The doctor IS in the house

April 21st, 2009 | Sources: Clinics in Geriatric Med., Washington Post


Dr. George Taler makes house calls!

The Washington Hospital Center-based physician belongs to an intrepid tribe of providers that are reviving a lost art one tongue-depressor at a time

Thedoctor'shere!Back in the 1930s, 40% of all encounters with physicians occurred in the home, but that number dropped to 10% by 1950, and 1% by 1980, according to Helen Kao and colleagues whose article appears in Clinics in Geriatric Medicine.

Patients preferred to visit hospitals and clinics, which were perceived to be modern wonders, jam-packed with gee-whiz diagnostic tools and treatments that became the sine qua non of medicine in the second half of the century.

Or, as Kao’s team put it, “house calls became old fashioned.”

Financial incentives also drove the migration. Physicians who opted for lucrative, technology-driven specialties found themselves tethered to the facility-based machines, while PCPs deduced that they could triple visit counts by having patients come to them rather than the other way around. 

Then, about a decade ago Medicare began facilitating payment to physicians who made home visits to the elderly and chronically ill, and sweetened their reimbursement pot by 50%.

Since then, physician home visits have risen from 1.5 million to 2.2 million.

“There is growing interest,” Constance Row told the Washington Post. The executive director of the American Academy of Home Care Physicians added it’s a “win-win situation for everyone. It is one of those things that patients, their families and caregivers want and also something that (could) save money.”

Heforgothisstethoscope!And ironically, technology–which helped undermine house calls 50 years ago–now assures that physician home visits are more productive than ever.

Nowadays, physicians carry laptops, electronic medical records, portable EKG machines, and ultrasound machines right into the bedroom.


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