PUBLISHED: 6:02 PM on Wednesday, August 20, 2008
New medical provider goes old school
Nurse Practitioner makes house calls to aid the weak and weary
JUNEAU - Local Nurse Practitioner Janna Brewster has started a house call practice called Alaska In-Home Medical Services. Some people are old enough to remember when the doctors came to our homes, but for most a doctor who makes house calls is a relic of the past that we only know about from watching television and movies.

Erik Stimpfle photo
  Nurse Practitioner Janna Brewster, of Juneau, visits one of her patients at home. Brewster saw a need for in-house medical visits and is the only medical provider in Juneau who exclusively makes house calls.
However, there is a new woman in town and she carries a medical bag and will visit sick people in their homes. As a nurse practitioner, Janna Brewster is considered a mid-level medical provider. Nurse practitioners are registered nurses who receive specialized training beyond what a regular nurse receives. Nurse practitioners can diagnose and treat common illnesses, order diagnostic tests, review and prescribe medications, and make referrals.

"We do most things that family practice physicians do," Brewster said, describing the services she provides.

Brewster worked as a registered nurse for 27 years before she decided to attend graduate school at the University of Vermont to become qualified as a nurse practitioner. Having worked 15 years as a homecare nurse, she cared for many older people who had difficulty getting to their physician or even a hospital. She recognized the need for house call services for these patients.

Aside from having trouble getting to a hospital, there is also the expense that comes with getting admitted into a hospital for treatment by a doctor. It's common knowledge that staying in a hospital can be expensive. Brewster has been able to help people avoid expensive stays in the hospital by seeing them at home.

She has worked with many elderly people suffering from a variety of chronic illnesses, such as congestive heart failure. These fragile patients needed to be seen by a doctor but they didn't need to spend the night in a hospital.

"Basically, all it might take is a little tweaking of their medications and you can keep them in their home, Brewster said. "They don't need to spend the night in a hospital."

Brewster said there are some doctors in town that make house calls for their sickest patients, but she is the only practice that does house calls exclusively.

For one of her first house calls patients in Juneau, Brewster was a Godsend. John, who didn't want his real name used in this article, has suffered from chronic neck pain for 30 years, which has gotten progressively worse. John injured his neck jumping off an eight-foot-high partition at a construction site. He landed in a squatting position, looking up, and heard a popping sound in his neck.

His neck didn't heal properly and over the years his pain worsened. It was caused by a calcium build up in his neck that was putting pressure on the nerves close to his spinal column. When this would happen, John's pain was so excruciating that he was unable to get out of bed.

"I would be lying in bed in so much pain that it would cause me to break down and cry," he said, describing the bouts of chronic pain. "I would be throwing up from the pain. I couldn't sleep for days."

He was also frustrated by going to see doctors who told him to come back in two weeks for an MRI. At other times he was physically unable to get out of bed to see a doctor.

When John heard that Brewster would be making house calls he was relieved to know that someone would see him at home when he was ill.

"Finally you can have a (medical provider) who will come into your house and look at you while the sickness is happening," John said. "They can see the extreme effects of that illness on you while it's happening."

Brewster made a referral for John to see a bone and joint specialist. John now says his quality of life is better than ever. "I never had this before until Janna helped me," John said. "Janna seems to have caught on to the fact that there are people out there that need a (medical provider) to come and see them."

Janna Brewster RN,MS,ANP (Alaska In-Home Medical Services) can be contacted at 723-6656 or She will have 5-6 appointments daily Monday through Friday on a first call basis. She does not currently accept private insurance but will provide a payment sheet to submit to the insurance provider for reimbursement. She will bill Medicare and Medicaid for those eligible.