Recent trends in health care have made it harder for some people to navigate the system and get the care they need. To make things easier and provide continuity of care, several types of services are filling the void. Dr. Daniel Gaitan, a personalized care physician, says the ‘concierge physician’ business model has allowed him to spend more time with his patients, providing them with better access and peace of mind. “It’s like when you were growing up and you had the doctor who also came over for dinner,” he says. “I have patients who bring me vegetables from their garden and I know about their kids. It’s the old- time kind of medicine that, for the most part, doesn’t exist anymore.”

Personalized care, otherwise known as the concierge physician model, originated about 10 years ago. It allows patients to pay an annual fee that entitles them to access to their physician 24 hours a day. The doctor generally sees fewer patients, giving him or her more time with each one. “I used to have 2,800 patients; now I may have about 400,” Gaitan says. “Where I used to see 25 patients a day, now I might see 12 a day, so I have more time with them.” If a patient calls with an illness, Gaitan sees them that day or the next day. He adds that his office arranges any appointments with specialists, and handles prescription fulfillment, streamlining the process for patients.

Gaitan explains that since he is available to patients by phone or email 24 hours a day, patients will never end up seeing a doctor they don’t know in an emergency. “If I send someone to the emergency room, I go and meet them there,” he says. “Personalized care physicians also are less likely to send a patient to the hospital and be admitted. We can do a better job because of the time factor, which is critical.”

Private duty nurses, or in-home caregivers, also can provide support for seniors and their families. Mark Blum, co-owner of BrightStar’s West St. Louis County office, became interested in the field after helping his father in a seven-year battle against COPD and emphysema. His business partner, Steve Fischer, staffed nurses for 10 years to help his own relatives. “Having a need for these services personally, we investigated the market and demographics. With 10,000 seniors turning 65 a day—and by 2020 they’re expecting more than 60 million—it’s a huge need that’s only going to keep growing,” Blum says. BrightStar provides a range of services, including companion care, personal care and skilled care, as well as tasks ranging from assistance with daily living, such as cooking and light housework, to medical care like blood sugar testing.

“They’re going to be getting a highly skilled, compassionate caregiver that’s going to show up with a smile on their face and know what’s needed,” Blum says, adding, “Our director of nursing has gone out on every case and created a person-centered plan of care. She does a full head-to-toe assessment of the patient, so that the caregivers can go in and know what they need to do.”

A plan of care and patient-centered approach also is central to success for Advanced Nursing Services of St. Louis, says owner Maggie Holtman. In many cases, private-duty caregivers fill the role of a family member if they can’t be there, she adds. “Many people don’t ever want to leave a family member alone in the hospital. They want someone there to hear and see everything that goes on. It’s not anything against the hospital, but people like that extra comfort zone, so that if they wake up in the middle of the night, there’s someone there. They have one patient, and that’s the patient they’re taking care of.” The services can be especially helpful in poor economic times, when families are pitching in more to help each other. “It’s not easy to take care of a sick family member,” she adds.

Often, the company starts working with a client for just a few hours a week, which can escalate to round-the- clock care, if necessary, Holtman says. “We keep the same group of nurses on a client, which is something people like about us,” she adds.

When it comes to caring for someone who is sick, Holtman stresses, the biggest key is trust. “You’ve got to maintain their trust. We are what we say we are; it’s not just a lot of talk. I want people to know they can trust me.”