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The Resurgence of the House Call

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And since it is 2001 after all, not the 1950s, of course some of today's house calls have a high-tech twist.

One pediatrician, Alan Greene, MD, an attending pediatrician at Stanford Children's Hospital and an assistant clinical professor of pediatrics at Stanford University Medical School put up a web site in 1995 to augment visits with patients and their parents.

"When I started in general office pediatrics, there just wasn't enough time to give the amount and depth of information to make a difference," he tells WebMD. "I could treat an ear infection but there wasn't enough time to investigate the possible causes so I put up a web site to supply the extra background information on common and rare conditions affecting children for parents to access at their convenience."

But virtual house calls really come into play with his five-day-a-week live chats where parents can ask specific questions via the web on a first come/first serve basis.

"Live chat is the closest thing to a house call because of the direct back-and-forth information," he says. "I get letters from people everyday saying that they worked just like a house call for them."

Greene also makes regular house calls for patients who have a tough time getting to the office.

"My first house call was for a set of quadruplets whose parent had a hard time getting all four of them to the office even for a well-visit, so I started stopping by their house on my way home from the office to do well-child visits and look for colds and flus," he tells WebMD.

"Then I began doing it for a number of families for whom it made sense," he says.

Greene brings a little black bag filled with a stethoscope, some other basic medical instruments and some medicines and examines his patients wherever the light is best in the home, he says.

"For a while, house calls were the most common type of visit, then they became almost extinct. Ideally they will become a part of every pediatric practice, but not the major part as the office is still the best setting because it has the best light and more medical tools than a doctor can carry in his or her bag," he says.

"Sometimes house calls end up being more convenient for me and the parent because we are closer to their home than my office so it just saves both of us time," says Anne Francis, MD, a partner at the Elmwood Pediatric Group, a group of pediatricians in various specialties based in Rochester, N.Y.

"House calls are not appropriate for a very sick child but may be good for something simple or for a homebound child who is in a body cast," says Francis, who's also a fellow of the AAP.

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