Nausea, Vomiting, Diarrhea, & Dehydration Housecalls
Why a Housecall?
Vomiting and diarrhea, usually due to stomach flu or food poisoning, are a major reason that patients call us. While these symptoms often resolve within hours, occasionally they are severe and persistent, causing significant dehydration. Patients with nausea, vomiting, diarrhea and dehydration do not want to travel to their doctor or sit in public waiting rooms. Remaining at home, in bed, with quick and easy access to the bathroom is the most comfortable option.
The Request for a Housecall and the Response
When we are called to evaluate and treat patients with vomiting, diarrhea and dehydration, we first determine the appropriateness of the housecall before responding. The doctor will ask questions to be sure that symptoms do not suggest a serious or life threatening emergency, in which case 9-1-1 should be called. An estimated time of arrival will be given to the patient at this time. The physician’s arrival will be subject to traffic conditions.
What We Bring and How We Treat
Our doctors carry antiemetic (anti-nausea) medications, including oral, sublingual, and injectable forms. Most patients will have their nausea resolved with sublingual (under the tongue) medication within minutes. Some will require an injection for these symptoms. Occasionally patients will have significant dehydration such that nausea persists until this is corrected. We always carry IV fluids for rapid rehydration in these cases. Once an IV is established by the house call physician, most young and otherwise healthy patients will begin to feel better within minutes. The IV fluid therapy is typically complete within 1 hour or so. Our patients usually express surprise and elation at how quickly they are feeling better.
The key to treating patients with vomiting and diarrhea is to rehydrate, rehydrate, rehydrate! Our goal is to bring our patients to a point where they can do this on their own. We usually will offer to leave our patients with anti-emetic and/or other meds for self treatment after our departure. When appropriate, we will encourage most patients to rehydrate with electrolyte replacement solutions such as Powerade or Gatorade. We usually bring these too!
While rapid rehydration is safe for young and healthy patients, people with certain medical conditions or who are age-enhanced may require slow rehydration, sometimes over 1-2 days. These patients will usually be referred for hospital treatment, unless round-the-clock home skilled nursing care can be arranged.
Modern Housecall Technology
In some cases, our mobile emergency physician will carry an iStat, a handheld device that is able to perform rapid blood testing on site. A few drops of blood and a few minutes are all that are needed before results are available. Glucose, electrolytes, including sodium, potassium and chloride, CO2, BUN and creatinine (kidney function), calcium, hemoglobin and hematocrit are the tests that we currently offer in this way. Your housecall physician can draw blood and transport it to any hospital lab for urgent processing as well. Instant urinalysis dip testing and urine pregnancy tests are also carried.
Hospitalization
On rare occasions, after the initial examination by our house call doctor, it may be determined that the patient has a more serious situation requiring evaluation in the hospital emergency department. Our doctor will help facilitate transportation arrangements if needed, and will communicate with the hospital emergency physician directly to help facilitate your care.
Modern Housecall Doctors
Our physicians are all experienced emergency medicine practitioners. We are licensed to practice medicine by the California Board of Medicine. We are Emergency Medicine board certified or eligible, are residency trained in emergency medicine, have rock-solid reputations, and our patients tend to like us. Our online reviews are top quality, and patients frequently express their gratitude for the work that we do. As emergency physicians, we believe that patient safety should be highly prioritized when it comes to housecall practice. As emergency physicians we are comfortable evaluating and caring for seriously ill patients. This fact means that you are in excellent hands when being cared for by one of our physicians.
Please realize, however, that we are NOT an emergency medical service. Seriously ill or injured patients should call 911 or go to their nearest hospital ER.
Paperwork and Insurance
Our treament will be documented in detail during the housecall visit. A superbill will be completed for all cases, which includes patient information, a medical report, diagnoses, treatment rendered, and itemized charges. A copy of this form will be given to the patient and may be submitted to the insurance provider by the patient for reimbursement.
For all PPO and HMO insurers, we are considered out-of-network at the current time. For PPOs, the annual out-of-network deductible that remains unmet will usually determine your out-of-pocket expense. PPOs typically cover up to 80%. HMOs may cover up to 100% if they have no nearby contracted facilities. Policies vary, so always check with your insurer directly for details about your coverage.
Health Savings Account (HSA) and Flexible (FLEX) spending account credit cards may be used for our services.
For patients with travel insurance (visitors to the USA) we may agree to bill your insurer directly if coverage for our service has been pre-authorized.
Payment for our services may be made with cash or major credit card at the time of service.
Our Fees
For patients with mild symptoms such as mild nausea without vomiting, and where no injections or IV fluids are required, our fees are limited to the basic housecall charge and any dispensed meds. Typically this will start at $265. Medications usually run $10-$80 for these problems. Patients may opt to have prescriptions filled by their pharmacy as well in order to use their insurance copay.
In some cases, afterhours, weekend or night service fees will apply. Travel fees are included when our physician must respond to distant areas.
Injections, IV fluids and lab testing will add to the cost, usually ranging from $100-$800, rarely more.
When the initial request for service is made, an estimate will be offered, and will usually include a range since we cannot usually know beforehand exactly what the patient will need in these situations involving vomiting, diarrhea and dehydration. Some directly paying patients opt to start with our convenient assessment, then if it appears that they will require more extensive care, they may opt to have their insurance billed directly by going to a nearby ER.
For patients without insurance, our IV rehydration services are always substantially less than hospital emergency treatment.
Instruction and Followup
At the completion of the housecall, detailed instructions are always given, and our patients always know that they can call us anytime, 24/7, with questions or problems that arise. Further simple telephone consultations as ongoing care for the same problem are free of charge.
Conclusion
Vomiting, diarrhea and mild dehydration are excellent reasons to request a house call
Remaining at home with these symtoms is far more comfortable for the patient than traveling and sitting in a waiting room
Symptom relief is usually amazingly rapid once our doctor has arrived!
Costs for housecall services for these problems varies depending upon many factors, can get pricey for the sicker patient, but is always less than the ER for those who have no insurance. Our services are insurance reimbursable in many cases. FLEX & HSA accounts may be used, and we accept most traveler insurances.
We always provide our patients with 24 hour telephone access for followup questions or problems.
We are the easiest urgent care service that you will find!
