Medic on the move

Dr. Helen Marie Schmidt is a lifeline for patients like Chester Knapp.

Knapp, 59, suffers from breathing problems and diabetes stemming from obesity. The last time he tried to leave the house for a doctor’s appointment – over the summer – he lost his footing and fell.

So Schmidt, hearkening back to one of health care’s oldest traditions, drives to Knapp’s bedside in his Spokane Valley apartment.

Schmidt, who spent 34 years as a surgical missionary in Cameroon, is the sole doctor for Spokane’s Mobile Medical Clinic. The clinic also employs three nurse practitioners who, along with Schmidt, have cared for some 900 patients since the mobile clinic began just under two years ago. The clinic has about 600 active patients at any given time, with about 15 new referrals each week.

Unlike visiting nurses or other home-health agencies, who must be requested at a patient’s home by another doctor, Schmidt serves as a primary-care physician for all of the people she sees. She is believed to be the only family doctor making house calls in this area. Dr. Susan Ashley, a family practice doctor who made home visits in the Spokane Valley last year, took some time off but plans to revive the business in early 2006, she says.

Although Schmidt is the lone M.D. traveling to patients’ homes, many other area medical services will take their practice on the road to help homebound people.

For years, Spokane podiatrist Dr. Borys Markewych has done about 10 percent of his work out of the office, largely attending to the foot-care needs of people with diabetes.

“It’s very important to make sure they don’t end up losing their limbs,” Markewych says.

Spokane’s Evergreen Ultrasound is an all-mobile business that sees patients in private homes as well as at long-term care facilities.

“The demand is just increasing now that there’s the awareness that we’re out there and we’re willing to go to the bedside,” says Diana Stevens, co-owner of the business.

And Mobile Medical Diagnostics of Spokane has four vans loaded with x-ray and EKG equipment to bring medical tests to patients in nursing homes, retirement centers and private homes as well, says technologist Rudy Kuki.

Medicare, Medicaid and many private insurers will pay for home medical services.

Many of the patients seen by the Mobile Medical Clinic are elderly, but others have trouble leaving their homes for other reasons – disability, mental illness, lack of transportation, poverty.

“It’s just growing in leaps and bounds,” says Tawny Miles, the clinic’s director and co-owner. “The need is tremendous.”

Schmidt, 70, returned to Spokane from Africa in 2003.

“I didn’t know where I would fit coming home,” she says. “I retired into here … It’s been a wonderful transition from the kind of work I was doing here.”

Schmidt sees about a half-dozen patients a day, she says. She spends much longer with each one than during a typical office visit.

“I talk to them a lot,” she says. “A lot of these people are really lonely.”

She checks vital signs and does physical exams. She also, as she did one recent morning, is called on to pronounce a death before the coroner arrives.

On the same morning, she spent some time with Knapp, checking his blood pressure and oxygen level. She asked about his blood sugar and whether he was having any pain.

“How’s your mom?” she asked, patting him on the leg.

“She’s a good doctor,” Knapp says, his voice muffled by the tracheotomy tube snaking from his throat. “She knows what she’s doing.”