The Resurgence of the House Call
April 20, 2001 -- Remember when your child's doctor used to make house calls? You don't? Well, here's a second chance, because pediatric house calls may be making a comeback.
While there is no official study planned or in the works, word of mouth suggests that more and more pediatricians may be making house calls. A recent survey by the American Academy of Pediatrics (AAP) found that half of those polled offered house calls to all patients and another 54% made house calls only to the very sick. Still, it's obviously not in some doctor's plans, because about a third of the 729 pediatricians polled ignored the question about house calls altogether.
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When asked whether or not she makes house calls, Paula Elbirt, MD, a pediatrician in New York, replies "sometimes."
Elbirt made her first house call when a parent called saying that her newborn had a 104 degree fever and that her husband was out of town and her other three children were awake. Clearly this mother wasn't going to make it into the office, says Elbirt, who's also the author of "Dr. Paula's House Calls to Newborns".
Now, Elbirt's house calls are mostly after hours. "After hours, house calls can be your very best friend. They have saved me from opening the office or going to the emergency room many a time," she tells WebMD.
"But even a nonemergency can still be something that a mom can't deal with for another 12 hours like a screaming ear infection," she says.
In addition, "house calls instill devotion and gratitude in the family," Elbirt says. These days, "anything you can do to improve the relationship and lower the hostility between consumers and healthcare providers is worth doing if you are going to survive financially and emotionally as a physician," she says.
Many practices may also advertise that they do house calls as a way to increase traffic, and thus revenues, to their practice, Elbirt says.
But house calls are not without their risks.
"The danger of doing house calls is twofold, " she tells WebMD. "The main one is that you may be in a situation that you didn't anticipate with less equipment than you need. The field doctor's bag can not carry a lot of tricks," she says, noting that fortunately this is a rare occurrence because emergencies can be weeded out during an initial phone call.
"The less serious danger is that if parents get a sense that they can get a doctor to come to the house, they may delay seeking care thinking if it gets worse, the doctor will come running," Elbirt says.
It's difficult to do house calls during normal working hours unless your practice has a person who is designated to make them on a given day, she says. Also, since insurance may not reimburse for house calls, a price needs to be agreed upon in advance.