Two Physicians Named 2003 "House Call Doctor of the Year"

Leslee Cochrane, MD
Dr. Leslee Cochrane started making house calls in Riverside, California three years ago and quickly spread his operation to a second site in San Bernadino. The practice was soon making 500 house calls per month with Dr. Cochrane himself making 120-150 of them while managing the busy practice. Things were going well until Medicare did a focus audit of forty charts and downcoded 39 of them, refusing payments altogether on 35. On appeal, Dr. Cochrane had 37 of the 39 downcoded opinions reversed by the Medicare carrier's medical director. Despite this, Medicare reviewed an additional 100 charts with similar negative findings.

Medicare then accidentally made duplicate payments to Dr. Cochrane because of his two sites of practice and this led to a restitution nightmare. Without notice, Medicare placed his practice on prepayment chart submission; this completely stopped cash flow. After two months the practice was out of cash. Dr. Cochrane and his wife took out a loan in order to pay his doctors and staff and he continued to make make house calls for free.

Dr. Cochrane finally decided he would have to close his practice on August 26, 2002, but not before his parent company notified the local press. An article critical of the way he was being handled by his Medicare carrier and detailing how a well-meaning doctor could be destroyed by the federal system came out in the San Bernadino Sun on August 23. That same afternoon a fax came from Medicare informing Dr. Cochrane that electronic payments would be restored and that Medicare's four-month evaluation had found essentially nothing wrong. Dr. Bayne, who nominated Dr. Cochrane, wrote, "In the promotion of the 'art, science and practice of medicine in the home' the Academy could not imagine a more honest proponent of the ideals of professionalism, integrity and simple hard work than Leslee Cochrane."

Eric DeJonge, MD
Dr. Eric De Jonge, named "East" House Call Doctor of the Year, was nominated by Dr. Bruce Leff who wrote, "As a geriatrics fellow at Johns Hopkins University, Eric demonstrated exceptional interest in and extraordinary dedication to the care of homebound older persons in his work in our Elder Housecall Program." In 1999, Dr. DeJonge left Hopkins to become the Section Director of Geriatrics at Washington Hospital Center. There, in partnership with Dr. George Taler, he developed the Medical Housecall Program. The program provides hi-touch care with hi-tech capability to the homebound in an eight zip code area around the hospital and also provides services to large Washington, D.C. senior public housing sites. They have enrolled over 750 patients who are cared for both at home and in the hospital as needed.

In addition to the wonderful care he provides, Dr. DeJonge works hard to demonstrate the clinical and economic effectiveness of a hospital-based house call program for frail elders. He gives talks educating physicians on the value of house calls and has done poster presentations at several national meetings. His house call program receives a variety of grants and donations and this support reflects a very strong commitment from the community and government.

Dr. DeJonge's program has done outcomes based research and has demonstrated a reduction in hospital length of stay of house call patients from a mean of 8.3 to 5.9 days as well as a reduction in emergency department visits by means of providing urgent house calls. Dr. DeJonge and his group have also sought to help others replicate their model around the country and provide ongoing consultative services. Dr. Leff ended his nomination stating, "Eric is a wonderful person who exemplifies all that is best in Medicine. He is the personification of everything the Academy has hoped to achieve in all its work. I can think of no other more deserving candidate."