Which chronic conditions we cover at home
During acute flares or decompensation we treat the common chronic diseases. Arterial hypertension with blood pressure peaks, type 1 and type 2 diabetes with hyper- or hypoglycaemic derailment, COPD with exacerbation, asthma with attack short of life-threatening dyspnoea, stable coronary artery disease, heart failure with decompensation at NYHA II–III, chronic kidney disease, atrial fibrillation, Parkinson's disease and rheumatological flares.
We also cover symptoms in internal-medicine oncology under outpatient chemotherapy: nausea, fever below the threshold of febrile neutropenia, pain crises, manageable infections. For life-threatening courses we arrange hospital admission.
Patients with chronic psychiatric conditions such as severe depression, anxiety or developing dementia receive somatic care and we facilitate referral to a Berlin psychiatric specialist.
Care strategy between practice, hospital and home
Outpatient management of chronic disease in Berlin depends on the interplay between family doctor, specialist practice and where relevant a hospital outpatient clinic. RAB is the fourth element: the bridge when a patient needs acute care between appointments and travelling to the practice is unreasonable.
Our specialists – general practitioners and internists among them – act not in competition but complementary to the regular family doctor. We document every visit, write a structured report and send it directly to the family doctor or specialist on request.
This integrated view reduces hospitalisations. Studies from the German system show that structured outpatient acute care for the chronically ill can reduce hospital stays by twenty to thirty percent. RAB patients benefit from this in daily life.
Examples: typical house calls for chronic disease
Diabetes example: A seventy-eight-year-old patient in Steglitz-Zehlendorf on metformin and sitagliptin develops blood sugars up to 280 mg/dl after a viral infection. We assess clinically for diabetic ketoacidosis, check vitals, temporarily adapt therapy and schedule close telephone follow-up. Outcome: no hospital, but structured home adjustment.
COPD example: A sixty-five-year-old patient in Pankow at GOLD stage II shows increasing dyspnoea and cough. Pulse oximetry reads 91 percent. We treat outpatient with short-acting bronchodilators, a steroid burst and antibiotic where indicated. Follow-up after forty-eight hours. With saturation below 88 percent or deterioration we organise hospital admission.
Heart failure example: An eighty-two-year-old patient in Charlottenburg-Wilmersdorf develops increasing leg oedema and exertional dyspnoea. Clinical examination, ECG, pulse oximetry. We adjust diuretics, add telephone monitoring and arrange an early echocardiography at the Reiche private practice.
Repeat prescriptions, medication review, polypharmacy
Patients with chronic disease often take five or more medications in parallel. Polypharmacy carries risks: interactions, opposing indications, paradoxical effects. During the house call we take time to review every current medication – including over-the-counter preparations and supplements.
We renew private prescriptions for regular medication when the indication is documented and no adjustment is needed. Adjustments are discussed with the patient and recorded for the family doctor.
When inappropriate medication is suspected – anticholinergic load in geriatric patients, missing anticoagulation in atrial fibrillation, problematic combinations – we contact the family doctor directly after patient consent. This is collegial care, not competition.
Continuity with the Reiche private practice
The Reiche private practice, led by Susanne Reiche, complements the house call structure through outpatient consultations, diagnostics and follow-up. Patients who need continuity after an acute house call can secure an appointment there – significantly shorter than the general Berlin practice waiting times.
This integration is particularly valuable for chronic patients: lung function follow-up after COPD exacerbation, HbA1c and structure review after diabetes decompensation, echocardiography and laboratory after heart failure decompensation.
On request we coordinate handover to sub-specialists such as cardiologists, pulmonologists, diabetologists or nephrologists within the Berlin private network. Call +49 30 550 77 870 – dispatch arranges both acute visits and outpatient follow-ups.