Physician House Calls - History of Portable ER
Urgent Care by Emergency Physician House Calls™  - "The Doctor Comes to You!™ with The PORTABLE ER®
Dr. and Mrs. John and Janice Sterba Emergency Physician House Calls Saved by Grace Ministry, Inc.
History of the
Community-Based
PORTABLE ER®
by 
John A. Sterba, MD, PhD, FACEP 
and Mrs. Janice E. Sterba
 

Emergency Physician House Calls are provided by Dr. John A. Sterba coordinated by Mrs. Janice E. Sterba in the Greater East Aurora, NY Region using the nation's first Federally Registered, Community-Based PORTABLE ER® (1, 20).  

The PORTABLE ER® is based on the Military Portable ER originally developed, Tested & Evaluated and published by LCDR John A. Sterba, Medical Corps, USNR.  This Military Portable ER was invented and rigorously used by Dr. Sterba in 1989 caring for patients for two months including upon the High Arctic Ice Pack of the North Pole Region.  This medical mission was successfully completed during a U.S. Navy expeditionary deployment involving multi-national forces conducting “Oceanography and Emergency Medicine/Diving Medicine Research” during an Undersea and Surface Warfare Exercise. The Inventory for this Military Portable ER was authorized for overseas use by U.S. Navy healthcare providers (e.g. Medical Officers- "Navy Doctors” and Independent Duty U.S. Navy Corpsmen) remotely deployed in the High Arctic. (2-4)  

Based on the successful Military Portable ER (4), John A. Sterba, M.D., Ph.D., FACEP thereafter expanded the PORTABLE ER® for Missionary Medicine and International Emergency Medicine overseas.  Dr. Sterba cared for those in greater need in under-served, impoverished communities of the Developing World during and recovering from catastrophic natural and man-made disasters. 

Working as an Emergency Physician and Medical & Scientific Director with Saved by Grace Ministry, Inc. of East Aurora, NY, Dr. Sterba field-tested the Medical Missionary Portable ER treating 4,300 emergency patients overseas.  This was done alongside many local healthcare providers and missionaries during seven civilian medical missions 2004-2008 in West Africa (Sierra Leone, recovering from its recent brutal Civil War) (5), Central America (Honduras, recovering from recent hurricane-flooding) and in the Caribbean Basin (Dominican Republic during the Haitian-refugee healthcare crisis) (6-7).

Since February 16, 2009, Dr. and Mrs. John and Janice Sterba have routinely used the Federally-Registered Community-Based PORTABLE ER® in the Greater East Aurora, NY Area (1, 20) to treat over 5,000 patients.  Responding within about four minutes, Dr. Sterba has transported needed Medical/Surgical Kits of the PORTABLE ER® in privately-owned mid-sized car or mini-van to conveniently treat adults and children in the safety of their homes.  In March 2015, Saved by Grace Ministry began transporting the PORTABLE ER® using the nation's first experimental Emergency Medicine specialty armored emergency vehicle, which was purchased by a vehicle grant from the Margaret L. Wendt Foundation of Western New York.  

The private medical practice of Emergency Physician House Callsis self-sustaining and steadily growing.  Dr. and Mrs. John and Janice Sterba invented and Trademarked these CMS*-approved "Home Visits" as Emergency Physician House Calls™ using The PORTABLE ER® (1,20).  For further details, please see www.PhysicianHouseCalls.org, under "About Us".

There has been wide support and encouragement from local doctors, insurance companies, the public and surrounding communities for Emergency Physician House Calls using The PORTABLE ER®. (8-20)

Historically, on January 1, 1998 Medicare and CMS* authorized physicians in the USA to be paid for House Calls, called "Home Visits".  Presently, all major healthcare insurances (e.g. BlueCross/BlueShield, Independent Health, UnitedHealthcare, Univera, Empire Plan in NY State, and others), Medicare, Medicaid, and U.S. Military TRICARE pay very well and are supportive for these specialized Emergency Medicine "Home Visits", invented and published as Emergency Physician House Calls using The PORTABLE ER®. (1,20)

Saved by Grace Ministry, Inc. conducts Institutional Review Board-approved clinical research on Emergency Physician House Calls using The PORTABLE ER®.  From published medical research, Emergency Physician House Calls billed to insurance companies is 25% compared to the same services billed from the more expensive hospital ERs (emergency departments). (20) 

Financially, Saved by Grace Ministry, Inc. is a Federal and State Public Charity and Non-Profit.  All insurance money, all tax-deductible donations and all insurance Co-Pays (tax-deductible donations) are used 100% to care for those in greater need.  

If patients do not have insurance or if they have high-deductibles not yet met, tax-deductible donations to "Saved by Grace Ministry, Inc." are encouraged and greatly appreciated, used to care for those in greater need.  No patients are turned away and no patients are billed or charged for Emergency Physician House Calls. This way we are all obediently caring for one another as Good Neighbors within our community.

Dr. Sterba uses CLIA**-Waived, Point of Care (POC) Blood Chemistry Labs approved for portable use including the Abbott i-STAT Lab for Basic Metabolic Profiles (BMP) and the Abaxis Piccolo Xpress Lab for Basic and Comprehensive Metabolic Profiles (BMP, CMP).  From our published medical research, the time from when Dr. Sterba orders a basic or comprehensive blood chemistry test until he explains these printed lab results to patients and family members is conveniently under 14 minutes (13.8 minutes (+ 5.2 minutes (SD), n = 45 patients). (20, 21)  

Dr. Sterba conducts other CLIA**-Waived bedside Rapid Diagnostic Tests.  He can draw other blood samples or take other urine and wound samples for medically necessary tests that he orders.  He conveniently drops off these samples at local labs, personally calling patients or family care-givers immediately when results are received at his home-based office.  Lab results are then forwarded and confirmed received with the patient's Primary Care Physician and other medical/surgical specialists.  Although Dr. Sterba is not a lab-drawing service for other doctors, he helps home-bound patients to arrange their needed home lab draws by outside blood-drawing services or visiting nurses.

Dr. Sterba provides many specialized medical and surgical techniques and treatments during Emergency Physician House Calls, some of which are not routinely done in hospital ERs.  

For example, Dr. Sterba expertly conducts computerized, calibrated Pulmonary Function Testing (PFTs), called spirometry, including %FEV1.0 and other PFTs (not just peak expiratory flow).  He provides expert medical and physiological interpretation to doctors, and explains results to patients and family in simple-to-understand language, before starting any needed aerosol breathing treatments.  Dr. Sterba has a Ph.D. with Distinction in Pulmonary Physiology (trained and experienced medical scientist in lung and breathing functions, in health and disease).   

Dr. Sterba is trained and experienced to begin intra-venous (IV) and intra-osseous (IO) infusions for hydration, medications and fluid resuscitation in children and adults.  He can draw IV or IO blood samples for immediate blood chemistry testing in the home using their Abaxis® Picollo Xpress™ Lab, a portable blood chemistry lab (not authorized for use in the hospital ER).  (21.) Dr. Sterba is the New York State Department of Health Laboratory Director for Saved by Grace Ministry, Inc. (21.)

Dr. Sterba uses specialized advanced Plastic Surgical Technique for lacerations (simple, complicated and complex).  He teaches his patients and family members/caregivers those simple Plastic Surgery techniques to reduce their scarring at home.  

Dr. Sterba provides on-going surgical and medical management of Advanced Wound Care, not only for lacerations, but for pressure ulcers-'bedsores', arterial and/or venous insufficiency ulcers using bedside Doppler blood flow assessment, diabetic and neuropathic ulcers, thermal and chemical burns, and skin tears. 

Dr. Sterba conducts comprehensive nutritional assessment and designs at-home nutritional treatment for accelerating Advanced Wound Care.  Dr. Sterba uses bedside blood chemistry testing, skin-fold thickness measurements, and Body Mass Index (BMI) measurements to guide his nutritional recommendations.  Routine wound surface area/volume measurement and photographic documentation of wound healing is done, confidentially sent to patient's doctors using his tested & evaluated, Copyrighted Advanced Wound Care Addendum.   

Specialty-trained and board-certified in Emergency Medicine, Dr. Sterba received additional specialized surgical and medical training and clinical experience.  He expertly diagnoses and personally treats trauma, lacerations, hand injuries, and orthopaedic injuries including fractures, dislocations, sprains/strains and Sports Medicine injuries.  X-Rays (called radiographs) are arranged by Dr. Sterba and are conveniently done at home (Buffalo Ultrasound) or at nearby X-Ray facilities.  X-Rays are immediately read and explained on-site by Dr. Sterba to patients and family members immediately after these digital X-Rays are taken.  Dr. Sterba answers all questions showing these X-Rays on the computer screen seconds after they have been taken.

Customized fiberglass or customized padded-aluminum Orthopaedic splinting is done by Dr. Sterba during Emergency Physician House Callsusing The PORTABLE ER®    Medical/Surgical Kit N (Orthopaedic Kit).  Dr. Sterba personally conducts his accelerated rehabilitation of orthopaedic injuries. When medically necessary, he can personally arrange Orthopaedic Surgery follow-up or set-up Physical Therapy rehabilitation.  Dr. Sterba received additional training and experience in Sports Medicine and Trauma.

In 2015, Saved by Grace Ministry, Inc. was awarded an emergency vehicle grant ($122,060.00) from the Margaret L. Wendt Foundation to purchase the nation's first prototype Emergency Medicine armored emergency vehicle.
 
The PORTABLE ER® is published in a 101-page comprehensive Inventory and is used to maintain the 92 Medical & Surgical Kits and Portable Dispensary Cabinets (PDCs).  It is found in Chapter Ten of the "Textbook of Equipping for Disasters, Sheltering at Home", Fourth Revised Edition, copyrighted 2016" (see www.PhysicianHouseCalls.org under Research and Publications” or see the Kindel eBook, 

Saved by Grace Ministry, Inc. successfully conducted and published T&E using the newest Motorola encrypted, UHF business radios, inside and outside the B6-armored car in a hilly environment, during a simulated catastrophic regional loss of electricity with loss of cell phone transmitting towers. (22.)  
 
Dr. Sterba professionally provides expert Emergency Medicine & Urgent Care Medicine for children and adults in the Greater East Aurora, NY Region on a daily basis Monday - Friday, 9:00 AM – 5:00 PM. (1, 8-22)  

Dr. Sterba's patients, under his current care for the problem he is treating, can reach him 24/7 (evenings and weekends) by our home-office phone, (716) 655-6854 or our Cell Phone, (716) 998-7474.  For details, please see "Can I call Dr. Sterba after hours?" in About Us.

Patients can request a Emergency Physician House Calls with The PORTABLE ER® brought right to them by calling our Office Phone, (716) 655-6854 or our Cell Phone, (716) 998-7474, Monday - Friday, 9:00 AM – 5:00 PM. For details, please see "How convenient are Emergency Physician House Calls with your PORTABLE ER®?" in About Us.

The private medical practice of Dr. John A. Sterba, Saved by Grace Ministry, Inc. was officially started on December 9, 1998. It is fully described and verified on the official New York State Department of Health’s Healthcare Provider Website, http://www.NYDoctorProfile.com, searching under his last name, “Sterba”.   

Dr. Sterba is the founding President & CEO, Medical & Scientific Director, and New York State, Department of Health Laboratory Director of Saved by Grace Ministry, Inc., established in 1998 by Dr. and Mrs. John and Janice Sterba.  Mrs. Janice E. Sterba is the founding Vice President, Secretary/Treasurer and Medical Transcriptionist Editor.  Other Members of the Board of Directors of Saved by Grace Ministry, Inc. include the Director of Comfort & Caring and the Director of Medical Affairs. (See About Us)

Dr. Sterba has been an Emergency Physician ("ER doctor") working in local hospital Emergency Departments (ERs) in Western New York   He has been a paid Clinical Instructor of Emergency Medicine in Western New York for practicing physicians, residents, nurse practitioners, physician assistants, nurses, and paramedics.  

Dr. Sterba is a Principal Investigator ("senior medical scientist") of Institutional Review Board (IRB)-approved clinical research with peer-reviewed publications in the fields of Sports Therapy and Rehabilitation, Emergency Medicine, Urgent Care Medicine and Emergency Physician House Calls using The PORTABLE ER® through Women & Children's Hospital of Buffalo, the University at Buffalo School of Medicine and Saved by Grace Ministry, Inc. (See About Us and Research and Publications).  

*CMS: Centers for Medicare & Medicaid Services
**CLIA: Clinical Laboratory Improvements Ammendments

References
1.  Sterba, JA and JE Sterba.  Chapter 10, The Community-Based Portable Emergency Room, “The Portable ER”, pp. 138-239.  In: Textbook of Equipping for Disasters, Sheltering at Home. Revised & Expanded, Third Edition.  Saved by Grace Ministry, Inc., 226 Center Rd., East Aurora, NY, 2012; 249 pages.  Published by Kindle as an eBook, www.Amazon.com.
2.  Sterba JA. Arctic cold weather medicine and accidental hypothermia.  Navy Experimental Diving Unit (Panama City, FL) Report 2-90.  March, 1990.
3.  Sterba JA.  Chapter 12: Thermal problems, prevention and treatment.  In: Bennett PB, Elliott DA (Eds.). The Physiology and Medicine of Diving, Fourth Edition.  W.B. Saunders Co., Ltd., London, 1993.
4.  Sterba, JA.  Arctic cold weather medicine and accidental hypothermia.  In: Underwater Construction Team (UCT) Arctic Operations Manual, NAVFAC P-992.  Naval Facilities Engineering Command, 200 Stovall St., Alexandria VA , June, 1994.
5.  Sterba, JA. Kamakwie Wesleyan Hospital.  An Assessment of Needs Report, April 24, 2004.  The Center for Sports Therapy Research, Inc., East Aurora, NY, 2004.
6.  Sterba, JA. Mission Guide: Cachón and Barahona Province, Dominican Republic.  Saved by Grace Ministry, Inc., East Aurora, NY, 2006.
7.  Sterba, JA. Mission Guide: Caribbean and Central America.  Saved by Grace Ministry, Inc., East Aurora, NY, 2009.
8.  “Focus: Health. Sterba Provides In-Home Emergency Medical Care”, East Aurora Advertiser, Thursday, June 18, 2009
9.  “Testimonial: Dr. John Sterba Says PennySaver Ad Works”, PennySaver, December 12, 2010
10.  “EA’s Sterba Makes Old-Fashioned House Calls”, East Aurora Bee, Thursday, April 28, 2011
11.  “Physician House Calls Provides Free Labs, at Home & at Work.” PennySaver,
May 1, 2011
12.  “Focus: Health.  Free Point of Care Labs Offered in East Aurora.  Sterba can do Blood Tests Onsite”, East Aurora Advertiser, Thursday, May 19, 2011.
13.  “Dr. Sterba to Talk About Service. Physician House Calls”, The Orchard Park Press, Friday, February 17, 2012.
14.  “Dr. Sterba to Speak at St. John’s Church. Emergency Care and Immediate Urgent Care by Physician House Calls”, PennySaver East Aurora - Elma Sunday, February 19, 2012.
15.  “Dr. Sterba to Speak at St. John’s Church. Emergency Care and Immediate Urgent Care by Physician House Calls”, PennySaver West Seneca, Sunday, February 19, 2012.
16.  “Dr. Sterba to Speak at St. John’s Church. Emergency Care and Immediate Urgent Care by Physician House Calls”, PennySaver Orchard Park, Sunday, February 19, 2012.
17.  “Healthcare Delivery Models Are Changing – A New Model as Practiced by “Dr. John” ”, April 9, 2012, Linda Brodsky, M.D., http://thebrodskyblog.com/?p=2623
18. “Focus: Health.  House Call Services is Growing.  Sterba Offers Care at Home for Local residents”, East Aurora Advertiser, Page 14, Thursday, May 17, 2012
19.  “Focus: Health.  Physician House Calls.  Faster, better and cheaper than your doctor (PA, NP) or Urgent Care or the overcrowded E.R., East Aurora Advertiser, Page 14, Thursday, August 16, 2012.
20.  Sterba, JA. "Wound Care On The Go.  ‘Portable ER’ Allows Physician to Reinvent House Calls". Today’s Wound Clinic. 2012, September: 18-21. 
21. Sterba, JA.  Emergency Physician House Calls™: Time, Outcome Benefits and Cost of Point of Care (POC) Laboratories Used with Community-based PORTABLE ER.  White Paper: Original Research.  Saved by Grace Ministry, Inc., 226 Center Rd., East Aurora, NY 14052, December 11, 2017; 23 pages.
22. Sterba, JA and JE Sterba. Test and Evaluation of Two-Way UHF Business Radios during Emergency Physician House Calls™ Transporting the PORTABLE ER® in a Hilly, Rural Environment. White Paper: Original Research.  Saved by Grace Ministry, Inc., 226 Center Rd., East Aurora, NY 14052, April 18, 2018; 49 pages.

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