2008 Comeback Stories: The return of the house call

This post is part of our series about people, places and things that have found new life in 2008.

When I was growing up, our pediatrician lived two doors away. After hours, the doctor could usually be found toiling away in his garden. When one of the four kids in my family got sick, my mother would tell us to cut through the neighbor's backyard, and go tell the doc what was wrong, in order to avoid both the waiting room and the bill. Of course, the doctor made house calls if we were really sick. Such personalized medical care seems a nostalgic memory, but in some places, house calls are making a comeback.

From 1998 to 2004, the number of physician house calls increased 43% to two million annually, according to a 2006 study reported in the Journal of the American Medical Association (JAMA). House calls by physician assistants and nurse practitioners also increased during that time.

So far, the trend seems to be most common in urban areas where emergency room waits seem endless and where it can also be difficult to get an appointment with a primary care doctor. "It's really designed for major urban markets where it's more difficult to get a doctor's appointment," says Kate Dussault, chief marketing officer for Sickday Medical House Calls, a team of six doctors and four physician assistants who offer acute medical care in Manhattan via house calls. In most cases, Sickday doctors arrive at your door (or your hotel room) within an hour or so of calling.

Most doctors who perform house calls charge a flat fee for the service, unlike so-called concierge or boutique medical practices, where patients pay thousands of dollars a year to have 24-hour access to a doctor. For example, Sickday charges $250 for a 30 to 40 minute visit and some patients' insurance plans will reimburse them for the visit.

Even though there may be increased interest in house calls, the trend may not spread so quickly in part because most doctors simply don't have the time. "House calls have generally been performed by primary care physicians, an area of increasing workforce shortage," notes internist R. Hal Baker, MD, Vice President and Chief Medical Information Officer of Wellspan Health, a non-profit community based health care system in Pennsylvania and Maryland. Baker points out that without access to patients' electronic health records (containing a patient's lab results, x-rays, etc.), which are increasingly used nationwide, doctors making house calls may not be able to provide the same quality of care as in an office setting.

To find a doctor who makes house calls in your area, visit the American Association of Homecare Physicians.

Michele Turk is married to an ob/gyn doctor who does not perform house calls.
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