History of the House call

What was your first image of a doctor growing up? For us, it was a kindly older gentleman opening his black bag beside a patient’s bedside. The patient was propped up on pillows, sweating while her parents dabbed her forehead with a cool compress.

The doctor administered a shot and then promised to return in the evening to see if there was any improvement.

We know, we know, our image is a bit outdated, but that was what all those old black-and-white movies on cable TV showed us. It was reflective of real life too —before World War II house calls comprised over 40% of physician encounters in the United States.

The reality of our childhood illnesses was far different, of course. By the time we were kids, in the 1980s, house calls comprised only 1% of care.

We would be hacking up a lung while our parents, looking harried, argued with each other about who was going to miss work that day to take us to the doctor. When they finally decided, we would be bundled up in a snowsuit and dragged to our paediatrician while we waited for hours staring at other kids, also hacking up a lung. After a 10 minute examination, our doctor sent us home. We stopped at the pharmacy along the way, sitting in the aisle, bored and miserable while waiting for our medication to be compounded.

How did the way we receive care change so much, so fast – especially when research on house calls consistently shows that it improves health outcomes?

House calls:

  • Create a closer, community-driven relationship between patients and doctors.
  • Identifies problems that may go unnoticed during an office visit, like environmental contributors to frequent falls.
  • Provides better coordination of care, since house call physicians are better prepared to partner with other home health providers, like pharmacy delivery services or caregivers.
  • Keep patients out of the emergency room. An incredible amount of emergency visits can be avoided if physician care was available outside of office hours to assess the complaint.
  • Remove accessibility barriers faced by people with disabilities and elderly patients.

House calls, in short, provide more comprehensive and supportive care.

So what happened?

Changing lifestyle

    • We became more spread out, moving from dense cities to the suburbs, making house calls less efficient.
    • Car ownership increased, so we could visit the doctor ourselves.

Obsession with productivity

    • As doctors increased their overhead, they were pressured to provide care as efficiently as possible, and started squeezing in as many patients as possible during the day.

Diagnostic technology improved and required space and maintenance

    • As technology improved, patients expected high-tech medicine and started to see house calls as “old-fashioned”, even when their diagnoses required low-tech care.

Liability

    • Although there has been very little litigation in home care, insurance companies, especially in the United States, became concerned about its potential.

Institutionalization

  • The medical field met the same fate of so many other sectors and professions that became more institutionalized after World War II. It moved outside communities and became more bureaucratic and impersonal.

House calls have started to make a resurgence, though, as the governments realize it actually saves money by freeing up emergency rooms and ultimately, hospital beds.

It helps that our lifestyles are changing yet again. People expect more convenient services, whether its transportation, finances or health care. In addition, diagnostic technology has improved to the point where it is almost all portable.  Coupled with a growing elderly and home-bound population, house calls are poised for a major revival.

That’s why MediSeen is here.

We’re committed to offering you convenient access to high-quality in-home health care through our digital house call platform.

MediSeen helps you build lasting relationships with health care providers in your community, allowing for consistent and familiar care.

We believe your time is valuable. It’s 2017 — you should be able to access health care the same way you access many other services these days — from the palm of your hand and at your doorstep.

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