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House Calls – One ER Doc’s Perspective

A BROKEN MEDICAL CARE SYSTEM

In my years of hospital ER medicine practice, I observed, first hand, the detrimental effects on patient health caused by our standardized system of urgent medical care that patients must endure. It requires patients to travel to get their care, then wait endlessly and unpredictably in the waiting room, surrounded by, and exposed to, other sick, contagious, frustrated, sometimes unruly and inconsiderate patients, all with the goal to spend a couple of minutes with an overwhelmed medical provider who is typically more focused on government mandated computer interaction (in ERs) than communicating and being with the patient.

HEALING POWER OF HOUSE CALLS

Since launching Urgent Med Housecalls in 2007, I over and again reaffirmed my belief in the power of the medical house call to heal. House calls allow for patients to be in control of their own care experience; and for older persons to “age in place”. Patients may rest and begin the recovery process at home in familiar and comfortable surroundings while awaiting the doctor’s arrival. The house call’s lack of added patient travel/prolonged waiting/disease exposure and other stressors usually associated with the ER or clinic experience enables patients to maintain a sense of well being, and thereby facilitates immediate path to the recovery process.

WHY HOUSE CALLS WENT AWAY

Past generations of doctors understood the healing power of house calls, which is why house calls were once commonplace throughout the United States. It was only with the advent of large stationary medical equipment and technology that required patients to become the the mobile party of the healing process. Medicare began reimbursing for house call for homebound Medicare recipients in 1998. This triggered a nationwide resurgence of house call services, and since that time medical house call offerings have progressed even more.

HOUSE CALLS NOW OFFER MORE FOR THE PATIENT

With newer technology, medical devices have become much more portable, and easier to use. For instance, most ERs now keep an i-Stat on hand for rapid bedside blood testing for emergent situations where speed is critical. This device is about the size of an adult size 10 shoe, and it is handheld when used. Test results, using just a drop or two of blood, are available within minutes. It is an amazing technology that is highly useful for the house call provider who is able to carry it. Multiple held portable high quality image ultrasounds are now available too. Some can even be used with a smart phone.  X-ray machines are now commonly brought to patients on site, with digital images wirelessly transmitted to the interpreting radiologist and results immediately available.

In addition to technologic innovation, in many states, medications may now be dispensed by house call providers. This allows for exceptional convenience for patients, and it is one more way to help lower patient stress, thereby facilitating the healing process. Patients always have the option to go to the pharmacy, or may arrange for delivery pickup service using an app.

House calls can be much more than a medical provider showing up to see the patient with only a stethoscope and prescription pad in hand.  Medical gear has evolved so that even more is possible with a house call, and your house call doctor can now travel lean and fast to help patients in need.

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