Dianna Davis suffers from myotonic dystrophy, characterized by the steady deterioration of her muscles and internal organs. She's reached the point where she not only is bedridden, her eyelid muscles have stopped working, so she can't see unless someone else hold her eyelids open. She counts on her sister, Juanita Woods, to take care of her 24/7 at their home in Gonzales.
If Davis needs to see her surgeon, getting her to Seton Edgar B. Davis Hospital in Luling can require an ambulance, an oxygen tank, paramedics to get her safely in and out of a vehicle, nearly 20 miles of driving one way and hours of so many people's time.
Or, Dr. Fernando Angeles can make a house call - which he has done for Davis about half a dozen times over the past few months.
A surgeon who makes house calls?
When Dr. Flora Edison, Davis' primary care physician, asked him the first time to go to Davis' home, Dr. Angeles' response: "Sure, why not?"
He noted that Dr. Edison had been going to Davis' home several months before that, so he's not the only Seton doctor to do this. But Dr. Angeles also has made house calls for other patients, such as a 90-year-old recovering from breast cancer.
"What the heck? It's just a matter of going down there and taking care of it," Dr. Angeles said.
It's not a big deal to him, in part because he grew up seeing his father, a Galveston-trained doctor, routinely make house calls when he practiced in the Philippines.
But it means a lot to Davis and her sister. And Juanita Woods knows better than most - she's a licensed vocational nurse who previously cared for her mother and brother, who also suffered from myotonic dystrophy, a genetic disorder.
"He is awesome. He's just been magnificent and so caring. I just couldn't believe there is anyone like him still in this world," said Woods.
"He talks directly to Dianna and explains what's going on. She's laying there with her eyes closed but she's fully aware. She likes him, she trusts him. You can tell that," she said.
"In 16 years of home health care, I've never seen doctor come to a home until now. Never a surgeon - that's totally unheard of," Wood said.
Not only do the house calls save Davis and Wood a lot of stress - it also saves them financially.
"No going to emergency rooms with strange doctors who are unfamiliar with case. You waste all that money and all that time - and one little visit down here by Dr. Angeles or Dr. Edison and you avoid that," Wood said.
It's also a perfect response to two major Seton concerns: fostering person-centered care and eliminating unreimbursed costs.
"I think it's fantastic, in this day and age, as fragmented as health care can be, there are still physicians who will call on patients at home, in nursing homes and other places, if necessary," said Dr. Patrick Garcia, vice president of medical affairs for Seton Edgar B. Davis, Seton Hays, Seton Smithville and Seton Southwest in Austin.
Everyone's impressed - except Dr. Angeles.
"Maybe I'm still old fashioned. That's the reason why
I like to work in a small town. You want to know everybody. You
want to take care of people and be friends," he