Caring for a Parent in San Francisco
One physician who holds your parent's whole picture, and keeps you in the loop at their direction.
For families arranging care
How we work with familiesWhen a parent's care becomes your job
Somewhere along the way you became the one holding the calendar, the records, and the worry. Your mother has four physicians who have never spoken to each other. Your father's medication list has grown for a decade and nobody has read it end to end. Getting to an appointment now takes a morning and a second person, and the last visit lasted eleven minutes.
We work with families in exactly this position, and we work with you directly: communication, scheduling, and logistics, always at the patient's direction. Your parent remains our patient, and our relationship is with them. Nobody wants to be managed. But most families are glad to have one physician who knows the whole story and a team ready for whatever comes up.
How we care for a parent who cannot easily get to us
Geriatric care is not a separate service here. It is part of what our concierge practice does for every member whose age and circumstances call for it, and the membership is built so that the physician, not the system, carries the coordination.
For a parent who can still come to the office, care looks like unhurried visits with the same physician, a practice that expedites access when something changes, and, at the VIP and Home Care tiers, a doctor who calls the cardiologist rather than handing your parent a referral to chase.
For members at the VIP and Home Care tiers, we make house calls in San Francisco when there is a medical reason to. Home Care is built around house calls; at VIP they happen when seeing your parent at home is clearly better than bringing them in. These are planned visits, not urgent care.
What a home visit is: your parent's physician, often with a nurse, comes to the home with enough equipment to conduct a real medical visit, and can arrange blood draws, x-rays, and an EKG there. It can include time with the family and a look at how safe the home is. More than anything, it is your parent's physician sitting with them face to face, examining them, and thinking.
What it is not: it is not urgent care, it is not a 24-hour response service, and it is not a replacement for an emergency department. Visits are scheduled in advance, typically during regular business hours, Monday through Friday. House calls are within San Francisco city limits. If you have specific needs or requests, please inquire.
We are opted out of Medicare. Labs, imaging, tests, specialists and hospital care are typically with Medicare-contracted providers and are billed and covered as they normally would be.
When hospital care is needed, VIP and Home Care members can have their own physician oversee inpatient care at California Pacific Medical Center, where we hold admitting privileges.
What actually changes an older parent's health
Several things sold to families of older adults have not held up when tested. Hearing aids did not slow cognitive decline in the primary result of the largest randomized trial that asked. The claim that nearly half of dementia is preventable is a population model, not a promise to any one person. Memory screening of someone with no symptoms is a different act from evaluating a change you have noticed, and the US Preventive Services Task Force still finds the evidence insufficient to recommend screening older adults who have no symptoms.
What does have evidence is quieter. Structured assessment is how good care of an older adult is organized, and we do it. Reviewing a long medication list and stopping what is no longer earning its place is one of the first things we do; deprescribing, done carefully, has a good safety record in trials. Safety is better established than benefit: it has not been shown to lengthen a life. Balance and functional training is the fall-prevention measure with the strongest evidence, and Cochrane rates the evidence for reducing the rate of falls (by 24%) as high-certainty. Blood-pressure control has the best randomized evidence so far for lowering dementia risk. Up to 40% of delirium during a hospital stay is preventable, and the prevention is attention, not a drug.
Continuity itself matters. Keeping one physician over time is consistently associated with fewer hospital admissions. That evidence is observational, so we offer it as a reason for confidence rather than a promise.
If you are coordinating from another city
You may be arranging all of this from Chicago or Boston, on the phone between meetings. We communicate with you by phone and video, at your parent's direction: what changed, what we are doing about it, what we need from you. Medical care itself is with your parent, in person, in San Francisco; a call with you is a conversation, not a medical visit. Records go to one place. When you fly in, the visit you sit in on is with a physician who already knows your parent.
If your parent is becoming home-bound
The harder shift is the one where the office visit stops being possible. A parent who no longer drives, who tires on stairs, who needs a second person for every trip, tends to stop going, and the care stops with them. That is the circumstance the Home Care tier exists for: the physician comes to the home on a planned schedule, the testing comes with them where it can, and the rest of the membership, the coordination and the hospital oversight, stays in place.
A physician-owned practice
My Doctor Medical Group is owned and operated by its physicians: no hospital system, no health network, no private equity, and no separate management company. Neither of us completed a geriatrics fellowship, and we do not hold board certification in it. Our training is family medicine and internal medicine, both of which include the care of older adults, and we have done this work for years. We keep our panel small on purpose, and membership pricing is discussed individually because it depends on tier and family configuration. We are currently accepting a limited number of new members.
Frequently Asked Questions
Will you come to the house?+
For members at the VIP and Home Care tiers, in San Francisco, when there is a medical reason to. Home Care is built around house calls; at VIP they happen when seeing your parent at home is clearly better. These are planned visits, not urgent care.
Is this an urgent care or a 24-hour service?+
No. Home visits are scheduled in advance, typically during regular business hours, Monday through Friday. If your parent has an emergency, call 911 or go to the nearest emergency department; we will pick up the coordination from there.
My parent has not agreed to any of this. Can we start anyway?+
You can talk with us, and we will be honest with you about what is realistic. For some people an unhurried first conversation, with no commitment, is what makes the decision possible. Care begins when your parent is ready for it.
How do you work with me as the family?+
Directly, and at your parent's direction. Communication, scheduling, and logistics run through whoever your parent wants them to run through; the medical relationship is with your parent.
Do you take Medicare?+
No. We are opted out of Medicare and patients sign a private contract, so Medicare does not pay for or reimburse our services. Labs, imaging, tests, specialists and hospital care are typically with Medicare-contracted providers and are billed and covered as they normally would be.
What happens at the first visit?+
It starts with time: the full history, the whole medication list, the specialists already involved, and what you and your parent actually want from their care. Testing follows from that conversation, not the other way around. The first visit is usually in our office; where that is not realistic, it can be at home for members at the tiers that include house calls.
Your parent's physician, with you in the loop
Start the conversation whenever you are ready; many families reach us months before anything is urgent. An inquiry call with our nurse is the first step, and it is about your parent's situation.
Caring for older adults is a core part of our concierge practice.