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Northampton physician offers house calls by bike

NORTHAMPTON, Mass. – After 17 years working in hospital emergency rooms, physician Jill Griffin tuned up her bicycle and launched a new venture she's calling PedalMed.

Griffin, 53, started cycling around the area earlier this month offering "health coaching" house calls to people with chronic diseases and other health issues. With realistic goals and encouragement, she thinks she can get them healthy at home, and keep them out of the ER.

She has been health coaching for two years, both by phone and at an office at 41 Locust St., ever since she realized that the health care system in the United States is "broken" because it does not support preventive care.

"Instead of focusing on medical care, which is what our system does, we should be focusing on getting healthy," she said.

The pedaling part of the business will help her keep control of her own disease, type 2 diabetes.

"I said if I'm going to get healthy and take care of my own diabetes, I've got to get more active," Griffin recalled. She found a free bicycle trailer on the side of the road, outfitted it with a PedalMed sign and loaded on a few medical supplies, and she was ready to hit the road.

Northampton City Clerk Wendy Mazza said PedalMed is the first business she has registered that does medical house calls by bicycle. Other businesses relying on bicycles for transportation include Pedal People, a Northampton business that transports everything from trash to furniture, and Halo Bike Couriers in Hadley, which delivers packages and paperwork and offers postering services.

After visiting five clients in her first two days of health coaching house calls, Griffin said she knew she made the right decision in starting the business.

"I go home every day excited," she said.

Griffin said working in emergency rooms gave her a unique perspective into the health care system.

"If you come into the ER with congestive heart failure and your lungs are full of fluid, I'm going to get the fluid out and then send you home to be sick. I'm putting a Band-Aid on disease," she said.

What she would rather be doing is visiting that patient at home, teaching him or her about lifestyle changes that could prevent another episode. "I'll ride my bike to your house and we'll talk about it. I'm not going to change your medications, I'm going to answer your questions," she said.

On her second day in business, Griffin pedaled to 582 Spring St., the home of Karen Mandeville, 59, and Samuel Adams, 69.

Most of her clients are older and suffer from chronic conditions such as heart disease, Crohn's disease, irritable bowel syndrome, high blood pressure or, like Adams and Mandeville, diabetes.

Usually she finds clients by word of mouth, but Griffin and Mandeville found each other on Aug. 12 when Mandeville put a request on Freecycle.org looking for a book about how diabetics can get healthy. Griffin emailed her, offering to help.

"She came over the same day," Mandeville said.

Three-and-a-half months later, Adams has shed 33 pounds and has reduced his insulin intake from eight shots a day to two. He can walk without the help of the two canes he used to use because his weight and his high blood sugar made him tired. "He used to have two chairs from here to the mailbox so he could rest," Mandeville said, gesturing to the approximately 75-foot stretch, which is now chair-free.

"It was really important to me to get him healthy because we just got married and I want him around for a while," Mandeville said. The couple married Nov. 11, 2011, after 17 years together.

She lost 22 pounds herself, and is completely off the insulin she used to inject twice daily and her oral medication. "Next, I want to get off my high blood pressure meds," she said.

Griffin said the key to helping people get healthy is "small steps." If you tell an out-of-shape person they have to drastically change their diet and start walking three miles a day, it won't happen, she said.

So she started them on house and yard work, including cleaning the garage, and later added riding a stationary bicycle, just three minutes a day at first, and then slowly lengthening the workout intervals.

With Griffin's expertise, she could do house calls to treat people, but she doesn't see the point. "I thought about it, but I'd still be putting a Band-Aid on it," she said.

Griffin said she got into health coaching because she used books and other expert opinions to coach herself when she was struggling to get her own diabetes under control.

She launched her health coaching business two years ago and now has between 25 and 30 clients. She coaches them mostly by phone because she has been busy with her other jobs, but some of her clients live in other parts of the country, she added.

With the advent of PedalMed, she is hoping to do many more house calls than phone calls.

"I'm doing 15 miles a day now, but I'd like to be riding 50 miles a day, year-round," she said. "I've got studded snow tires." She said she has only traveled to clients in Northampton so far, but is excited to expand her network now.

She works with a billing company and accepts all insurances. Her rates for the uninsured are on a sliding scale – $100 per session at the most – but she said she is happy to work with uninsured people to make the coaching affordable.

Since starting PedalMed, Griffin has reduced her hours at the Mercy Medical Center emergency room to one day a week. She also works part-time at Clean Slate, a substance-abuse treatment center in Northampton.

Griffin said she thinks that meeting her clients at their homes can help her connect with them more than she would in a white lab coat at a doctor's office. "It helps to see I'm a human being and we're working toward a common goal," she said.

The thing that has surprised her most about the business is how much fun she would have with her clients, who quickly become friends. "It's amazing. I love these guys," she said of Mandeville and Adams, while sitting at their kitchen table recently.

Mandeville even joined her family for Thanksgiving dinner because Adams was out of town for the day.

"I love it," Mandeville said of Griffin's visits. "We both look forward to it."

Griffin said she hears positive comments from people when she rides her bike around town, towing her PedalMed sign. Some of those who stop her are doctors who say they wish they could focus more on preventive medicine, she said.

She said she used to believe the doctors who said their patients don't want to change to get healthy.

"But it's not true," she said. "I have yet to go to someone's home and find that they don't want to get better."

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