The Return of the House Call

Ideas and Opinions21 April 2015The Return of the House CallThomas Daschle, BA and E. Ray Dorsey, MD, MBAThomas Daschle, BAFrom The Daschle Group, Washington, DC, and University of Rochester Medical Center, Rochester, New York. and E. Ray Dorsey, MD, MBAFrom The Daschle Group, Washington, DC, and University of Rochester Medical Center, Rochester, New York.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M14-2769 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail For the first half of the 20th century, the house call was a dominant means of providing medical care, accounting for 40% of patient–physician encounters in 1930 (1). House calls embodied "patient-centered" care by delivering care to persons in their environment on the basis of their preferences, needs, and values. However, technological advances, better transportation, and economic factors led to its virtual disappearance (2, 3). New diagnostic and therapeutic equipment moved care from the home to more expensive medical institutions. Transportation became less expensive and more widely available, and reimbursement for home care fell (1). By the 1950s, house calls ...References1. Meyer GS, Gibbons RV. House calls to the elderly—a vanishing practice among physicians. N Engl J Med. 1997;337:1815-20. [PMID: 9400040] CrossrefMedlineGoogle Scholar2. Kao H, Conant R, Soriano T, McCormick W. The past, present, and future of house calls. Clin Geriatr Med. 2009;25:19-34, v. [PMID: 19217490] doi:10.1016/j.cger.2008.10.005 CrossrefMedlineGoogle Scholar3. Leff B, Burton JR. The future history of home care and physician house calls in the United States. J Gerontol A Biol Sci Med Sci. 2001;56:M603-8. [PMID: 11584032] CrossrefMedlineGoogle Scholar4. Landers SH, Gunn PW, Flocke SA, Graham AV, Kikano GE, Moore SM, et al. Trends in house calls to Medicare beneficiaries [Letter]. JAMA. 2005;294:2435-6. [PMID: 16287953] MedlineGoogle Scholar5. Landers SH. Why health care is going home. N Engl J Med. 2010;363:1690-1. [PMID: 20961239] doi:10.1056/NEJMp1000401 CrossrefMedlineGoogle Scholar6. Institute of Medicine; Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Pr; 2001. Google Scholar7. Dorsey ER, Venkataraman V, Grana MJ, Bull MT, George BP, Boyd CM, et al. Randomized controlled clinical trial of "virtual house calls" for Parkinson disease. JAMA Neurol. 2013;70:565-70. [PMID: 23479138] doi:10.1001/jamaneurol.2013.123 CrossrefMedlineGoogle Scholar8. Pearl R. Kaiser Permanente Northern California: current experiences with internet, mobile, and video technologies. Health Aff (Millwood). 2014;33:251-7. [PMID: 24493768] doi:10.1377/hlthaff.2013.1005 CrossrefMedlineGoogle Scholar9. Grabowski DC, O'Malley AJ. Use of telemedicine can reduce hospitalizations of nursing home residents and generate savings for medicare. Health Aff (Millwood). 2014;33:244-50. [PMID: 24493767] doi:10.1377/hlthaff.2013.0922 CrossrefMedlineGoogle Scholar10. Willis AW, Schootman M, Tran R, Kung N, Evanoff BA, Perlmutter JS, et al. Neurologist-associated reduction in PD-related hospitalizations and health care expenditures. Neurology. 2012;79:1774-80. [PMID: 23054239] doi:10.1212/WNL.0b013e3182703f92 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Thomas Daschle, BA; E. Ray Dorsey, MD, MBAAffiliations: From The Daschle Group, Washington, DC, and University of Rochester Medical Center, Rochester, New York.Acknowledgment: The authors thank Denzil Harris for his assistance in the preparation of this manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2769.Corresponding Author: E. Ray Dorsey, MD, MBA, Department of Neurology, University of Rochester Medical Center, 265 Crittenden Boulevard, CU 420694, Rochester, NY 14642; e-mail, ray.dorsey@chet.rochester.edu.Current Author Addresses: Mr. Daschle: The Daschle Group, 901 K Street, Northwest, Suite 900, Washington, DC 20001.Dr. Dorsey: Department of Neurology, University of Rochester Medical Center, 265 Crittenden Boulevard, CU 420694, Rochester, NY 14642.Author Contributions: Conception and design: T. Daschle, E.R. Dorsey.Analysis and interpretation of the data: T. Daschle, E.R. Dorsey.Drafting of the article: T. Daschle, E.R. Dorsey.Critical revision of the article for important intellectual content: T. Daschle, E.R. Dorsey.Final approval of the article: T. Daschle, E.R. Dorsey.Provision of study materials or patients: T. Daschle, E.R. Dorsey.Administrative, technical, or logistic support: T. Daschle, E.R. Dorsey.Collection and assembly of data: T. Daschle, E.R. Dorsey. 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