Are house calls set to make a comeback?
House calls, often seen as a costly and time-consuming thing of the past, have all but disappeared in Canada over the past several decades. However, some signs indicate that they may be poised for a rebound, particularly as an estimated 9% of the entire Canadian population will be over 85 in 2050. The medical implications of this rapidly aging population certainly haven’t been lost on our politicians: during the last provincial election, Ontario’s Liberals promised to bring medical house calls back to the mainstream to better serve those who find it difficult to leave their homes.There are several reasons patients are homebound, whether it be disability, decreased mobility, chronic illness or old age. For many of these individuals, access to preventative care visits is out of the question because leaving the house is difficult, if not impossible. This results in skipped appointments, which in the long run opens people up to the risk of missing warning signs of more serious and costly health problems until it is too late. The consequences could be serious health concerns and a strain on public health care resources that quite possibly could have been prevented with a house call.

Pitfalls to house calls
If you’re looking to integrate house calls into your practice, keep in mind that they have downsides, like everything else. House calls can be emotionally taxing. The majority of house call cases are complex and often times difficult, and patients are likely frail with multiple medical conditions.

Also, some health care professionals much prefer office time to the time spent travelling in the car that is required for home visits. And house calls necessitate a great deal of paperwork in order to meet the requirements for home health care, hospice, durable medical equipment and social services.

Benefits of house calls
On the other hand, some may find that this line of work, although demanding, is incredibly satisfying. Many medical professionals feel that house calls present them with opportunities to really get to know their patients and have the one on one time with them that isn’t always possible in the office. And with almost a quarter of Canadians already over 65, the market for house calls is certain to grow in coming years.

Get everyone on board
If you decide that house calls are in your practice’s future, ensure your staff that they will have resources available to them while on the road. The use of laptops and tablets will allow instant and easy access to office documents and patient medical records. Provide caretakers with a logo’d iPad® case or laptop bag to take with them.

Spread the word
Let your patients know you will now be making house calls. Mail a letter alerting them to this new service and consider including a business card magnet giving them quick and easy access to your phone number and hours. Get the word out in the office and generate buzz by providing front office staff with T-shirts and/or buttons to wear promoting that you now offer house calls. Display banners within the office and at your local senior centre as well.

Include information about this new service on your website and on your company’s voice message system. Highlight some of the benefits of house calls on promotional giveaways such as a pill box or a first aid kit that can be given to patients at each office visit.

Finally, make sure you measure and monitor your progress. Have house calls helped your practice to increase the number of kept appointments by your homebound patients? Are you seeing a decrease in hospitalizations for this population and a correlation between early intervention and better health? If so, the adoption of house calls has had a profound impact on your patients and can be considered a success.

Mickleburgh, Rod. “The doctor’s house call: An old-fashioned remedy for health care’s rising costs.” The Globe and Mail. Web. 8 May 2012.

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