House calls

By Carrie Johnson Weimar • Published: June 11th, 2009
Category: Health in a Heartbeat

Imagine getting a visit from your doctor without ever leaving home. It happened back in your grandparents’ day. It happens in foreign countries. But here in twenty-first century America, the house call long ago went the route of the dodo bird.

Or did it? Slowly but surely, it’s making a comeback. Thanks largely to new Medicare changes that make the practice more easily billable, more and more doctors are making home visits. Since 1998, the number of house calls jumped from one-and-a-half million in 2000 to more than two-point-two million in 2007.

Once an American institution, house calls made up about forty percent of physician encounters with patients back in 1930. But by 1950, the number dropped to ten percent. And by 1980, it was only one percent.

Blame technology. As medical equipment became increasingly sophisticated, patients wanted to visit hospitals and clinics because that’s where the advanced treatments were offered. Financial considerations for doctors were also a factor. A physician stands to make far more as a specialist than as the kind of general practitioner who typically makes home visits. Plus, private insurance rarely covered house calls.

But the practice is winning raves from both doctors and patients. Experts say it also saves money. The main beneficiaries of house calls are elderly patients with limited mobility, who usually end up in the emergency room. And a typical E-R visit costs ten times as much as a house call.