Who may visit, and what each clinician can do
Depending on the wound and the patient's health, the clinician may be:
- A physician (MD or DO). Physicians evaluate complex or worsening wounds, direct the overall plan, perform debridement when it is appropriate, order advanced treatments and decide when a wound needs a hospital, a vascular specialist or a surgeon. Read more about doctor house calls in St. Louis.
- A podiatrist (DPM). Podiatrists are foot and ankle specialists. They are often the right choice for diabetic foot ulcers, heel pressure injuries, toe and nail wounds and offloading questions. Read more about podiatrist house calls in St. Louis.
- A nurse practitioner (NP, some with a DNP degree). Nurse practitioners assess wounds, set and adjust the dressing plan, write orders for supplies and follow-up, and manage many wounds from start to finish within their scope of practice. A nurse practitioner is not a physician, and we never describe one as a doctor. Read more about nurse practitioner house calls.
- A nurse (RN or LPN). Nurses carry out the plan the treating clinician sets: dressing changes, wound measurements, teaching the family and reporting changes back to the clinician.
Before the first visit, we explain roughly what the visit will cover. If a different specialist should see the wound, Gateway arranges that handoff.
Why a specialist comes to the home
Most people searching for a wound doctor who comes to the home are not looking for convenience. They are looking for a way to get a wound treated when a clinic visit is hard, risky or simply not happening. A parent who needs two people and a lift to get into a car. A patient on bed rest after surgery. Someone with a diabetic foot ulcer who has been told to stay off the foot, which makes a trip across town counterproductive. Someone living with dementia for whom a waiting room is frightening.
When the visit comes to the patient, the wound gets seen on schedule instead of when a ride can be found. The clinician also sees the real environment: the bed, the chair, the bathroom, the shoes, the way the family is changing the dressing. That context changes plans more often than people expect.
Learn how the practice works on our approach page, or read more about mobile wound care in St. Louis.
What happens at a home wound visit
A home visit is a real clinical visit, not a quick look. It usually includes:
- Assessment. The clinician reviews the history, medications, circulation, nutrition and anything else that affects healing, then examines the wound.
- Measurement and documentation. Length, width, depth, tissue type, drainage and the surrounding skin are recorded so progress can be tracked from visit to visit.
- Cleaning and a dressing plan. The wound is cleaned and dressed, and the clinician chooses the dressing type and how often it should be changed between visits.
- Debridement when the clinician decides it is appropriate. Dead or unhealthy tissue may be removed at the bedside. Whether and how to debride is always the treating clinician's decision. See debridement at home in St. Louis.
- Orders and supplies. The clinician writes orders for dressings, offloading devices, compression, labs or imaging. Gateway coordinates the supplies and any referrals.
- A follow-up schedule. The clinician sets how often the wound should be seen. Gateway schedules it and tells the family and any home health agency.
Our guide to what happens during a home wound care visit walks through a visit step by step, including how to prepare the room and what to have ready.
Wounds a visiting specialist can see at home
Nearly every slow-healing or complicated wound can be assessed at home. The most common reasons families call are:
- Diabetic foot ulcers, especially when the patient has been told to stay off the foot
- Pressure injuries and bed sores on the tailbone, hips, heels or back, in bed-bound or chair-bound patients
- Venous leg ulcers with swelling, weeping and skin changes on the lower leg
- Surgical wounds that have opened, drained or stalled after a hospital stay
- Wounds that are not healing after weeks of the same dressing
- Skin tears, abscess sites, burns, traumatic wounds and wounds related to lymphedema or poor circulation
If you are not sure what kind of wound it is, that is fine. Describe it when you call and the clinician will sort it out at the visit.
When a wound clinic or hospital is the better choice
A home visit is the right tool most of the time, not all of the time. A wound clinic or hospital is the better place when the wound needs imaging, surgery, hyperbaric oxygen, IV antibiotics or a vascular procedure, or when the patient is acutely ill. Signs that a wound needs urgent, in-person hospital care include spreading redness, fever, a foul smell with increasing pain, black tissue that is growing, or bleeding that will not stop. For a medical emergency, call 911.
When a home visit is not the right fit, the visiting clinician says so and Gateway helps arrange the clinic or hospital referral. Our guide to wound clinic versus wound care at home compares the two in more detail.
How to arrange a wound specialist visit in three steps
- Call 314-325-0126 or request care online. Tell us who the patient is, where they live, what the wound looks like and how long it has been there. Family members and caregivers can call on a patient's behalf. A referral is not required to start the conversation.
- We gather records and confirm coverage. With the patient's permission, Gateway collects recent notes, medication lists and any wound photos, confirms the address is within the service area and answers insurance questions before anyone commits.
- The first visit is scheduled. We tell you which clinician is coming and when. After the visit, the plan, the orders and the follow-up schedule are shared with the family and any home health agency or primary care practice involved.
Gateway arranges home wound visits across the City of St. Louis, St. Louis County, St. Charles County, Jefferson County, Franklin County and the Metro East in Illinois. See wound care in St. Louis for the full picture of how care is arranged, or the service area for your town.
Common questions
Will a doctor come to my home for a wound?
A physician, a podiatrist (DPM) or a nurse practitioner may visit, depending on your needs and what the plan of care calls for.
Do I need a referral?
No referral is needed to call Gateway or to ask about a home visit. Some insurance plans and some situations do require an order from a physician, and we will tell you if yours does. Our guide answers do I need a referral for wound care in more detail.
How soon can the first visit happen?
It depends on where the patient lives, the clinician's schedule and how quickly records and coverage can be confirmed. When you call, tell us how urgent the wound is. If it needs same-day care, we will say so and help you get it.
Can the visiting clinician do debridement at home?
Often, yes. Physicians, podiatrists and nurse practitioners can perform bedside debridement within their scope when they decide it is appropriate for the wound. Some wounds need debridement in a clinic or operating room instead, and the clinician will tell you if that is the case.
What if I already have a home health nurse?
That is common and it works well. The visiting clinician sets the plan and writes the orders; the home health nurse carries out dressing changes between visits. Gateway shares the plan with the agency so everyone is working from the same instructions.
How does Medicare handle a home wound visit?
It depends on the plan and on the patient's situation. Original Medicare and Medicare Advantage plans each have their own rules for clinician visits at home, for supplies and for home health, and only the plan can say what it will pay. Ask us about your plan before the first visit and we will explain what to check. Our guide on Medicare and wound care at home lists the questions to ask.
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.