Before leaving the office to visit a homebound patient, Dr. Tony Ohotto gathered a few necessities: his stethoscope, medical notes, and a pair of well-worn bicycling shoes.

Dark clouds threatened rain, so Ohotto packed a rain slicker before hopping on his 10-speed. Kevin Callahan, a

, joined him for a 15-minute ride to their patient's home, a residential care facility in Southeast Portland.

"When you roll up on a bike, it gets you some street cred with patients and caregivers," says Ohotto, a geriatric specialist and staff physician at

, a program that provides health care, housing and other services for older adults.

Through good weather and bad -- and despite the social and professional pressures favoring car transport -- Ohotto and Callahan have found on-the-job bicycling to be eminently practical.

Callahan took up cycling for the obvious benefits: exercise, avoiding traffic jams, spending less money on gas. Ohotto says he began using his bike for home visits more or less out of necessity. He wanted to commute by bike, which left him without a car at work.

Both have discovered unexpected benefits. Callahan said the impression he makes when he shows up on a bike helps establish rapport with the chronically ill and disabled people he cares for.

"I tend to get a little easier buy-in," Callahan says. "People see you as regular human being rather than the intimidating medical professional."

Bicycling also improves the caregiver's state of mind. Callahan says riding to a client's home gives him a few invigorating minutes to breathe fresh air, get the blood circulating and clear his head. It helps lighten up interactions with clients. "I'm feeling refreshed, energized, and ready to roll," he says.

"It helps with attitude adjustment," Ohotto agrees.

Greg Rillera, who runs two adult care homes with his wife and sister, was surprised the first time he saw Ohotto arrive on a bicycle.

"I didn't realize he was a doctor," Rillera says. He decided that the doctor was serving as a good role model, engaging in healthy exercise and polluting less. But he wondered if bicycling would waste too much time.

"All I know is, time is gold, you need to work faster. That's what my question is."

Because of time pressure, Ohotto doesn't ride as often as he'd like. For many home visits, he carpools with a one of ElderPlace's registered nurses. Not only can he travel faster, but he can also use the time in the car to discuss care issues and solve problems.

But Callahan says that in five years, he's rarely needed a car. "My visits tend to be with residences and skilled nursing facilities within 4 or 5 miles. So it's relatively efficient."

Despite the much talked about animosity of motorists toward cyclists, Callahan says in his experience, Portland drivers are overwhelming polite. Oregon's notorious weather isn't as bad as its repution either, he says.

"There is no such thing as bad weather, just bad clothing."