House call primary care in the Metro East
For people in the Metro East, seeing a doctor sometimes means crossing the river. That works for a healthy commuter. It works poorly for an older adult who needs a ride, tires easily and has several conditions that need regular review. In-home primary care follow-up keeps that review on the Illinois side, in the patient’s own living room or facility room. Gateway arranges visits with partner clinicians and coordinates records with hospitals and specialists in both states. The treating clinician decides on the plan of care.
Care settings in the Metro East are as varied as the region. There are brick homes in older neighborhoods, farmhouses, subdivisions, apartments, mobile homes, senior living communities, memory care units, rehabilitation centers and skilled nursing facilities. Gateway arranges wound care and primary care visits with partner clinicians in all of these. We start by asking where the patient is living and who helps with daily care. Then we coordinate the visit with the household or the facility staff and make sure records and orders reach the treating clinician.
This page is part of Gateway's guide to primary care in St. Louis, which covers house calls, wellness visits and chronic care across the region.
What in-home primary care includes
A house call covers much of the ground an office visit would. Depending on what the treating clinician finds, primary care follow-up at home can include:
- A check on long-term conditions such as diabetes, heart failure or high blood pressure
- A look at every medication you take, including over-the-counter products and supplements
- Follow-up after a hospital or rehab stay, starting with the discharge papers
- A yearly wellness visit and a talk about vaccines and screenings
- Orders for lab work, imaging or a specialist, with someone tracking the results
New problems that are not emergencies, such as a lingering cough, a rash or poor sleep, can be raised too. The clinician decides what belongs in each visit. Gateway handles the scheduling and records around it.
People who benefit most
Recovering from surgery or living with a wound changes what a trip to the doctor involves. A leg that needs to stay elevated, a dressing that should stay dry, pain with sitting, or instructions to keep weight off a foot all make travel harder. For people in the Metro East in that situation, Gateway can arrange primary care follow-up where they live, so the conditions that affect recovery are not put off until the wound has closed.
The same service helps adults who rarely leave home for other reasons, people in assisted living communities, and people who have no primary care clinician right now.
Why wound care and primary care go together
A wound on the leg or foot needs blood flow to heal, and checking circulation is partly a primary care job. The primary care clinician asks about leg pain with walking, checks the pulses in your feet, reviews risks such as smoking, diabetes and high cholesterol, and decides whether a circulation test or a vascular specialist is needed. The page on circulation and vascular health explains the basics.
Those results matter to the wound care clinician, because poor arterial flow changes which treatments are safe, including compression. Gateway sends test results and specialist notes to both clinicians, so each one is working from the same facts.
Homes, assisted living and skilled nursing
Where you live can change during an illness: home, then a hospital, then rehab, then perhaps assisted living. Gateway arranges primary care follow-up in the following settings across the Metro East:
- Private houses, condos and apartments
- Assisted living communities
- Memory care communities
- Skilled nursing and rehabilitation facilities
If you move, tell us the new address and who is in charge of care there. We confirm whether a partner clinician is available for that location and setting, and we help get your records to the new care team so the next visit does not start from zero.
Keeping your current physician involved
It helps to know who is responsible for what:
- The treating clinician examines you, makes the diagnosis, writes orders and prescriptions, and decides on treatment
- Your existing physician and specialists keep the parts of your care that they and the treating clinician agree on
- Home health nurses and therapists carry out the orders they are given and report changes
- Gateway schedules visits, gathers records, follows through on orders and keeps everyone informed
- You and your family decide who is included and tell the team what has changed
If you are ever unsure whom to ask, call Gateway and we will point you to the right person.
How to start
There are two ways to start in the Metro East. The direct one is to call 314-325-0126 and talk with a coordinator. If you would like us to call you instead, send a request for care through the website. The form asks only for a name and phone number, so please leave health details out of it. When we call back, we go over where you live, what you need and who is already part of your care, then confirm whether a partner clinician can see you there.
- County: St. Clair, Madison and Monroe counties, Illinois
- Nearby hospitals: Memorial Hospital Belleville; Memorial Hospital Shiloh; HSHS St. Elizabeth's Hospital in O'Fallon, Illinois; Anderson Hospital in Maryville; Alton Memorial Hospital; OSF Saint Anthony's Health Center in Alton; Gateway Regional Medical Center in Granite City; Touchette Regional Hospital in Cahokia Heights (not affiliated with Gateway)
- Nearby communities: Belleville, Illinois, Edwardsville, O'Fallon, Illinois, Collinsville, Alton, Granite City
- Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation
Insurance and coverage
The visit itself is not the only thing to ask about. Lab tests, imaging, medical equipment and supplies are usually billed by whoever provides them, under their own rules. Programs that add support between visits, such as chronic care management or remote monitoring, are billed separately from visits and may carry their own cost share, so ask about that before you enroll. Gateway does not quote prices. The treating practice and your health plan are the sources for what you would owe.
Common questions
Does someone have to be homebound to get a house call in the Metro East?
You do not have to meet a formal definition to ask. Homebound is a word that certain programs, such as home health under Medicare, use with specific rules. Just describe what makes leaving home difficult. The treating practice and your plan decide what applies to you. Our guide to what homebound means explains the term.
Where do I go for lab work or an X-ray if I get primary care at home in the Metro East?
It depends on the test and on your location. The treating clinician decides which tests are needed. Some blood draws and imaging can be arranged where you live in some areas, and others have to be done at a lab, an imaging center or a hospital. Gateway schedules the test either way and can help with transportation arrangements when a trip is needed.
How is in-home primary care in the Metro East different from home health?
Home health is a service from an agency that sends nurses and therapists, usually for a limited period after an illness, injury or hospital stay, and it runs on a clinician’s orders. Primary care is the clinician who manages your overall health, prescribes medications and writes those orders. Many people have both at once, and the two work better when they share information.
Does Gateway arrange primary care in the Metro East for people who do not have a wound?
Yes. The company name says wound care, but you can ask about a primary care clinician who visits at home whether or not you have a wound. Long-term conditions, a recent hospital stay or simply being unable to get to an office are all reasons to call. If a wound does develop later, having primary care already in place makes it easier to coordinate both.
How often will a primary care clinician visit me in the Metro East?
The treating clinician sets the schedule after seeing you, and it changes with your health. Someone just out of the hospital, or with a condition that is not yet stable, is usually seen more often than someone who is steady. Gateway cannot promise a set number of visits or a set interval in advance. Ask at the first visit when the next one should be.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.