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Back to Basics: Doctors Making House Calls Again


WebMD Health News

Feb. 11, 2000 (New York) -- Everything comes back, whether afros, bell-bottoms, or even lava lamps, so it stands to reason that another dinosaur -- the doctor house call -- is en vogue again.

According to the American Medical Association (AMA), 6 million Americans receive medical care at home. And a study in the Archives of Internal Medicine found that 65% of family doctors and 44% of all internists reported that they might make house calls.

A convergence of factors may play a role in the resurgence of doctor house calls, from doctor and patient dissatisfaction with managed care insurance companies to the rapid aging of the population.

Calling the resurgence of doctor house calls "a very positive trend," Joanne Schwartzberg, MD, director of aging and community health at the AMA in Chicago, predicts that there will be even more house calls in the future. "We have a group of people both under and over 65 who are homebound and cannot get out easily, so they have limited access to medical care and greatly benefit from house calls," she tells WebMD.

Started in May 1996, one Florida-based firm, AM/PM HouseCalls of Hollywood, Fla., now has a team of 6,500 generalists and specialists in 12 major cities (New York; Miami; Chicago; Washington, D.C.; Baltimore; Los Angeles; Ft. Lauderdale, Fla.; Palm Beach, Fla.; Kansas City; Las Vegas; San Francisco; and San Diego) who can be at the doorstep within an hour. In its first year of operation, AM/PM HouseCalls made 12,000 house calls. "We have literally exploded, and we anticipate signing up another 10 to 12 cities this year," Ramsey H. Saffouri, MD, founder of AM/PM HouseCalls, tells WebMD.

"I was completely appalled by the amount of time patients spent waiting in the emergency room for nonemergency services," he says. "The average wait in major cities can be four to six hours or more, and I felt that there had to be a better way."

A visit costs between $150 and $175 plus the cost of medicine or therapy. Saffouri says that all major American insurance companies are willing to reimburse patients for these home visits because they are much cheaper than emergency room services.

"One element that is missing in health care today is service, and people are willing to pay a little extra for service," Saffouri says. "Our doctors really enjoy the contact with patients. We are putting the patient and the doctor back together."

Location also adds to the appeal. "Our patients can be treated in the comfort of their own home, office, or even hotel room," he says. "We treat a wide range of patients, from traveling tourists and working class families to VIPs."

Doctors such as Ghassan Fayel, MD, medical director of South Florida for AM/PM HouseCalls and a family practitioner, can dispense medications, issue drug prescriptions, and make referrals to medical specialists. Fayel makes up to 12 house calls per day and has been doing so for four years. "I enjoy this much more than sitting in an office and waiting for patients to come to me," he says.

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