Pretoria East House Call Doctor
Dr Tomek ‘Thomas’ Piorkowski – General Practitioner, House Call Doctor, Home Visit GP
A home visit doctor bringing mobile GP services to homes in Pretoria East, since July 2017.
To book an appointment, preferably send an sms or WhatsApp to 0659755032 or email email@example.com – please note that I do not run an emergency response service, so for emergencies you will need to call an ambulance/emergency house call nurse; for that I recommend Sister On Call (Sr Dreyer), their numbers are: 083 305 4175, 082 341 0701
Please note that all new patients to my practice will have to fill in some forms either before the appointment or at the time of consultation. The form is available below in PDF and Word formats, and should be filled in and emailed to myself, or emailed my practice manager at firstname.lastname@example.org, or handed in at the time of consultation.
Description of Service
I am a GP who provides routine, scheduled medical services in people’s homes in and around the Pretoria East area, focusing specifically on the frail, the elderly, the disabled, the housebound and the terminally ill.
Although I do not provide emergency or urgent care, my practice is a viable alternative to calling the ambulance for every little health problem for your elderly relative, and I assist with managing chronic diseases, maintaining a happy and comfortable aging/disease process, and to sort out minor problems in patients who have lost the ability to easily go to a GP practice.
Many of my patients have been forced to either use emergency units or to constantly phone their old GP for telephone-only consultations, but these are not good options for patients who need careful, long term attention to their medical needs, with the end result being extra pain and suffering when you really just want someone to be as comfortable as possible.
I work in collaboration with many home nursing agencies that operate in Pretoria and can also assist with finding home nurses and caregivers for families who have begun to struggle to look after their loved ones in the home.
Not everyone wants to die in a hospital and so I also assist families with pain and disease control at the end of life as well as making plans to make the process of dying at home uncomplicated for the families involved, as well as being available to do all the necessary paper work required in order to apply for a death certificate. Nursing a dying relative at home used to be a normal part of human life but in our 21st century comfort zones many people assume that the only place to die is in a hospital or hospice, but dying at home is an option to consider.
What do I do?
Since starting my mobile practice, I have dealt mostly with severely ill patients in the last stages of their life, commonly having multiple illnesses such as Alzheimer’s, kidney failure, heart failure, etc. I am comfortable with terminal care and I can with pain and symptom control for those patients who have decided they would prefer to die at home. I have also taken over the care of elderly patients who used to go to state hospitals but now are too old or ill to leave the house.
I also have younger clients who simply appreciate having a scheduled home visit and are willing to pay for having an unrushed and comfortable medical examination. I firmly believe that many medical problems do not fit neatly into a 15 minute consultation and I have spent an hour, often two, helping to sort out my patient’s problems.
Currently I do not treat emergencies though – please go to an emergency unit or call an ambulance if you have sudden new chest pain, sudden difficulty breathing, altered states of consciousness (such as seizures or confusion), loss of vision, visual disturbances, suicidal thoughts/ideas, pregnancy complications or severe traumatic injuries.
Please note that I also no longer do insurance examinations; for a home insurance exam visit, please rather contact Dr Nothnagel on 082 325 3599 or emailing email@example.com
What does it cost?
There are two billing options available for my consultations: a private hourly rate, and then the medical aid fee-for-service rate. The medical aid rate will be phased out in 2019 and all patients will be charged a standard fee.
For 2018, I charge an hourly fee of R400 for the first hour, plus a home visit fee of R250. After the first hour, there is a fee of R100 per 15 minutes for the second hour; however fees are capped at a maximum of R1050 for a consultation.
Please note that many of my patients have been very complex, difficult cases and the typical first visit often lasts 2 hours.
Private patients are requested to preferably pay be EFT. An invoice will be emailed after the consultation and proof of payment is requested within 2 weeks; payment plans can be arranged with my practice manager as needed.
As of April, 2018, I now accept medical aids. The billing is handled by a separate company called smeMetrics; new patients who wish to their medical aids to be billed for the visit will have to be registered with smeMetrics. This should preferably done before the consultation via email or fax, but for those who don’t have access to these, I will bring the necessary forms to the consultation. Once the patient’s medical aid details are confirmed, I will then be able to proceed with the house call on a fee-for-service basis. Unlike the flat hourly private rate, this will mean that any service (eg an ECG, lung function test, injection, etc) will be billed. This will end up costing more or less the same as the private cash rate for most patients on most medical aids. For 2018, medical aids will be billed at medical aid rates, although the patient will still be liable for payment should the scheme not have sufficient funds at the time of billing.
What do I treat?
I don’t do emergency visits, but otherwise I can treat most General Practice / Primary Health Care needs; basically, things that can wait for an appointment. I don’t do surgical procedures but I can freeze suspicious skin lesions.
I also assist patients who have decided to leave specialist care (for example, state patients who don’t want to attend hospital anymore) and I treat these kinds of patients according to available specialist guidelines and the patient’s preferences.
Here is a small sample of conditions I’ve treated doing house calls:
- Dementia symptoms
- Joint pains
- Urine infections
- Heart infections
- Heart failure
- Kidney failure
- Chronic stroke care
- Urine catheter changes and management
- Ingrown toe nails
- Cancer pain
- Irregular heart rhythm
- Thyroid problems
Why house calls?
House calls are a necessary service to people who are unable to easily access a GP practice or a hospital. This sector of the market has been deliberately ignored and underserviced by medical aids and by government. By providing a streamlined, low-overhead house-call only GP service, I help patients have access to healthcare, as is their right according to the constitution, in a way that is reasonably affordable but still financially sustainable as a working professsional.
Where I do housecalls and when
Anywhere in the eastern part of Pretoria, from more-or-less Steve Biko hospital to Rayton, and more-or-less from Montana to Morelata Park, during office hours (8am to 4pm on weekdays, Saturdays 8am to noon).
Please note that I don’t treat serious emergencies such as sudden new chest pain, sudden shortness of breath, altered states of consciousness such as confusion or seizures, sudden loss of vision or visual disturbances, pregnancy complications, and severe traumatic injuries. For serious emergencies, please call an ambulance or go to a 24 hour emergency unit.
I do reserve the right to refuse or cancel any appointment that takes me to an area which I consider unsafe or suspicious, or that is too far from my catchment area.
What to do when your relative passes away at home
I often am called to help make patients as comfortable as possible in the last days of their life, especially those who have decided that they would prefer to pass away at home rather than in a hospital. Exactly what are the steps to take once a patient passes away at home is a question I’ve been asked so often that I made a video about it (which you can find a bit further below); but in summary, for Pretoria East:
- First call your preferred ambulance service to come to your home and confirm death; they will issue a Certification of Death letter (which is NOT the same as a Death Certificate! A Death Certificate can only be issued by Home Affairs.)
- Once you have the Certification of Death, call your preferred undertaker service (your undertaker will not take the body until death is confirmed by the paramedic service or another qualified health care provider.)
- The undertaker will then take the body and will need the details of the patient’s last doctor and the deceased’s ID. (If your relative was one of my patients, please give the undertaker my details.)
- The doctor will then fill in a Death Notice form and a Cremation form (if applicable). I do these free of charge for all my patients (who are not in arrears) but most doctors charge for this service.
- The undertaker will then take the doctor’s Death Notice form and the deceased’s ID to home affairs in order to get a Death Certificate.
- Burial arrangements can then be finalized at this point, because you can’t bury/cremate until you have the Death Certificate.
About Doctor Thomas
Doctor Tomek Piorkowski graduated medical school in Pretoria in 2006. He did his internship at Kalafong hospital for 2 years and then did community service at Mamelodi hospital for 1 year. He then worked a stint at Tembisa hospital emergency unit before moving on to working in private emergency units, mostly at Morningside Medi-clinic emergency unit. After about 2 years of emergency medicine, he worked for a while at the University of Pretoria as a lecturer in physiology while locuming part-time at the PierneefMed GP practice in the Pretoria Moot area. He then worked in Garankuwa at a government clinic, before deciding to go back into private practice in 2017.
To confirm Dr Piorkowski’s current registration as a doctor, you are welcome to click the following link:
Videos I’ve made
Alternative house call service providers in Pretoria
If for whatever reason you can’t get hold of me, consider using one of the following alternative service providers:
Sister On Call (Sr Dreyer): 083 305 4175, 082 341 0701
Dr Philip Nothnagel: 082 325 3599
Dr Edmund Schutze: 072 086 6162
Old Video on My Equipment Bag
Here is a video of what I used to bring to a house call. Some of the equipment has been phased out but it still gives a general idea of what I bring.