Wheaton doctor serves his patients through house calls
Twenty-three years ago, Dr. Paul Chiang could not have imagined practicing medicine the way he does in 2015.
As with many internal medicine doctors finishing their residencies, his career path led him from working in a teaching hospital to a traditional clinical practice.
Chiang believes his path to doing house calls, which he began 15 years ago, was providential.
Although there was not one particular case that led him to pursue house calls, the change in his practice stemmed from a sense of feeling badly for his patients who he watched struggle to get to and from his office for only a short visit.
Chiang also realized that medicine is about service, and he felt that there was a better way to serve his older and frail patients. So when an opportunity to practice house calls was presented to him, he took it.
“I came to understand more and say, 'Hey, somebody up there knows this is where I was meant to be,'” Chiang said.
Chiang said there are a number of benefits to making house calls.
“I get to see so much more of a patient if I go to their home,” as opposed to a traditional office or hospital visit, he said. While he admits that hospitals — and even offices — possess amazing technology for diagnosis and treatment of ailments, in recent years many of those same technologies that used have to be wheeled around now can be held in the palm of his hand.
For Chiang, treating a patient is more than just using the latest technological instrument. He is able to see how they live and the struggles they may face in their daily lives, such as moving from room to room or even issues in the bathroom or sleeping areas.
He gets to see what they eat and what is in their refrigerator. If all he sees in a patient's refrigerator is microwave meals, for example, that could be a possible reason for someone's high sodium levels.
What Chiang likes the most is being able to know his clients as real people, not just as patients. Because he is in their home, he is able to see photos of children and grandchildren, and sometimes even wedding photos showing his most elderly patients in the prime of their lives.
Chiang also is easily able to see if there is a good social structure and support system for his patients.
Chiang is a spiritual man and at times will pray with his patients before leaving the home.
Due to the nature of performing house calls, Dr. Chiang only sees around eight to 12 patients a day, as apposed to a traditional clinical practice where doctors see 20 to 30 patients a day. Since no patient is the same, a house call visit can last anywhere from 15 minutes to two hours.
Chiang is assisted by a licensed practical nurse to help with retrieving vital signs, doing blood draws and administering injections. The SUV they travel in is equipped with a clinical centrifuge and chilled case to keep blood samples stable until the they can be dropped off at the lab.
Dr. Chiang works for HomeCare Physicians Palliative Medicine in Wheaton, which is part of Cadence Physician Group. He visits patients in DuPage and Kane counties.
Chiang said it is tremendous that Cadence has allowed him to practice medicine this way. Without the support of the hospital group, he said, this type of medical practice would not be able thrive on its own since Medicare only pays for the actual patient visit and not the travel.
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