Nurse practitioner makes the rounds with pediatric house calls
Years ago it wasn’t unusual to see a physician making a house call.
But by 1980, fewer than 1% of doctors were going to homes to see their patients, explained Charles Wetmore, a certified nurse practitioner. Technology mandated that the physician work from an office, where sophisticated medical equipment could be stored.
But the times started changing, and Wetmore took advantage of that about three years ago to leave the medical group he’d been with and step out on his own with Pediatric House Call Solutions.
It was a bit of a leap, the longtime Milford resident admitted. The possibility of financial failure and the loss of other medical professionals to consult with meant Wetmore had to trust in himself.
But the motivation was strong.
“I wanted to do house calls,” said Wetmore, who is married with three daughters. “As a parent I know how hard it is to bring a sick child to the doctor.”
Wetmore spent his youth in Fairfield and Stratford, graduated from Andrew Warde High School, and then joined the Army. After military service, he attended Fairfield University, studying math, political science, and then nursing. He worked at Yale-New Haven Hospital several years and then entered Yale's program to become an advanced practice registered nurse (APRN).
He learned a lot as he began his new medical profession, working over the years with the Milford Pediatric Group, Pediatrics Plus and Pediatric Healthcare Associates.
It was when laws changed, allowing nurse practitioners with enough experience to practice on their own, that Wetmore took advantage of that and opened his own pediatric house call business, seeing children from birth up to age 21.
Whereas more than 30 years ago technology confined nurses and doctors to their office and their equipment, new technology makes it possible to carry the tools of the trade. Urine tests, strep tests and other medical tests can be done in the home.
“The bag I bring in is pretty small,” Wetmore said, adding that he carries additional equipment in his car.
His home base is his Milford home. He has his computer and phone, and a lower-level room, complete with a refrigerator for vaccines, and that provides all the office this mobile nurse practitioner needs.
“Fifteen years ago, everything was paper charts,” he said. “I learned on paper charts. Now everything is on the computer.”
Pediatrics is seasonal in many cases — during cold and flu season Wetmore may see 60 to 75 patients in a week. During the summer, that may be 15. Ten percent of his patients see him for everything; the other 90% are PRN — from the Latin pro re nata, which means, when necessary.
Typically calls come from the mother, often about ear pain, a rash, cold or flu symptoms.
Wetmore gets the call and sets a time to visit — sticking to a 10- to 15-mile radius from home.
When he arrives to a new patient, he gathers medical history and then examines his patient and determines treatment, calling in any medications he deems necessary.
He appreciates the time he can spend, and sometimes other issues come up, and he can talk to the parent about those concerns as well.
“Another thing that often happens is that a parent will call me over to see one kid, and while I’m there they’ll ask me to see a sibling — it’s no problem,” he said.
The fee for a sick house call is $100 and for a physical, $140, which is generally covered by insurance.
Wetmore takes many insurances, so often families are responsible just for the deductible.
He will make house calls between 5 a.m. and 8 p.m., and said his phone is always on and that he will take phone calls anytime, day or night.
Over the past three years, he hasn’t visited children only in their homes, he’s gone to their daycare centers, preschools, relatives’ houses, schools and places of work.
“My personal favorite is when I saw a kid at a relative’s tattoo parlor,” Wetmore said.
After three years, Wetmore said, the career risks have paid off and his practice is growing.
Bottom line, he said, house calls make it easier when a child is sick.