For some people, death is the scariest thing they can imagine. But Dr. Bob Uslander deals with it every day. In fact, he considers it his calling. “I had a sort of an awakening that I was supposed to be helping people at the end of life,” says Dr. Uslander.
A long-time medical doctor, he has practiced medicine in California and as far away as Guam. After decades in the traditional medical system, he recognized that this was not where he is most needed. “The system does fine for people who are healthy,” says Dr. Uslander. “We’re learning more and more all the time about prevention of disease. We can often fix people with surgery and sometimes with medications.”
But what happens when things get complex? “We are completely missing the boat and coming up short,” says Dr. Uslander. “When someone’s health becomes challenged, there isn’t nearly enough support for them at home, and especially not from physicians who are committed to their wellbeing.”
In 2001, Dr. Uslander helped a 32-year-old friend battling metastatic melanoma. He became his home-care physician and helped him and his family – a wife and three young children – through the end of life process. “My family also became very connected and supportive, and we ended up creating this little cocoon for Darren, and then we brought in hospice. That was the first time I’d ever actually seen hospice at work,” says Dr. Uslander, “and it was transformational for me.”
That experience planted a seed that later took root and blossomed into a new practice for Dr. Uslander, based on an innovative medical care model. “The work I know I’m supposed to be doing is with people at the end of life, guiding and supporting the patients and families. But I also love caring for people in the time before, as their health is changing and their needs are getting more complex, when they just need more support and compassion.”
He founded Integrated MD Care about a year ago; his office overlooks the beautiful Torrey Pines Lagoon and is steps away from his Del Mar home. “I’m trying to make sure that people aren’t living with fear. The circumstances that they are in can be overwhelming and scary but they don’t have to be if they have the proper connections and support.”
He explains that most of the time, patients and loved ones are left in the dark when the patient is facing a terminal illness. Traditional health care providers are short on time and long on patients, which weakens their ability to provide the highest quality care. Each physician at Integrated MD Care will care for no more than 15-20 patients at a time.
“We have incredible resources and incredible people and technology. But on the personal side of it, we are unable to meet people’s needs because there are too many people and too few providers to serve them,” says Dr. Uslander. That’s where Integrated MD Care can help patients and families. “No one is taking care of the families, guiding them. They’re out there hanging, trying to do the best they can.”
After a complimentary consultation, if the patient and family are agreeable, Dr. Uslander does an in-home assessment to review the patient’s situation, medical records, medications, and concerns and goals, and then he and his team design a program that will best meet the needs of the patient and the family.
The cost varies depending on people’s needs, time and resources, and ability to pay. The less intensive in-home care program might consist of a care manager and/or nurse visiting regularly, and Dr. Uslander visiting every few months, but being available 24/7 via phone, text, and email. More intensive programs involve Dr. Uslander being in the home two or three times a week (or more) and a caregiver team on-hand, collaborating to provide the best care.
Dr. Uslander, now more than ever, is filled with purpose and passion. “I feel like our patients are having the absolute best experience in the last phase of their lives – the most peace, the most comfort. Their families are feeling supported and they feel like they’ve done everything they possibly could for their loved one, and that’s incredibly satisfying for me.”