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Doctors Return to House Calls

By Dr Christopher Segler

Republish: EasyPublish™ Published: 03Feb2010 Word count: 945 Viewed: 691 time(s) Get Free Content For Your Site

Nancy noticed her husband clutching something in his hand. “Ronnie, what is that?” she asked. He opened his hand and revealed a small plastic model of the White House, that he was holding. He said, “I am not sure what it is, but it has something to do with me.”

For anyone has knows someone with Alzheimer’s disease, this story of former President Ronald Reagan doesn’t really seem far-fetched. It is painful to imagine that someone could be President and then have no clear recollection of it. A whole life lost, in a sense. It is also hard for the spouse an children providing care.
 Not only is it difficult to sit by, helpless, and watch the persistence of the disease eat away at the memory and character of a loved one, but it can be very challenging to get medical care. As Alzheimer’s progresses, agitation, anxiety and confusion can make it down right difficult to even get the patient in the car for a doctor’s appointment. But they still need care.

A long-time friend of my family developed Alzheimer’s. He was a father, a husband, and a successful retired businessman. I saw his wife at church one day. She came up to me and apologized for missing his appointment.

“Some days Harold just won’t get into the car. He gets frightened when he doesn’t understand where we are going. Sometimes it takes me hours to get him to the doctor. Last Wednesday, we were on the way to your office, but he got so confused and upset that we had to turn around and go home” she said, shaking her head.

I thought about this for a minute and said, “Why don’t you let me stop at your house on my way home from the office tomorrow night. I’ll see him there. That way, neither of you will have to worry. “You mean doctor’s still make house calls?”

House calls are a rarity these days, but they’re making a comeback. And with good reason. The aging Baby Boomer population is creating a rapidly growing need for those who find it difficult to get to the doctor’s office. In addition, more families are doing their best to keep aging loved ones at home, instead of sticking them in some nursing home.

Doctors are now reconsidering house call based practices. Many of the doctors that are making house calls do so simply to have the patient-doctor relationships they crave, and thought they would get when the enrolled in medical school. House call doctors are abandoning the rat race in exchange for meaningful medicine.

The reality is that big insurance companies have been paying doctors less and less over the past fifteen years. Many doctors get paid less today for office visits than they did when they first started practice. The only way to make up for the lost revenue is to see more patients. That means less time with each patient. No more time for “how are the grandkids...” The doc is just running from treatment room to treatment room, often seeing as many as 60 patients a day.

The average time a patient spends in the doctor’s waiting room is 68 minutes. But the average time spent with the doctor is only about 10 minutes. This is a direct result of decreasing reimbursement from insurance companies. So many docs are abandoning the big insurance ship. They crave the days gone buy when a doc understood who the patient was, and took a genuine interest in their well-being.

Housecalls allow the doctor to regain control of meaningful medicine while decreasing costs for the patient. The patient who is seen at home is never sitting someplace waiting in a dingy room with outdated magazines. They are at home, comfortable and at ease. There is time to talk. The daughter or wife doesn’t have to cancel a half day of work just to spend ten minutes with a physician across town. As a result, the patient saves money on gas, lost wages and toll road fees.

But even more important, there is a renewed ability to understand the patient. With the doctor’s visit right in the living room, it easier for the doctor to determine other needs that might not be considered. The doctor would know it is a two-story house. With a broken metatarsal bone in the foot, a cast and crutches really wouldn’t be a good idea. A fracture walking boot might be better. These sorts of problems often get ignored during rushed office visits.

The choice to pursue medicine is personal and is not taken lightly. A doctor spends between 10 and 16 years after high school in college, medical school and residency. Some do it for the money, but most do it because it is a higher calling. It is a chance to spend a life helping people in their time of need.

For the doctors who choose to make house calls, it will usually mean making less money. But they have a much more meaningful, personal practice. For their patients, it can mean real medicine with a doctor who really cares.

Dealing with a loved one at home with Alzheimer’s is tough enough. Getting good compassionate medical care shouldn’t be a burden. No matter where you live, there is almost certainly a physician near you that is willing to make house calls. Doctors in specialties ranging from Primary Care to Podiatry are again making housecalls. A brief internet search can go along way to helping you find the care at home you need to make your life a little easier.

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