The case for house calls: Patient satisfaction and practice profitability

Some physicians are finding it makes financial sense to see patients at home. Here's advice from doctors on how to take your practice on the road.

By Larry Stevens, AMNews correspondent. March 19, 2007.

About five years ago, family physician Samantha Pozner, MD, received an urgent request from the daughter of one of her chronically ill patients. Her mother was experiencing breathing problems, but the daughter didn't think she could bring her mother into the office. The daughter was hoping Dr. Pozner could recommend a home care nurse who could come over quickly.

Instead of referring the daughter to a nursing service, Dr. Pozner did something that was at once quaintly old-fashioned and radically forward: She made a house call.

At the time she didn't think much of it. "The family lived near my office. I was leaving within an hour or so. So I offered to come by," she remembers.

But the process didn't end with that visit. The house calls continued every few weeks over the year as the patient's health deteriorated. The patient stayed out of the hospital and died in her own home. "I had a great sense of satisfaction," Dr. Pozner says. "I really feel I made a big difference in that woman's and the family members' lives."

Dr. Pozner, who is part of four-doctor Springfield (N.J.) Family Practice. now regularly does house calls every other Wednesday and occasionally at other times if patients need to be seen quickly. She limits this service to a handful of patients: only those who absolutely cannot come to the office, and who live relatively near the office or on the route Dr. Pozner follows when she picks up her children after work.

She says she has been able to keep many patients out of the hospital and finds she gets to know people better when she can examine their home situations. "I see their environment, their quality of life, the effectiveness of their caregivers. Those all helps me make better medical decisions," she says. She also has a much better relationship with patient and family than she can achieve in brief office visits.