SAN FRANCISCO (KCBS) - An innovative care model for adults with disabilities is being pioneered by UCSF to deliver primary and follow-up care in the home, rather than requiring them to come into the clinic.
Dr. Clarissa Kripke, a family medicine doctor and professor of family and community medicine at UCSF School of Medicine, told KCBS Radio's Bret Burkhart on this week's "As Prescribed" that it's about bringing joy and independence to those living and coping with disabilities.
"The goal of health care isn't just to be free of disease. It's to live in the community, to participate fully, and to have a full life with friends, civic participation, work if that's for you, and to do the things that you want to do, to go the places you want to go," Dr. Kripke said. "So successful community living is a lot more than just being free of disease, and our health care system has to support that."
Part of breaking the health care mold includes bringing care directly to the patient. Dr. Kripke cares for 100 patients at approximately 25 group homes in the Bay Area, and this model has improved their care, wellbeing and quality of life.
"I come to them instead of having them come to me, because coming to a doctor's office is hard. Being a patient is hard," she said. "We try to make things easier for people and their caregivers by being responsive, by having a small patient panel. My patients and their caregivers have my cell phone, and then I go to them when they need care. And on a regular basis, I go and provide care in their home so that they are not spending all of their time thinking about their medical care, but can spend their time doing the things that they want to do."
Many of Dr. Kripke's patients have complicated disabilities, usually requiring skilled nursing needs -- some have catheters, some need oxygen, some may be on a ventilator, some use wheelchairs, and some are fed through gastrostomy tubes.
"So when I say it's difficult to get around, I mean there's a lot of medical complexity and logistical complexity to doing even simple things," she said.
Dr. Kripke didn't set out with intentions to develop a specialty practice in caring for people with disabilities. But when her patients who have disabilities said the traditional model of care wasn't working for them, she knew she needed to do something.
"I said, yes, I can see that these appointments in this small exam room where you can't bring your whole support team and where the appointment times are too short and where we don't have the right equipment is not working. Why don't I just come to you instead of having you come to me, and I'll learn something about the community, I'll learn something about the priorities of the people I'm serving, and I'll get to know the nurses who are serving you, and I'll get to know the caregivers who are serving you, and I'll get to know you, and then we'll figure out how to do this better," Dr. Kripke explained.
It's not just easier on them, but Kripke said this approach can actually lead to physical improvements for patients.
"When people truly have a home, people who love them, people who care about them, they have a life, they also have a will to live. And when my patients get hospitalized, it's not uncommon for the people in the hospital to assume that they're at the end of life and that they need hospice care," she said. "And yet, when they come home, they recover dramatically. They perhaps weren't able to eat by the time they were done with their hospitalization, but when they get home with the people who know them and in a comfortable environment, they get stronger, and they recover to their previous baseline."
"My patients do have complicated medical conditions that are serious and life-threatening, but when you have good care, you thrive," Dr. Kripke added.
Listen to this week's "As Prescribed" to learn more. You can also listen to last week's episode to learn what's behind the surprising surge of fatty liver disease in children, here .
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"As Prescribed" is sponsored by UCSF.
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