old doctor bagDoctor house calls, long considered a relic of the ‘good old days’, are making a comeback in San Diego and everywhere else. Sickness, frailty, a compromised immune system and even post-partum precaution are all legitimate reasons why a patient might not be able to travel to the doctor. When the alternative is a costly trip to the ER in an ambulance, a house call suddenly becomes a reasonable alternative.  Seniors are choosing to live independently in their own homes longer, with the help of family caregivers and home care companions, and ensuring access to medical care is a common reason for relocation to assisted living. The return of the house call means loved ones can live at home on their own terms longer, and San Diego residents have some choices when it comes to house call physician services available.

Less than 100 years ago, but before high-tech hospitals and ultra-specialization, three-quarters of physicians were family doctors, who made house calls when patients were too sick to move around. As much as 40% of a doctor’s interaction with patients took place during house calls. But by 1980, only 1% of doctor visits were house calls, and if your loved one wanted good medical care, she went to an office, a clinic or a hospital. But the house call never died completely, and resurged by 2013 to the point where 13 percent of family doctors were making regular house calls. This trend is on the rise thanks to the Affordable Care Act, since one of its provisions penalizes hospitals for high readmission rates and also turns Medicare away from quantity of care toward quality of care. Both of these goals are served by house calls. And worse, a study estimates that 71% of emergency room visits could have been handled by care from a primary care physician – or a house call – wasting $38 billion a year.

Housecalls don’t just save money, though – they have a positive impact on patient health, too. The frail and elderly don’t have to drive, take the bus or brave inclement weather to get regular check-ups. People of any age who are already sick, who didn’t schedule an appointment three weeks in advance, don’t drag around making everyone else sick. New parents and newborns don’t have to expose themselves to a germ-filled hospital, and are also observed in the home environment. In particular, seniors living independently benefit from the doctor’s assessment of the home environment, which can give clues to conditions that may not manifest in the doctor’s office.

And of course, there’s even an app for that, with ‘Uber for doctors’ style services now available in many cities, including New York, the Twin Cities, and Los Angeles. San Diego is the home of Call Doctor Medical Group, a San Diego-based home call service that ministers to the needs of high-cost seniors with multiple chronic conditions. Their work has reduced ER visits among their patients by nearly 60 percent. San Diego is home to other house call physician services, and the medical home visit/telemedicine trend is growing every day. Social, legal and medical pressures have combined to make the house call – by a doctor, a physicians’ assistant, or a nurse practitioner – a cost-effective and smart alternative to over-reliance on the ER. Caregivers and home care companions can work in conjunction with a house call doctor to help a loved one stay independent as long as possible.