Nurse Practitioner / Physician Assistant - Home-Based Primary Care

Home-Based Primary Care – San Diego County
Four-Day Work Week | No Call | Physician-Owned Practice

Old-Fashioned House Calls. Modern Internal Medicine.

Medicine has changed dramatically over the last century. One thing shouldn’t have: the value of truly knowing your patients.

Comprehensive Medicine is a physician-owned Internal Medicine practice providing home-based primary care to medically complex adults throughout San Diego County. We are not a Home Health agency, hospice organization, or nursing service.

We are the patient’s primary care provider. Our office simply happens to be wherever the patient calls home.

Patients may live in a private residence, independent living community, assisted living facility, or residential care home. Wherever they live, our mission is the same:

Keep patients healthy, independent, and out of the emergency room whenever safely possible.

About the Role

We are seeking an experienced and compassionate Nurse Practitioner (NP) or Physician Assistant (PA) to provide comprehensive Internal Medicine and primary care services to medically complex patients in their homes.

This is a highly autonomous clinical role for a provider who wants more time with patients, greater continuity of care, and the opportunity to practice medicine outside of a high-volume clinic environment.

Rather than treating a single complaint and moving on, you will become the clinician who truly knows the patient—their history, medications, specialists, family dynamics, living environment, and ongoing medical needs.

You will follow patients over months and years while coordinating care across the healthcare system and identifying problems early enough to help prevent unnecessary emergency room visits and hospitalizations.

What You’ll Do

• Provide comprehensive primary and Internal Medicine care to adult and geriatric patients in their homes.
• Evaluate, diagnose, treat, and manage acute and chronic medical conditions.
• Develop individualized treatment plans for medically complex patients.
• Perform comprehensive history and physical examinations.
• Manage chronic conditions such as diabetes, hypertension, heart disease, COPD, kidney disease, and other common Internal Medicine diagnoses.
• Review and reconcile medications and address polypharmacy concerns.
• Order, review, and interpret laboratory testing and diagnostic studies.
• Coordinate mobile diagnostic services including portable X-rays, ultrasound, EKGs, and other testing when appropriate.
• Recognize changes in patient condition and intervene early to help prevent avoidable emergency department visits and hospitalizations.
• Provide follow-up care after hospitalizations, rehabilitation stays, and other transitions of care.
• Coordinate treatment with physicians, specialists, hospitals, skilled nursing facilities, Home Health agencies, hospice organizations, therapists, pharmacies, and mobile diagnostic providers.
• Communicate with patients, family members, caregivers, and facility staff regarding treatment plans and changes in condition.
• Educate patients and caregivers regarding diagnoses, medications, preventive care, and disease management.
• Maintain timely and accurate clinical documentation.
• Develop long-term relationships with patients and their families through consistent continuity of care.

What Makes This Role Different

This is not traditional high-volume outpatient medicine.

You will have the opportunity to understand the full clinical picture—not just what appears during a 15-minute office visit.

You’ll see how patients actually live, how they take their medications, what support systems they have, and what barriers may be preventing them from staying healthy.

You’ll also gain a deep understanding of how every part of the healthcare system works together, including hospitals, specialists, rehabilitation facilities, Home Health, hospice, pharmacies, and community-based services.

Most importantly, you’ll have the opportunity to keep patients from falling through the cracks.

Qualifications

• Licensed Nurse Practitioner (NP) or Physician Assistant (PA) in the State of California.
• Graduate of an accredited Nurse Practitioner or Physician Assistant program.
• Current national board certification.
• Current DEA registration or ability to obtain one.
• Experience in Internal Medicine, Family Medicine, geriatrics, hospital medicine, primary care, or another closely related specialty preferred.
• Experience working with medically complex or geriatric patients strongly preferred.
• Strong clinical assessment and diagnostic skills.
• Comfortable practicing independently in a mobile/home-based environment.
• Excellent communication and care coordination skills.
• Ability to build long-term relationships with patients, families, caregivers, and other healthcare professionals.
• Valid driver’s license, reliable transportation, and ability to travel throughout the assigned San Diego County territory.

Ideal Candidate

You may be a great fit if you:

• Want to spend more meaningful time with patients.
• Enjoy managing complex Internal Medicine cases.
• Value continuity of care and long-term patient relationships.
• Are comfortable making clinical decisions independently while collaborating with physicians and other members of the care team.
• Enjoy solving problems and coordinating multiple aspects of a patient’s care.
• Want to practice proactive medicine rather than repeatedly treating preventable crises.
• Believe excellent primary care can prevent unnecessary hospitalizations.

Schedule

• Four-day work week
• No call
• Home-based patient visits throughout an assigned San Diego County territory

Why Comprehensive Medicine?

Our practice was built after seeing the same cycle happen far too often:

Emergency room → Hospital → Rehabilitation → Home → Back to the emergency room

Many of these patients lacked consistent primary care from someone who truly knew them and could recognize problems before they became emergencies.

Comprehensive Medicine was created to change that.

We bring comprehensive Internal Medicine directly to patients who may have difficulty accessing traditional office-based care. Our providers build relationships, coordinate care, identify changes early, and help patients remain healthier and more independent in the place they call home.

If you’re looking for an opportunity to practice thoughtful, relationship-driven medicine while enjoying a four-day work week and no call, we’d like to hear from you.

“We didn’t build this practice because house calls are nostalgic. We built it because too many patients were cycling through emergency rooms, hospitals, rehabilitation facilities, and back home with no one truly coordinating their care. We believed there had to be a better way. We still do.”
Brian Peterson, PA & Dr. Mary Gessner-Peterson