Doctors find home visits a flexible practice option

Whether it's an extra service or a full-time practice, some physicians have found leaving the office to be a profitable alternative.

By Mike Norbut, AMNews staff. July 26, 2004.

When Michael Smothers, MD, decided to start his own practice, he had to make a few trade-offs.

He had to give up his office. But for that sacrifice, he gained nearly unlimited flexibility.

Dr. Smothers, a family physician in Elkhart, Ind., started a full-time home-care business a few years ago, and feels like he's making a good living practicing the type of medicine he's always enjoyed.

"I was disillusioned with the lack of autonomy I had at hospital-based practices," said Dr. Smothers, who operates Housecalls LLC with his wife, a nurse. "I began making house calls in my residency, and no matter what I did, I always tried to include some house calls in my practice because it was the most satisfying part."

While other physicians might not be creating full-fledged home-care businesses, it appears some are finding house calls satisfying and lucrative enough to make them part of their practices.

While membership at the American Academy of Home Care Physicians has remained steady at about 700 over the last few years, the database of physicians providing home care has risen dramatically, said Constance Row, the Edgewood, Md.-based academy's executive director.

When the academy started a directory of home care specialists on its Web site about five years ago, the listings represented only 14 states. Now, close to 40 states, Washington, D.C., and Puerto Rico are covered.

Based on data provided by the Centers for Medicare & Medicaid Services, the academy has calculated the number of submitted house call codes to be about 1.8 million in 2003, up from about 1.7 million in 2002. House call codes were 1.6 million in 2001 and 1.5 million in 2000, according to the academy. Attempts to obtain home visit data from CMS were unsuccessful.