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Still Hopes residents may remember a time or two in their youth when their doctor made a house call. Often the doctor was a beloved member of the community who they all knew well, and might even think of as a family friend. 

Fast forward to 2021… when the old way of doing things has become the innovative new way within the Still Hopes community.

The term today is called concierge medicine. It started to reappear in primarily metropolitan areas in the last 10 to 15 years. A concierge practice typically caters to business executives who want to pay an extra retainer for the convenience of having a physician who provides enhanced, personalized care. It’s easy to schedule an appointment, with little to no wait, and sometimes in their own homes. And these physicians will really take the time to get to the root of their patients’ medical problems, thoroughly examining them and explaining a treatment plan that can be easily understood and followed.

And here is why Still Hopes residents can feel special. Geriatric Health And Wellness at Still Hopes is one of the only concierge medical practices anywhere in the U.S. that caters exclusively to retirement community members.

The practice started in 2019, when discussions between Victor Hirth, M.D., and Still Hopes Executive Director and CEO, Danny Sanford, led to focus groups with Still Hopes community members to see if there was a need. The response was overwhelming.

So in the fall of that same year, Hirth hung his shingle right on campus and hired Still Hopes nurse alums, Natalie Hinkle and Nicole Newton, to assist.

“They both have experience with older adult care, and since this was a completely new program, it was extremely helpful to have someone who was familiar with the system and the community,” said Hirth. “They have been a great fit.”

Hirth grew up on the West Coast. As a young adult, he served as a nurse aide in a retirement community in Seattle, establishing his love of caring for older adults. So it was no surprise that he would pursue a career in geriatric medicine.

“When I entered medical school, I already knew it was my path. I knew I enjoyed older adults, and I enjoyed long term care. That just pulled for me,” said Hirth. 

After his fellowship training, Hirth was recruited by the University of South Carolina, working his way up from clinical instructor to full professor and Chief of Geriatrics. He helped to develop a senior primary care program, a geriatric fellowship training program, an inpatient geriatric unit, and the geriatric psychiatry training program. He focused his research on Alzheimer’s, hypertension, and other age-related diseases. He served as Editor-in-Chief for a geriatric textbook, on the board of directors for the American Geriatric Society, and even started a program to attract other physicians to this small field of medicine. 

But when he saw that health care was becoming more corporatized, he decided it was time to reexamine how he, himself, wanted to deliver care. 

Hirth had served on the Board of Directors at Still Hopes for a number of years. He said that he could see Still Hopes was a very well run organization, and that the community was focused on resident wellness. 

“Geriatrics is the care of the oldest most medically complex people, in order to maximize their independence, health and wellbeing, and to minimize hospitalizations,” said Hirth. “It can’t be done in fast order, so it became clear to me that being in a big organization was not optimal for me.”

Hirth and his team are available Monday through Friday, and provide coverage, by telephone, on weekends, holidays and evenings. If one of his Still Hopes patients takes a tumble one evening and ends up in the emergency room, he can advise them on their pain management and watch over their healing. Or if a resident can’t tell if they’ve developed a cold or Covid, he will suit up in his medical personal protective gear and pay them a house call.

“It really is soothing to the residents, both physically and emotionally, to have someone with his expertise become a partner in their health,” said Tacey Gohean, Still Hopes Director of Community Services.

Gohean says the business model is simple. Residents can pay $230 per month or $2,600 a year. Since they are a 100-percent Medicare practice, they are required to file Medicare. The retainer is separate from Medicare, and covers accessibility to Hirth and his team, continuous communication to patients and their families, and peace of mind. 

“Almost all of my children live out-of-state, and they are delighted that I have this program here, so that they don’t have to worry about me getting an appointment when needed. I have a short wait, and of course, transportation is not an issue,” said Joyce Steele, a Still Hopes independent living resident.

Hirth is just as appreciative of his patients and their families.

“It’s been hugely rewarding. They send emails with questions and information about the latest research, medicine or supplements. I like getting these because I often learn something as well.”

While some physicians may balk at this, Hirth welcomes the opportunity for growth. He says he has always been a big proponent of continuing education. In fact, he might be considered a lifelong student himself. If he is not spending his free time with family, he is restoring cars... and does all of his own maintenance, from starters to alternators to connecting rod bearings.

He also started his own research enterprise. For the past 10 years, he has partnered with the USC College of Engineering and Computing, Department of Civil Engineering to develop a system of fall detection using small seismic sensors, placed inconspicuously on the floor of an apartment or dwelling. The project has two National Institutes of Health-funded grants and one in review supporting it. Still Hopes residents have also participated in the study and more work will be conducted at Still Hopes in 2021.

“It’s novel. Most of the fall detection systems are almost exclusively watch or pendant based. But if you are not wearing either and you take a fall, you may not be able to make it to the phone,” said Hirth. “Ours is completely ambient - the environment knows what you are doing. You don’t have to interact with the system but the system still recognizes a fall.”

Hirth also spends a few times a month with his staff, training for everything on falls and delirium to UTIs. He also trains Prisma Health residents in internal medicine and fellows in Palliative Care and Hospice as well as Geriatrics. You might see one of these visiting doctors with Dr. Hirth's team on campus during the year.

Hirth treats about 60 to 70 patients in Greenway Supportive Living's skilled nursing neighborhoods, and over 100 independent living residents, with more coming on board with the opening of the new HopeWell independent living apartment building

“Being here at Still Hopes Retirement Community in Columbia, SC has been highly rewarding. I think everyone has come to realize what we are doing here,” he said. “It’s not what might be considered innovative. It’s probably just more old school, right? It’s how medicine used to be.”

And to his patients, it’s how it always ought to be.

For more information about the Geriatric Health and Wellness concierge practice, email Tacey Gohean, Director of Community Services, at [email protected].