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This doctor is always in the house

House calls are a way of practice for one Illinois physician.

By Damon Adams, amednews staff. Sept. 16, 2002.

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Community Spirit
An occasional series exploring how physicians take extra steps to ensure the well-being of those in need. Contribute

Robert Patten stares at a wall, his face sunken. Sitting across from him with a laptop balanced on his legs, Thomas Cornwell, MD, recalls the video he saw of Patten as an Elvis impersonator, gyrating hips and all. It's hard to believe the lively person on the video is the same depressed man staring into nowhere, he tells Patten. "Come on, give me a smile."

Patten, 47, has a neurodegenerative disorder that keeps him homebound. It's more practical for Dr. Cornwell to come to Patten's Illinois apartment to review his medications, draw blood and check his condition.

Across the western suburbs of Chicago, Dr. Cornwell's practice goes curbside to bedside.

The office is the backseat of a green Ford Explorer. The file cabinet is a plastic milk crate stuffed with folders.

As medical director of HomeCare Physicians in Carol Stream, Ill., Dr. Cornwell makes house calls full-time. Since starting in October 1993, the family physician has made more than 12,700 house calls to about 2,000 home-bound patients.

He prefers it.

"You're dealing with a very sick population, and that is very challenging," said the fast-talking, energetic doctor with baby blue eyes that match his medical coat. "It's those challenges that make it so rewarding. You really get to know patients, and you can really help them through a difficult time."

For his work, Dr. Cornwell, 42, was recognized in March by the AMA with a 2002 Pride in the Profession award. In 1998, he was named House Call Doctor of the Year by the American Academy of Home Care Physicians.

His patients give him high praise. "If I didn't have him come here, I wouldn't be here," said Pat Rocco, who has been seeing Dr. Cornwell since 1997.

On a recent morning, Dr. Cornwell brought special pumps to help get circulation to her legs. Rocco, who has chronic lymphedema, is in bed, photos of her family attached to its frame so she can see them.

Rocco's blood pressure is good, and she seems in good spirits. But she was not always this way. "Before you," she tells Dr. Cornwell, "I was in the hospital constantly."

House calls help many homebound patients avoid hospitalizations. Ambulance trips and emergency department visits also are reduced, Dr. Cornwell said. Elderly patients are kept out of nursing homes.

"I've always been drawn to the disenfranchised. They just can't get to health care," said Dr. Cornwell, a father of two who earned his medical degree from the University of Illinois at Chicago.

Dr. Cornwell got into house calls when a colleague launched a program in Chicago in 1993. But in two years, the effort struggled financially.

Dr. Cornwell went to a former employer, Central DuPage Health, and proposed starting a new house call program. Central DuPage Health backed the idea, and HomeCare Physicians was started in 1997 with Dr. Cornwell as its medical director.

The service has had money problems, losing $250,000 last year, Dr. Cornwell said. But donations totaling $600,000 are helping ease the burden.

Today, Dr. Cornwell, two other doctors, a nurse practitioner and a medical assistant form the core of HomeCare Physicians. They serve DuPage County, west of Chicago, and travel to about 800 patients in vehicles with "Medical Care at Your Door" emblazoned on the windows.

"The worst that happens to people is what we take care of. We go into these horrible situations and make them better," Dr. Cornwell said.

Dr. Cornwell sits in the backseat as his medical assistant drives. He may call patients via cell phone before his arrival. The service has the technology to do electrocardiograms and ultrasounds in patients' homes.

On a normal day, Dr. Cornwell sees about nine or 10 patients. But the demand is likely to swell as the nation's elderly population expands and stretches the home health care system, he said.

Patients such as Mary Gutierrez are grateful to see Dr. Cornwell at their door. "I'd have a very hard time getting to see the doctor," she said.

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