent to and from a medical office. Besides the limited patient base, Feltes intends to further manage his own time through a business plan that would limit his coverage area to within about a 10- or 12-mile radius of his base: in other words, Westerly, Stonington, Groton, and portions of North Stonington and Ledyard.

Who is a geriatric patient? Feltes said it’s a person over 80, but a geriatrician’s skills can be applied to younger persons, too, who have a mix of functional difficulties that make them frail.

Although more than a dozen doctors with geriatric credentials show up in local medical listings, Feltes, who is 60 and a native of Chicago, said he is the “only fellowship-trained” geriatrician in eastern Connecticut, a professional designation he earned at the University of Connecticut in 1988-90; his work in geriatrics dates to 1985. A graduate of Williams College and Rush University, he was the founder of Sound Seniors Geriatrics in Mystic, where he worked for 20 years serving the region’s rehabilitation and nursing homes. He has also practiced at hospices in Norwich, East Lyme, and East Hartford. He maintains an active geriatrics consulting service and a faculty association with UConn and its Center on Aging. He and his wife, Betsy, have lived in Mystic for the past 8½ years.

Although the new practice’s fees cover the added attention and “enhanced thinking” of a concierge service, Feltes said he had also negotiated with Medicare and private insurers and would bill them accordingly for other patient care items.

Feltes acknowledged the risky nature of his new enterprise: “We’re trying to do it different and see if we survive,” he said.

But the trend toward an older population, as noted in his announcement, would be a factor in his favor.

“I’d love to have three Harvard-trained geriatricians parachute into the area because there’s so much work to do for a precious population that needs a lot of attention,” he said.



Online:

The practice website is www.MysticGeriatrics.com. Telephone: 860-536-5302. Email: info@mysticgeriatrics.com.

Photo by Karin Burgess.


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