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Yes, They Make House Calls : S.D. Doctor, Dentist Bring High-Tech Service Home

April 20, 1987|BILL MANSON

SAN DIEGO — Radio was still king, television just a dream, and space flight only happened in comic strips in the days when the family doctor who made house calls vanished from the American scene.

But maybe not forever. Medical care providers who will actually come to your house, rather than answering your telephone call with the advice to take two aspirins and drop around the office the next day, are back in San Diego, at least in a small way.

A San Diego doctor and a dentist have centered their practices on making house calls. But if you want to see them, don't expect a couple of horse-and-buggy drivers to show up on your doorstep.

Both are throughly modern medical men--and one uses the latest in computer age equipment.

Here's a look at what they're doing.

The boyish face of 40-year-old Dr. Gresham Bayne pops around the front door of Juanita Younie's condo on a sunny street in Point Loma.

"How's the chest?" he asks breezily.

"The chest" has brought Bayne around to this door many times, not all on sunny mornings at convenient hours. Younie has respiratory problems. Most people in her situation face the prospect of regular midnight trips to the emergency room. The trips are about $220 each by ambulance--according to Hartson Ambulance Service--probably rising to $250 later this year. Then there are the hospital fees.

Since coming under Bayne's wing 14 months ago, she hasn't been to a hospital once. He has done several tests on her without her having to leave home--for $150 per visit.

"I was thrilled," said Younie's mother, 80-year-old Grace Cates, who is visiting her daughter from Texas. "When Juanita was born, our doctor came seven miles from town by horse and buggy to our farm. I remember when your little brother was born, Juanita. That was a hard birth, and Dr. McCulloch came from town in the very first car I had ever seen.

"Now, here's a doctor coming home again. After all these years! It makes me feel so secure for my daughter."

"I don't do home births," Bayne said, "just because of that 2% risk of problems that really do need hospital facilities. But coming to the patient's home helps me, too. This way, Juanita is much more relaxed. She knows she can call me anytime, and coming here I can get much more input than in the clinic. Plus seeing her mother gives me an insight to her family background. Their longevity, and so on.

"What's more, it saves everybody a lot of money. Sometimes, even saves lives. Not long ago I was checking up on a patient. He had angina. I asked him how it was. 'OK,' he said. But his wife called out from the kitchen, 'Honey, that's not true!' And from that remark I decided to investigate further.

"He had crescendo angina--and the result was five-vessel coronary artery bypass surgery. He now has a pacemaker, but without his wife's remark--which I wouldn't have heard in my office--he would be dead, for sure."

He leans down to listen to Juanita's chest.

"You're honkin' and squeakin,' " he says, "but your theophylline level last week was 12. That'll give us a window for your next crisis in spring."

Up on slightly less-fashionable El Cajon Boulevard, Philip Lepor, 38, dentist, is setting out in his elderly car with a few little boxes, some wax, paper face masks, a burring drill and protective glasses. Oh, and rubber gloves. He just about forgot those. He sets off for University Avenue and the first of today's four patients.

She is Pearl Davis. Lepor is standing with his electric grinder, glasses and gloves in hand, knocking at her door.

"Hello, Mrs. Davis," he says. "Any problems with the plate? Can you eat yet?"

He's leaning over a frail little old lady lying on her bed in a blue dress with red stripes, long stick legs in brown stockings, and rosy cheeks.

"It still rubs on this side," she says.

"I'm going to set up in your kitchen, OK?" Lepor says.

"Go right ahead. You will anyway."

This is a refinement visit. He has fitted her, had her plate made, and last week he brought her her new set of teeth. Now, he wants to make sure they are just right.

He feels in and out of her mouth, talking all the way. He has her bite on a sort of napkin to find where pressure points are.

"I like bacon," she says. "I can't eat it unless you take that rise off."

Lepor takes the plate to the kitchen, and starts whirring his grinder.

"I'll be 89 soon," she says, "and this is the best dentist I ever had. Before him, I couldn't eat! In the nursing home, they only cooked for people with teeth. All I had was soup that I sucked through a straw. I was starving to death! I went down to 65 pounds.

"I've seen four dentists. Paid over $1,000 to the last one. No good. No good! Just getting there to his office, with my broken hip, wheelchair, car--that laid me out for two days. They made all sorts of promises.

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