SEMINAR

Practicing Medicine by Physician House Calls 
Basic Seminar plus Hands-On Advanced Skills Seminars
Revision Date: July 19, 2023

Hello Providers (Physicians, Nurse Practitioners and Physician Assistants),

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We are pleased to offer all of you our Basic Seminar, Practicing Medicine by Physician House Calls.  This Basic Seminar has been very well received.  It has steadily been updated including suggestions resulting in its current updated 16th Revision (© 2023).  

The Basic Seminar is confidentially taught often at night in the privacy of provider's homes, or in their offices.  During SARS-CoV-2, it was conveniently taught only by the Take-Home Version PowerPoint thumb drive mailed out with all the Seminar’s referenced handouts.  Now, it is again taught in-person, or by the Take-Home Version.

Providers are fully-equipped to “care for those in greater need", at-home.  They report back to me being grateful to return to the “old-fashioned days with the joy of practicing medicine.”  Providers learn how to accurately code and bill, and how to successfully chase-down hard-earned income.  I teach how to reduce overhead costs, reduce medical malpractice risk and premiums, and reduce many other costs (e.g., how I purchase either at near-wholesale or get free medical, surgical, and pharmaceutical supplies paying only S&H).

After their Basic Seminar, I teach the hands-on Advanced Skills Seminar detailed below (e.g., phlebotomy, IV’s, Point of Care (POC) labs, and advanced medical and surgical wound care procedures done at-home with very high insurance reimbursement).

Rest assured; I am not recruiting or hiring.  So, why am I teaching others?  As a condition of receiving a 2015 equipment grant (The Margaret L. Wendt Foundation of Buffalo, NY), I was wisely encouraged to share what we have learned in order to help others start-up or improve their own Physician House Calls.

This began in 2015 with University at Buffalo medical students who were most enthusiastic.  

To date, I have trained medical students, nurses, physicians, nurse practitioners (NPs), and Physician Assistants (PAs) from Western New York State (WNY), out-of-state, Canada, and NASA.  

The Basic and Advanced Seminars are Real World based on my out-of-hospital acute and urgent care of over 10,000 emergency patients treated in my solo private practice of Physician House Calls.  This included 150 emergency patients overseas (US Navy, Greenland and North Pole region, 1989), 4,300+ emergency patients on overseas missionary trips (Sierra Leone, Honduras, Dominican Republic, 2004-2008) and 6,000 emergency, urgent care, and advanced wound care patients in WNY from insurance credentialing with very high reimbursements. (2009-present).

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For details, please see www.PhysicianHouseCalls.org, under the Tab, “History of the Portable ER.”  Our Physician House Calls (Emergency Physician House Calls™) use America’s first community-based and Federally-Registered PORTABLE ER®.

Basic Seminar Outline

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If interested in the Basic Seminar Outline, I am happy to Email it to you.  Please contact me at PhysicianHouseCalls@roadrunner.com .  

Basic Seminar PowerPoint Full Notes, Handouts and Textbook

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After the Basic Seminar’s tax-deductible donation is received by Saved by Grace Ministry, Inc., (see below), the 22-page, highly-referenced Seminar’s Full Notes covering everything in the 179-slide PowerPoint Presentation, plus all handouts (detailed below) and the Textbook are promptly mailed out.

The Textbook is the Fifth Revised Edition © 2020, “Textbook of Equipping for Disasters.”  It has the 101-page Chapter Ten, the full inventory of “The Community-Based Portable ER” plus other key Chapters in: 
Sterba, JA and JE Sterba.  Textbook of Equipping for Disasters, Sheltering at Home.  Revised & Expanded, Fifth Edition.  Saved by Grace Ministry, Inc., 226 Center Rd., East Aurora, NY 14052, March 27, 2020; 250 pages.

In the Basic Seminar, the current literature, accelerating national trends and local research on Physician House Calls in (Western New York (WNY) are reviewed and discussed.  Physician House Calls are published to be “faster, better, and cheaper” than hospital-based emergency departments (ED).  Well known by the public and replicated in peer-reviewed medical literature, hospital EDs are becoming too expensive, under-staffed, over-crowded, most-stressful with provider burn-out, and are research-confirmed to be the major source of nosocomial (hospital) infectious diseases.   Physician House Calls helps patients, family members, care-givers and providers to avoid all these accelerating hospital-based problems. 

Physician House Calls: Medical & Surgical Wound Care Done At-Home 

Our first prospective Institutional Review Board (IRB)-approved clinical research study documented that in 45 patients treated by Physician House Calls in WNY, all of whom required advanced wound care (e.g., pressure injury surgical debridement, closure, and medical care), nine-out-of-ten (91%) of these 45 patients never needed to go to the hospital ED.  All 45 Physician House Calls were cared for at-home at only 25% of the average patient-care allowable insurance-charge of the hospital ED.  

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In this study, I first had to appeal Corporate Medical Directors of National Government Services (NGS), administrators of Medicare Part B.  They reviewed our patient’s charts and preliminary research results in this novel research study investigating surgical advanced wound care provided at-home on Physician House Calls.  The NGS favorably ruled on my behalf adding over 300 highly-reimbursed Integumentary billable precure codes for physician reimbursement when done at-home for all U.S. practicing physicians conducting Physician House Calls (e.g., Current Procedural Terminology-CPT Codes including surgical advanced wound care) .  

In this 2011-2012 wound care study, patient-care, allowable insurance-reimbursement for surgical advanced wound care (e.g., pressure injury/ulcer debridement, other surgical care) plus other necessary medical care was a reimbursement range of $600-$800 per Physician House Call.  These payments were dependent on depth, surface area and severity of the pressure injuries/ulcers being debrided, plus all other surgical and medical care requiring extra direct (face-to-face) patient contact beyond the usual Evaluation & Management (E&M) service of just the medical Physician House Call (CPTs 99341-99350).  

Physician House Calls: Medical Care (Non-Surgical) Done At-Home 

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In our follow-up IRB-approved clinical research study sponsored in-part by the Margaret L. Wendt Foundation of Buffalo, NY, we prospectively investigated 100 successive patients who medically required Point of Care (POC) Labs immediately done and interpreted real-time, at-home.  

In this study, as in our wound care study, nine-out-of-ten (89%) of these 100 patients treated on medical Physician House Calls safely stayed at-home never needing to go to the ED, or ever needing to be admitted over the next three days as confirmed by close follow-up. 

There were no adverse events or complaints. Everyone was happy and encouraged from patients, family members, and care-givers to patients’ 22 Primary Care Physicians/Providers (PCPs), their medical/surgical specialists and Emergency Medicine emergency physicians working at regional hospital ED’s and Urgent Care Centers in Western New York State (WNY).  
 

In this medical study, we documented that in 100 patients who medically required immediate POC labs with bedside explanation at-home, the average patient-care allowable insurance-charge was $375.53 per patient. These 100 medical Physician House Calls were done at 1/10th (9.8%) of the patient-care allowable insurance-charge vs. the hospital ED using nationally-reported ED statewide statistics ($3,808/single ED visit, FL, 2012).

Physician House Calls: Provider Burn Out

Physicians and mid-level healthcare providers are burning out. This is well-known by the public and has been a key complaint in private medical practices of Primary Care (Family Medicine, Internal Medicine, Pediatrics and OB/GYN), medical and surgical specialties, and particularly in Emergency Medicine in today’s high-stress, fast-paced hospital EDs and Urgent Care Centers.  

It is my professional opinion from my clinical training and experience (not published) that this Basic Seminar, Practicing Medicine by Physician House Calls will help to treat and prevent provider burn-out.

Plus, the actual practice of medicine by Physician House Calls should allow more people to experience the joy of practicing medicine every day.  

For example, you can conduct your own Physician House Calls conveniently on your own time.  You can also leave the busy clinic a little early and see someone in greater need, at-home, and still make it home for supper, on-time, adding hundreds of extra dollars into your private medical practice.  

Patients are so very grateful knowing that a someone has taken time to come, listen and medically care for them suffering at-home.  You can aim to likewise try and keep nine-out-ten of your patients from needing to be sent to the ED. Patients dread the ED waiting room, which has had a reported very long wait-time in NY State of 6.1-hr., before being medically treated (not just RN triaged) by a provider.  

Cost, Basic Seminar, Practicing Medicine by Physician House Calls

Basic Seminar at-home or in-office is usually scheduled in the evenings (6:30 pm - 8:00 pm) or whenever the time is convenient for everyone.  The Basic Seminar at-home or in-office suggested tax-deductible, receipted donation is $260.00 per each physician, NP, PA, or staff member (minimum 3) payable to “Saved by Grace Ministry, Inc.”, by mailed check or using the donate button (credit/debit card, PayPal) at www.PhysicianHouseCalls.org.  

This $260.00 donation, which supports the Ministry, includes each person receiving the required reference “Textbook of Equipping for Disasters”, plus each person gets their full copy of all handouts, listed here:
1.    Seminar Notes with References (22-pages), so no need to take notes as I go through all 179-PowerPoint slides.
2.    VistaPrint Brochures and Business Cards for both our Medical and our Surgical Wound Care Physician House Calls as your guide.  They all work very well.
3.    Research Article: Sterba, JA. Wound Care on the Go. ‘Portable ER’ Allows Physician to Reinvent House Calls. Today’s Wound Clinic.2012,September:18-21
4.    “Medical/Surgical Basic Kit G Inventory” to get you started for your first Physician House Call immediately with your own medical/surgical basic stock supplies
5.    “Common Procedure Codes (CPTs) and Medical Insurances on Surgical and Medical Physician House Calls.”  
6.    “Coding by Procedures (CPTs).  Suggested CPTs (Highlighted in Yellow) for Physician House Calls Depending on Training and Clinical Experience” in an easy-to-modify, 43-page Spread Sheet in Microsoft Word emailed to you to be easily updated by you with your own current Fee Schedule and any CPT and current Modifier changes.
7.    “Insurance Reimbursement for Medical and Surgical Physician House Calls: Coders & Biller, Choose Wisely,”
8.    “Billing Extra Time CPT Codes on Physician House Calls,”
9.    “Advanced Skills Training Seminar Outline.”
 
Cost, Basic Seminar Take-Home Version 

The Basic Seminar Take-Home Version suggested tax-deductible, receipted donation is $260.00 per each physician, NP, PA, or staff member (no three person minimum) payable to “Saved by Grace Ministry, Inc.”, by mailed check or using the donate button (credit/debit card or PayPal) below and on the "Home" page of www.PhysicianHouseCalls.org.

This $260.00 donation, which supports the Ministry, includes each person receiving the required reference “Textbook of Equipping for Disasters” plus each person gets their full copy of everything, listed here:
1.    PowerPoint thumb drive of 179 PowerPoint slides mailed out (16th Revised Edition © 2023),
2.    Seminar' Notes with References (22-pages), to add your own notes,
3.    VistaPrint Brochures and Business Cards for both our Medical and our Surgical Wound Care Physician House Calls as your guide.  They all work very well.
4.    Research Article: Sterba, JA. Wound Care on the Go. ‘Portable ER’ Allows Physician to Reinvent House Calls.  Today’s Wound Clinic. 2012, September: 18-21.
5.    Medical/Surgical Basic Kit G Inventory to get you started for your first Physician House Call immediately with your own medical/surgical basic supplies,
6.    “Common Procedure Codes (CPTs) and Medical Insurances on Surgical and Medical Physician House Calls,”  
7.    “Coding by Procedures (CPTs).  Suggested CPTs (Highlighted in Yellow) For Physician House Calls Depending on Training and Clinical Experience” in an easy-to-modify, 43-page Spread Sheet in Microsoft Word emailed to you easily updated by you with your own current Fee Schedule and any CPT and current Modifier changes.
8.    “Insurance Reimbursement for Medical and Surgical Physician House Calls: Coders & Biller, Choose Wisely,”
9.    “Billing Extra Time CPT Codes on Physician House Calls,”
10.    “Advanced Skills Training Seminar Outline.”

Hands-on Advanced Skills Training Seminar

Since the SARS-CoV-2 (COVID-19) emergency is reported to be over, for all those providers that took or will take the Basic Seminar, whether in-person with me or the Take Home Version, I am grateful to announce that I am again teaching, in-person, the hands-on, follow-up Advanced Skills Training Seminar.  

It is fast-paced, lasting about two-plus hours.  Supplies and handouts provided by me include hands-on training in phlebotomy, IV/IO (chicken/turkey legs), POC Labs and RDT supplies, Personal Protective Equipment-PPE (gloves, goggles, masks, COVID-19 methods), the seven-page highly-referenced Advanced Skills Training Notes, four-page highly-referenced Health Insurance Information Sheets, six-page Surgical Kit H5 Inventory, and other practical handouts.  

Cost, Hands-on Advanced Skills Training Seminar

The Hands-on Advanced Skills Training Seminar suggested tax-deductible, receipted donation is $300.00 per each physician, NP, PA, or staff member (minimum 3 people) payable to “Saved by Grace Ministry, Inc.”, by mailed check or using the donate button (credit/debit card, PayPal) found below or on the "Home" page of www.PhysicianHouseCalls.org.  

Advanced Skills Training Seminar includes the following: 

1.    Phlebotomy setting up all bedside supplies and methods; 
2.    Bedside Blood Testing using our BMP, CMP disks and actual blood in our portable Point of Care (POC) Abaxis Piccolo Xpress Blood Chemistry Laboratory, or learning how to drop off patient’s vacutainers to local Labs; 
3.    Intravenous/Intraosseous (IV/IO) Fluid Therapy Lab, Tricks-of-the-Trade; 
4.    Rapid Diagnostic Testing (RDTs) using our (expired) common RDT's; 
5.    Clinical Laboratory Improvement Amendments of 1988 (CLIA) and CLIA-Waived Tests.  
6.    How to Apply to New York State (NYS) Department of Health (DOH) for Limited Services Laboratory Registration and Certificate of Qualification to be authorized to run your own POC Laboratory or conduct bedside RDTs; 
7.    Using the Hand-Carried Advanced Surgical & Medical Wound Care Kits.  You will tear-down and inventory our hand-carried surgical advanced wound care Kits for pressure injuries (‘bed-sores’), lacerations, and burns with basic surgical advanced wound care (AWC) methods, charting, coding and billing.  
8.    Advanced Wound Care.  You will review wound photographs, comprehensive documentation and CMS-required charting, coding and billing using an actual patient’s chart (with permission) with name, address, member I.D., etc. redacted.
9.    Actual Charting of a Typical Patient.  Includes common CPT procedures done.
10.    Quality Assurance (QA) CMS Audit Tool.  Checking off all your work actually done (history, physical exam and other categories, and start-stop times) to honestly determine the appropriate, justifiable Physician House Call procedure code using the Common Procedural Terminology Code (CPT Code) with the current insurance fees. 
11.    Coding Books for All Procedures (CPTs) and Diagnoses (ICD-10). Using the Optum CPT and ICD-10 two spiral-bound coding books, which are excellent (very intuitive, easy-to-use and most helpful). 
12.    Populating an Actual CMS-1500 Pink Medical Insurance Claim Form. Hands-on practice using the templated, computerized system (~$99) downloaded on our computer, populated for printing-off CMS-1500 pink medical insurance claim form (CMS-1500 Form) for a typical medical or advanced wound care patient for an insurance reimbursement check to be mailed to you or to your bank.  
13.    Health Insurances:  Key contacts and phone numbers are provided.  How to transfer or get new insurance credentials, get fee schedules, PaySpan, etc.
14.    Western New York HealtheLink, HealtheCommunity Portal and WNYHealtheNet:  On-line to check patient eligibility and when you’ll be paid.
15.    National Provider Identifier (NPI): How to get your NPI & Tax I.D. #’s faster.
16.    Contracting with a Group Purchasing Organization (GPO): Reduced prices.
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17.    National Distributor:   On-line GPO ordering with next-day delivery to you.
18.    e-Prescribing Waiver (NYS Health Commerce System-HCS): Forms needed.

We gratefully Email or U.S. Mail everyone’s tax-deductible donation receipt with our Thank You Note for your tax purposes.  

Saved by Grace Ministry, Inc. is a Public Charity founded in 1998.  

Please know that 100% of all donations and all medical insurance money go to our Public Charity’s mission, “caring for those in greater need”, and not for any salary.

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It would be my honor to speak with you to help you.  

My office is 655-6854, (9:00 A.M. – 5:00 P.M., Monday – Friday) and my cell is (716) 998-7474.

Sincerely,
'Dr. John'

John A. Sterba, M.D., Ph.D., FACEP, FACCWS

President & CEO; Medical & Scientific Director; NYS DOH Clinical Laboratory Director, 
             Saved by Grace Ministry, Inc.  Emergency Physician House Calls™ using the PORTABLE ER®
Board-Certifications: American Board of Emergency Medicine (ABEM), American Board of Wound Medicine 
      and Surgery (ABWMS), American Board of Urgent Care Medicine (ABUCM)
Fellow, American College of Emergency Physician (FACEP); Fellow, American College Clinical Wound 
      Specialists (FACCWS)
Member, American College of Emergency Physicians (ACEP), American College of Clinical Wound Specialists
      (ACCWS), American Academy of Family Physicians (AAFP), American Academy of Urgent Care Medicine
      (AAUCM) 
Commander, Medical Corps, U.S. Navy-Reserves (Hon Disch), Undersea & Arctic Warfare, Operational Medicine