In Norwich, a doctor who makes house calls

Mar. 18—NORWICH — If he was a DJ, he'd be spinning vinyl.

But no, he's rather a throwback of a GP, which is to say he's a general practitioner who makes house calls.

In fact, Dr. Jan Akus made such a call Friday morning, driving from his Clinic Drive office near Backus Hospital to visit 95-year-old Rose Johnson in her Baltic Road home.

Sitting in a rocking chair opposite his seated patient, Akus pulled a stethoscope and other implements of his trade from a well-worn doctor's bag and leaned forward to check Johnson's vitals ― her heartbeat, her blood pressure, her lungs ― while chatting her up with medical questions and whimsical banter as her primary caregiver, her son David, watched.

They say doctors used to do this sort of thing all the time.

Akus, 74, said he's been doing it more and more lately, employing a technique that was much more in evidence when he started in private practice some 45 years ago. Much has changed, he said, in the way primary medical care is dispensed.

"We're on our own," he said, referring to baby boomers. "It's getting more complicated, with the insurance, governmental intervention ... Insurance companies are concerned about costs and they have a right to be. I see lots of tests being done for the sake of doing them."

"The narrowing of a heart valve requires an echocardiogram. But do you need to check it every six months?" he said.

Akus said the confluence of aging physicians and forces unleashed by the corporatization of medical care ― none of them evil, by the way, but merely the "price we pay" ― have created "a perfect storm."

Most of his patients are older than the boomers, in their 80s and beyond. Those in the largest age group, he said, are in their 90s.

"I have patients who have to go to the hospital, where they get very fragmented care," Akus said. "They have hospitalists now who do a very good job. But there's lots of tests and X-rays that generate charges. Patients see so many doctors, then they're discharged with no plan. There's no thought about their story."

"And we have to put the puzzle together," he said of doctors outside the hospital.

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Akus treated Rose's late husband and has treated her children and grandchildren.

Diagnosed with congestive heart failure, Rose experiences shortness of breath and uses a walker, her mobility somewhat curtailed since a recent hospital stay.

"It's fantastic he makes house calls," David Johnson said of Akus.

During the visit that lasted about 30 minutes, the doctor found Rose to be doing pretty well.

"You seem a little bit better than last time," he told her.

She was tired, though.

"I've been puttering around this morning trying to get some things done," she said. "I was able to function better than in the last few days."

On this St. Patrick's Day, she had corned beef cooking.

Akus checked on the status of her prescriptions and, in response to David's question about her breathing, said he'd give some thought to increasing the dose of the Lasix she's taking.

Then he engaged Rose about her gardening.

"I don't think I'm going to garden this year ― just a few pots," she said.

He suggested she keep her hands in it.

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Akus said his patients often ask him when he's going to retire.

"I have no plan," he said he tells them. "I enjoy what I do. I get frustrated, but basically I enjoy it."

A Willimantic native, he graduated from UConn and the Tufts University School of Medicine in Boston and did his residency at Rhode Island Hospital in Providence. Then he joined his father-in-law, Dr. Albert Gosselin, in a family practice in Jewett City.

"I did house calls with him, and saw how families were appreciative of him," Akus said. "I wanted that kind of feeling."

He started his Norwich practice from an office in Backus and moved to his current location about 25 years ago. Over time, he made fewer and fewer house calls, a trend he's happy to now be reversing, on average making two or three calls a week. The vast majority of his patients still come to his office.

He said most physicians are employees now, working not for patients but for corporations. And like workers, they're evaluated according to their productivity ― how many patients they see in a day, how many tests they order.

In another throwback, his wife, Sandra, helps him run what he calls his "mom and pop" office. He also employs two medical assistants. Walking a visitor through the facility, he joked it might be a museum one day.

"Most young doctors today couldn't open their own practice," he said. "They'd rather work a 9-to-5 job."

"But being an employee of a corporation doesn't lend itself to getting to know families," he said.

b.hallenbeck@theday.com