Fiona Tobler recently created her Happy Tired Dog service to provide high-energy dogs, like her border collie mix Marty, with activities to keep them occupied and out of mischief. She is one of several Howard County women who have started businesses based on needs they have found in the community. Photo by Jenni Combs

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Recently, after spending decades on other pursuits, three Howard County women independently decided it was time for them to start up their own companies — both for- and not-for-profit.

It wasn’t so much a sudden — or even a lingering — desire toward entrepreneurship that moved them to create their new enterprises. Rather, each wanted to fill a perceived community need.

Sandra Nettina, 57, a nurse practitioner with 25 years of experience, decided it was time for a medical professional to revive the once common practice of house calls. Prime Care House Calls operates out of Nettina’s West Friendship home.

Susan Cohen, 60, a former longtime resident of Columbia and Ellicott City, recently moved to Kansas. She began a nonprofit organization, Americans for Older Driver Safety (AFODS), that has a grant for work in Maryland.

A dogged pursuit

For Columbia resident Fiona Tobler, 61, it was the recent acquisition of a mixed border collie named Marty that led her to see that a regimen of “enrichment training” was necessary in order for her dog (as well as all other canines, and their owners) to find contentment. Thus was born Happy Tired Dog, Inc.

Tobler worked at the Nuclear Regulatory Commission for 34 years. When she retired in 2009, she decided to get the first dog she had owned since she was a child.

“Í got him as a puppy from a shelter. Now, five years later, he has definitely changed my life,” Tobler said. “I got to experience the joy of having a dog, went to training classes, and started my own business because of him.”

 Happy Tired Dog, Inc., which Tobler just started operating in December, provides “home training and enrichment sessions,” in which the pet owner is shown “how to use dog puzzles, food dispensing toys, and games to tire out your dog inside your own home.”

Tobler believes that dogs should not be fed their meals out of bowls. Most dog owners, she said, are not aware of food dispensing toys, which make the mutts, and thoroughbreds, “work for their food, as they would in the wild.”

She noted that the physical and mental challenges of the toys keep dogs from getting bored. Boredom in dogs can lead to them shutting down or acting up, “just like some people you may know,” Tobler said. 

An added advantage of the enrichment training, she pointed out, was that on icy winter days or in overheated summers, the dogs will be able to romp around indoors, enjoying a variety of foraging and hunting-like activities.

The training sessions, she pointed out, are especially helpful for dog owners who are “busy, tired, short on time, physically impaired, or just wild about having fun with dogs.”

Besides making house calls, Tobler sells a 30-minute video (price $15) on her Happy Tired Dog website. Her 90-minute in-home sessions cost $75. She brings along all the training toys, and guarantees that “your dog will be tired when I leave.” 

Learn more at www.happytireddog.com or by calling (410) 290-5159.

Making house calls

Sandra Nettina, a nurse practitioner, has taken up a practice that most medical doctors have long abandoned: making house calls to treat sick patients. She is the only medical provider in Howard County that she knows of who regularly goes to patients’ homes to diagnose and treat them.

Since she started Prime Care House Calls in January 2015, Nettina has been making about 15 home visits a week. Many of the patients she visits come through referrals from home nursing agencies, she said.  

“I’m specifically making visits to people who are homebound and feel isolated. When I worked in doctors’ offices, I would see patients coming in with wheelchairs or  walkers, and I could see that it was really difficult for them to make the visits.

“We’re living longer. There is a need of aging patients for home visits. So I started doing them,” she said.

Nurse practitioners are registered nurses with advanced clinical training that qualifies them to diagnose medical problems, order treatments and tests, perform advanced procedures, prescribe medications and make referrals.

While nurse practitioners mostly work in hospitals, private offices, clinics and nursing homes, in Maryland, they are not required to practice under a physician’s supervision.

The profession began in the mid-1960s, when there was a shortage of doctors. Today, there are some 180,000 nurse practitioners around the country. 

As for house calls, many family doctors made them through the 1950s. But as insurance companies and government health programs started setting reimbursement rates and expecting higher efficiency, fewer and fewer doctors found it profitable to take the time to make house calls.

Even today, making house calls “is not a way to make a lot of money,” Nettina said. “I have to submit the charges for the visits, and often have to fight for reimbursement from insurance companies.” She said she has to work part time in a hospital to make a living.

But she said she will continue to make house calls because “I do patient care, and I love it.”

To learn more about Prime Care House Calls, visit www.primecarehousecalls.com or call (443) 280-3480. 

Born of tragedy

Susan Cohen’s nonprofit enterprise was spurred by a family tragedy. In 2011, Cohen’s 20-year-old son was killed by a car while biking near Johns Hopkins University in Baltimore, where he was a student. An 83-year-old driver turned into the bike lane without noticing him.

Cohen, a lawyer who had worked in the Maryland attorney general’s office, was studying for a career switch to public health when the tragedy occurred. She then began to research safety and older drivers, and found what she felt was a paucity of concern.

“I realized this was an area of public health neglected across the country. There is plenty of public awareness for seat belt use, but little about driving safety and the elderly. I decided I should help raise awareness of aging and driving, and of medical conditions that can make it unsafe for older people to drive,” she said.

Cohen offers seminars around the area to help make older drivers more aware of medical impairments that come with aging that could affect their judgment or physical abilities.

“It’s not about age, it’s about function,” she said. “But as we age, our ability to drive a car changes.” 

Cohen suggests drivers start downsizing their driving time after the age of 70, cut down on nighttime driving, and ask family members to ride along to observe their abilities or any decline thereof.

She noted that the aging of the baby boom generation, who took to the wheel like no other generation before or after, makes the concern a growing one. The number of Americans age 65 or older is expected to more than double by 2050 — from the current 40 million to 88 million.  

State driving laws also have come under Cohen’s scrutiny. Among other things, she has been advocating for a change in the Maryland Department of Transportation regulations regarding driver license renewals, which are required every eight years.

Drivers need to appear in person for eye exams at a motor vehicles office only every other renewal — or once every 16 years.    

“Older drivers should have to renew more frequently,” Cohen believes. “They’re not worse drivers, but they’re more likely to have medical impairments” that a trained DMV staffer could spot.

To learn more about Americans for Older Driver Safety, call (443) 520-9716 or visit www.afods.org.