It might be hard to imagine, but there was a time in the U.S. when doctors regularly made house calls. Yes, they came to your home when you felt sick. What a luxury – no dragging yourself (or a loved one) out of bed, spending the time and energy to get to the doctor’s office or hospital, then sitting in the waiting room when what you really want is to be home in bed.
When you’re feeling lousy, getting to the doctor or hospital can seem overwhelming. When you are critically ill, elderly, or both, getting out of your home for medical care might not just be an inconvenience, it can seem downright impossible.
Unfortunately, regular house calls went by the wayside in the 1960s, when doctors worked towards economic efficiency, insurance plans became more commonplace, and the doctor-patient relationship moved from personal to more business-like.
Good news – house calls are making a comeback! It’s good for patients, and it’s good for our collective wallets.
What does the research show?
A recent study of “high risk” patients – older and with multiple co-morbidities – found that house calls could provide a better level of care for patients. The researchers found that hospitalization rates dropped significantly for those who were enrolled in a home care program, from 159/1,000 patients to 100/1,000 patients. Money was saved in the reduction of healthcare spending and hospitalizations, as the medical teams were able to better monitor high-risk patients, and improve care coordination among multiple healthcare professionals. Study lead Glenn Melnick reports that “monitoring and coordination keeps them out of the emergency room and hospitals as inpatients.”
Another study of VA and Medicare patients found a 25% reduction in hospital admissions, a 36% reduction in hospital days, and a 13% reduction in combined costs for those in a home care program.
Note that these programs did not rely exclusively on doctors for home care. Participants were also visited by a variety of healthcare professionals, including nurse practitioners, nurses, physical therapists, dieticians, rehabilitation therapists, mental health providers, and/or social workers.
It’s also worth noting that the savings identified in these studies doesn’t include money that patients and families can save with home care, including a reduction in expenses such as gas and parking.
Do you have to be old and very sick to take advantage of house calls?
Although the medical world is moving towards providing more home care for those who are old and very ill, there is also movement in our new “service economy” to provide house calls to anyone who wants one.
How do you find a doctor to come to your home?
If you, or a loved one, are elderly and/or very sick, ask your doctor if he/she makes house calls, or if he/she could refer you to a practice, program or hospital that does so.
If you are just looking for a doctor to come to your home, because it is more convenient or you are away from home, you can use an app to find a doctor who will come to your home (or hotel, etc). Apps for home-based care include Heal and Pager (Pager also provides phone and video consults). Note that these services are not available in all locations, and costs may not be covered by your insurance policy. It’s also important to realize that these apps, and the care they provide, are not a substitute for emergency care. Obviously, these doctors cannot bring heavy and/or complex equipment with them, and cannot perform surgery and other procedures that require specialized expertise.