The Return of a Bygone Tradition: Doctors’ House Calls

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Years ago, it was commonplace for a doctor to make house calls to patients. As medical technology progressed, this became a rarity. Many of the complex pieces of equipment a doctor relied on were too bulky to transport to a patient’s home. Going to the doctor’s office became the rule, and house calls became the exception. Now, technology has produced smaller and more portable medical equipment. Armed with such small but powerful devices, many doctors are again beginning to make house calls.

House Calls Are Becoming More Affordable

Many doctors, due to pressing schedules and unwieldy vital equipment, only made house calls in extreme situations. A hefty price tag accompanied such calls, as doctors charged significant premiums for the inconvenience.

Since, as mentioned, technology has made house calls more feasible, the costs of house calls have diminished. This, combined with the emergence of a patient-centered view towards practicing medicine, has led to the re-emergence of house calls.

There still remain some significant hurdles to house calls becoming commonplace again. Yet there is a trend towards the increase of the practice. This trend began with a change in the perception of lawmakers and patients alike. If legislation can pass authorizing Medicare to cover care done in a patient’s home, house calls will increase. Since Medicare enjoys widespread bipartisan support, the legislation may pass and the revival of the practice may speed up.

 

What House Calls Mean for Elderly Patients

The major beneficiaries of the trend back towards house calls are elderly patients limited in mobility. Many caregivers are familiar with the challenges of getting an elderly person of compromised mobility to the doctor’s office. Now, instead of being forced to go through the machinations of doing so, caregivers may soon find the doctor’s office coming to them.

Procedures that would require a doctor’s office visit—such as X-rays, EKGs, and other diagnostic procedures—may now be done in the comfort of an elderly person’s home. This, in turn, simplifies health care and contributes to the ability of seniors to age in place.

Caregivers know that an elderly loved one’s emotional condition can greatly impact his or her quality of life. Now, because much more medical care is available in the home, there are fewer pressures to institutionalize an elderly patient. This means seniors can live at home longer, resulting—in many cases—in higher satisfaction and increased happiness.

 

What Can Caregivers Do?

As with anything involving a radical change in health care practices, there are significant legislative hurdles. As noted above, an expansion of the services that Medicare covers would be a significant step forward in this arena. Other issues involve caregiver liability for care rendered in the home, procedures for quantifying and classifying services provided in an elderly patient’s home, and others.

What can caregivers of elderly loved ones do to move the process along? One thing to do is contact legislators and let them know that this issue is important. Providing adequate health care to elderly persons in the comfort of their own homes should have favor on both sides of the aisle in Washington. Regardless of personal political affiliations, advocating for the elderly is everyone’s issue.

In addition to contacting lawmakers, caregivers can take steps to increase the availability of health care in the home by searching for advocacy groups for elderly patients and assisting them in their endeavors. There are a number of patient advocacy groups working for change in the administration of health care services. Simply joining one of them would be a useful first step.

The future of aging in place involves receiving health care in the home. To this end, caregivers should work towards making house calls a commonplace practice once again.

 

Sources

De Jonge, K. Eric, Jamshed, Namirah, Gilden, Daniel, Kubisiak, Joanna, Bruce, Stephanie R.,Taler, George. (October 2014). Effects of Home-Based Primary Care on Medicare Costs in High-Risk Elders. Journal of the American Geriatrics Society, 62(10). Available at http://onlinelibrary.wiley.com/doi/10.1111/jgs.12974/full. Last visited October 3, 2016.

Meyer, G., and Gibbons, R. (December 19, 1997). House Calls to the Elderly—A Vanishing Practice among Physicians. The New England Journal of Medicine, 337:1815-1820. Available at http://www.nejm.org/doi/full/10.1056/NEJM199712183372507#t=article. Last visited October 2, 2016.

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