The Generalist: House Calls
Ben Shepherd, MD, and Heidi James, MD
Ben chats with Heidi about one of the favorite parts of her clinical work - house calls!
- Seeing patients in their homes is an important part of care.
- In 1950, half of all visits were in the home
- By 1980, it was <1%
- Since 2000, the number of house calls has been increasing
- House calls (in-home care) can be provided by physicians and allied health staff.
- Both acute and non-acute services can be provided.
- Benefits of in-home care:
- Removes patients’ transportation barriers
- Provides insight into patients’ at-home environment and life in general
- Reduces hospitalizations and can reduce health care costs
- Supports allied health staff providing community-based care
- Adds clinical variety to generalist practice
- Challenges providing house calls:
- Finding time in our busy schedules
- Safety considerations
- Heidi’s tips:
- Incorporate house calls around planned travel.
- Have specific simple goals for a home visit, which reduces the need to carry a lot of equipment.
- Schedule house calls with known patients who you consider low risk.
- Take another person with you and have the patient’s family member meet you at the house.
- Meet in a common area within the house with a clear exit route.
- Ensure you are expected by the patient and that pets are restrained.
PEARL: House calls can be invaluable to patients. If you’re worried about not having the right equipment, remember that “just turning up” matters.
Ian L. - July 4, 2021 7:06 PM
General Practices also do emergency house visit like for Chest Pain a severe exacerbation of asthma or COPD a collapse and an anaphylactic reaction to a medication or food consumed because the General Practitioner can excuse themselves explaining they have an Emergency Visit and get to a patient in 1-2 minutes whereas an Emergency Ambulance make take 5-10 .minutes .
You have Oxygen in the Car plus Adrenalin (epinephrine) Salbutamol (albeterol) Glucose 50% in 50 ml water plus Glucagon and other Emergency Medications .
Some have an Automatic Defibrillator in their car .
Heidi J., MD - July 5, 2021 7:03 AM
That's the wonderful thing about house calls; you can pretty much practice any type of medicine in the home if you're set up for me. Ben used to do a lot acute house calls...sounds like quite an adventure.