Affinity Senior Care CEO Chris Zayid in conversation with community visiting physician Dr. Faris Atchoo.

Benefits of a Visiting Physician with Dr. Faris Atchoo | Connecting the Community

In this episode of Connecting the Community with Chris, Affinity CEO, Chris Zayid speaks with Community Visiting Physician Dr. Faris Atchoo.

  • What is the role of a visiting physician?
  • What are the typical problems that a visiting physician attends to?
  • Treatment and the role of insurance
  • Advantages of having a visiting physician versus going to the primary care doctor
  • Taking a holistic approach to an individual’s care plan
  • A walk through of a typical visit from a visiting physician
  • And special health recommendations from Dr. Atchoo to people over the age of 60.

Watch the full podcast or read the transcript below (edited for clarity).

Chris: Welcome to our show Connecting the Community with Chris. We have a special guest for you today – Dr. Faris Atchoo.

Dr. Atchoo is an internal medicine physician who has been in practice for over 30 years. After graduating from the College of Osteopathic Medicine of Michigan State University, Dr. Atchoo practiced medicine in Mount Pleasant and in 2014 he relocated his family to the Metro Detroit area and took over the practice that his parents established for over 40 years before.

Now, in addition to seeing his patients in practice, Dr. Atchoo also sees patients in their homes.

So, welcome to our show.

Dr. Atchoo: Thank you very much. Great to be here.

Chris: I’m honored. We have lots of history together and you and your family. We are so happy to hear your story that you share it with us today.

I’d like everybody to get to know you and your background and your role in the community.

So, tell me, what was your purpose and your story? Why did you want to become a doctor?

Dr. Atchoo: I had a whole lot of exposure. Both parents are doctors. My mother is a retired gynaecologist, my father was an ophthalmologist, an eye doctor. So, I grew up in medicine and I always kind of assumed I’d be going into it. And then as I got older it became more of a drive, a passion, and I’m in the right field for me.

I like what I do. I like helping people get better. I like trying to keep people from getting worse. Unfortunately, that’s what a lot of internal medicine is trying to do.

I try to advise patients on what’s going to be the best way for them to take care of themselves. I work with what they can do, what they’re willing to do.

I like doing a variety of things. I was on staff at McLaren Oakland hospital. So, I was doing inpatient and outpatient work, which is a rarity in this time, most doctors will either do one or the other. I just gave up the hospital work this year. I turned 60, I have a young family, and the lifestyle just didn’t work out to let me keep doing that.

So, I see patients in the office that my parents had.

Chris: Of over 40 years in practice I believe, in the city of Waterford?

Dr. Atchoo: In the city of Waterford. They bought the building that they were in, in the late 70s, and then I moved into it when I relocated back to this area.

I see patients in there and I’m a visiting physician, so I’m on the road four days a week.

Chris: Let’s dive into that. So, you have this name and this reputation of your family for many years in the community. So, taking over the practice was a big role to fill. And I think that’s really amazing. But you also made a differentiator in the community. You became a visiting physician on top of seeing your patients, which I respect.

Since I was nine years old, I’ve seen my dad visit homes outside of his practice, and it was something that I always saw when I was a young kid, what was going on in the home setting versus what goes on in the hospital setting or just going to the doctors. It’s different.

 I respect what you do, because obviously it’s something that is imperative and I think it’s necessary, but I don’t think the public knows that the resource is truly out there and how valuable it is.

I like you to explain to everybody what is the role of a visiting physician?

Dr. Atchoo: A visiting physician is going to oversee the care of patients in their own home, in their own environment, because they have trouble getting out of the house – whether it’s mobility issues, whether it’s mental issues, sometimes even transportation issues.

You’re limited on how much you can do in the home compared to say a hospital where you’ve got all kinds of options, tests, procedures available. But the object is to try to keep the patients in their home as long as possible, try to give them the best quality of life that they can get, they can achieve.

Sometimes you can bring in outside services – Physical Therapy, Occupational Therapy, Speech Therapy, Nursing, Personal Caregivers, you can order Social Work evaluations to make sure that the patient’s needs can be met in their home or in their current environment.

Chris: Medical supplies. Now there’s MRI companies and phlebotomist companies coming in and taking blood and urine, giving you the results at your house.

Dr. Atchoo: I have a company that comes out and does radiologic studies, ultrasounds, x-rays, EKGs, Holter monitors.

So, more and more options are coming online to meet patients needs in their homes.

Chris: What are the typical problems that you are seeing or that you’ve faced in the homes?

Dr. Atchoo: The most common problems you see are blood pressure problems, diabetes, COPD, heart problems like congestive heart failure. Many patients have problems with strokes, dementia, diminished capacity and for various reasons, Parkinson’s, MS. Patients can be bed bound where they can’t get themselves out of bed and in those people, you have to be especially aware of bed sores and continence problems.

Chris: Yeah, bariatric clients do, who are overweight. Obesity is a huge Factor too.

Dr. Atchoo: Yeah, it can be challenging to get professional wound care out to patients. They are available but they’re very much in demand. So, if they’re established with somebody it makes it a lot easier. I’ll manage as many of the bed sores myself as I can, but sometimes I need help.

Chris: Yeah, depending on what stage it’s in. I know that coming from the Home Care world, that there’s a cost factor. With insurance is that family members have to make a decision depending on what’s ordered, some products are very expensive, and so, it depends on if they can actually afford that. That is kind of one of those gray areas in healthcare where if you have a wound, but you can’t treat it the right way, because you can’t afford to actually purchase the product, because your insurance won’t cover it.

Do you see that?

Dr. Atchoo: Oh yeah, and Medicare has put some rules in place that can be obstacles, that require a lot of documentation. And then the durable medical equipment company where you get the wound supplies, will have forms that you have to fill out, and if you don’t fill them out exactly the way they want, you do it over and over again. But they have to do it that way, so they make sure they get paid for what they supply.

Chris: Yeah, or the liability to make sure that. It’s a necessity too as well.

What advantages are there having a visiting physician, someone coming into your home? If you had to say top reasons, why would you have a visiting physician versus going to the primary care doctor?

Dr. Atchoo: A visiting physician is going to be able to pick up on changes faster than a routine every three month, every six-month visit. There’s continuity. Unless the doctor and the patient understand each other to track any problems while they’re still small.

Chris: So, doctor can talk to another doctor? So, it doesn’t replace the primary care doctor?

Dr. Atchoo: It’s a supplement.

Chris: This means that you can have a visiting physician talk to your primary care doctor, and your primary care doctor does not come to the home, so that’s an advantage to me. I think that’s a misconception where some primary care physicians think that it’s a replacement and they’re never going to see them again, and that’s not true.

Dr. Atchoo: It’s the patient’s choice. Medicare has shown that visiting physicians do save money. They decrease the hospitalization rate. One saved hospitalization can pay the doctor’s cost for years.

Chris: Absolutely. The average what they say every time someone has to re-admit, it’s between ten thousand and up per person if they come in within 30 days, whether it’s CHF, COPD, diabetes. And that’s huge.

So, that’s what our goal is as care providers in the home, to keep our parents safe at home but also not re-admit them, keep going back in the hospital too.

Does seeing a physician in the home environment allow you to take in a holistic approach when tailoring an individual’s care plan for the family?

Dr. Atchoo: Sure. You get to see their actual environment, how much they can do. When you see them in the office, sometimes they are putting on an extra effort. In the home you see more of what it’s really like. Sometimes you look in the refrigerator, you know how much food they have, are they actually eating. You see their medicines, are they really taking them?

Chris: Or are they hoarding in their home? Are their medications all over the place?

Dr. Atchoo: Yeah. Sometimes you will go into a house, and you’ll see 50 bottles of pills, stuff that’s years old.

Chris: Yeah, I’ve seen from 1990s and before sitting on the counter. A lot of family members say, “my mom and dad are not listening to me, they do not let me touch their medications.” Then the care provider comes in and they’re okay with it. Third party validation, right?

Can you describe now to everybody – they call Dr. Atchoo, and you schedule an appointment, right? Let’s walk through for everyone what’s a typical visit when you come in.

Dr. Atchoo: My wife works with me. She schedules all the patients, she calls them. She can speak English, Arabic, and Chaldean. A big part of our clientele is Arabic speaking patients.

I will go to the home. I bring a bag with me. I carry a blood pressure cuff, thermometer, pulse oximeter, I have an otoscope, a thermoscope. I carry various things for injections if needed.

I’ll go in, introduce myself. I will take a history; I will get a as good a list of their medications as I can. I check their allergies. I find out if they smoke or used to smoke. If they drink alcohol. It is one of those hidden problems. It’s not as obvious as smoking.

I’ll examine the patient. I will try to figure out what their main problems are. I will try to assess how many of those problems are remediable and how much I can improve them, what I could do to try to improve them and try to get that set up. Sometimes it’s a matter of adjusting their medications. It can be up or down. Sometimes it’s a matter of ordering more testing for them.

A smoker that has had a cough for two or three months that won’t quit, needs at least a chest x-ray. Somebody getting pain in their chest when they walk around should at least get an EKG and might need something more. But that’s a starting point.

Chris: What if requiring a blood draw?

Dr. Atchoo: We have a lab that will come out to the house and draw blood. The results come to me. Sometimes patients are more mobile and friends or family or even caregivers can take them to a local place, typically a hospital, where they can get their labs done.

For them it might be a treat to get out of the house, for others it can be a burden.

Chris: That leads into my next question. How often should someone over the age of 60 visit their primary care doctor?

Dr. Atchoo: It’s going to depend on how many problems they’re dealing with. Somebody that is healthy and has no blood pressure, cholesterol, sugar issues, no breathing problems, no heart problems, once a year is a good frequency. There are other people who have all of those problems and more that might need to see their doctor once a month. It’s going to depend on how many problems you’re dealing with, how much they change, how much management, how much fine-tuning they need.

Chris: As a visiting physician are you able to refer to a Geriatric Specialist when you are in the home?

Dr. Atchoo: I can, but if somebody’s homebound it’s going to be very difficult for them to get out to see the geriatrician and sometimes, they can be hard to find too. There’s a big need for them.

Chris: Are you considered a geriatric physician?

Dr. Atchoo: No. But every internist or internal medicine doctor deals with geriatrics.

Chris: In essence though, you could still care for the geriatric community, right?

Dr. Atchoo: Yes. I’ll manage 95 percent of geriatric problems easily or routinely.

Chris: Now, the conditions that you’re seeing in the homes, let’s zero in on that. Special health considerations for people for over 60 – what would you recommend for that? Any special health considerations for our aging population?

Dr. Atchoo: Two big things are diet and exercise. If people eat better, they feel better, they do better. If they exercise, they feel better, they do better. They just had a study that showed that exercise is more effective for treating depression than medication is.

Exercise reduces the cortisol or stress hormone levels and increases the endorphins, and it costs a lot less than medications.

 I send people to walk in the big box stores all the time for exercise. I tell them to leave their wallet or purse behind so they don’t have any shopping distractions and they can walk for 30, 40, 60 minutes, it’s protected, it’s free, and in this area there’s a big box store no more than a couple of miles from anybody.

And the weather is on the upswing so over the next month or so we’re going to see a big improvement.

Chris: What is your favorite aspect of your practice? What is it that makes you jump out of bed?

Dr. Atchoo: I enjoy doing manipulation and adjustments on people. I also got trained on doing injection therapies called Prolotherapy that help injured ligaments and tendons to heal. No cortisone involved, although there is a place for cortisone, but this is going to help things like rotator cuff tears, or bad knees, or ankles and feet.

Surgery isn’t the answer for a lot of these problems. Physical Therapy can only take you so far. This is another step up.

Chris: I have a family member who has rotator cuff issues, but they’re at a certain age where they could be a risk to do a surgery. So that would be a candidate where injection therapy can help them live their life without pain.

Dr. Atchoo: Or less pain. You can’t always cure everything, but many times you can make it better.

Chris: That’s a good point, a good statement. So, one last question I have for you is that can you tell our listeners about the reference to your name that you heard on The Late Show with David Letterman and also on Jay Leno too as well?

Dr. Atchoo: When I was in Mount Pleasant, those two did funny doctors name segments on their shows. Somebody, nobody has ever admitted it, sent my advertising in the local newspaper to the network and they both made fun of my name on TV. Each of them did it twice.

I can remember Jay Leno going, “I’m sure he’s a fine physician, but still, ahchoo, ahchoo (makes sneezing sounds).”

Chris: Thank you doctor Atchoo! We were honored to have you on our show Dr. Atchoo. It’s not just we, the community is lucky to have you and so, what’s the best way for anybody to reach out to you and contact you?

Dr. Atchoo: My office phone number is 248-383-8172, and that gets you to my wife who does all of the scheduling and handles all the administrative stuff for my office. It lets me concentrate on the medical stuff. We’re technically a micro practice because there’s only the two of us.

Chris: You know what, we utilize your services, and we were so lucky, and we’ve never had one issue. And only because you concentrate on your purpose. And a lot of our family members are really lucky. I know in the community it’s very difficult to find good visiting physicians and for them to stay around too.

So now anybody who’s looking for a visiting physician, please contact Dr Atchoo, and he left his phone number as well too.

Thank you for being on our show.

Dr. Atchoo: Thank you for having me.