A Doctor Is In The House. Really!

Saturday Early Show On House Calls Making A Comeback

(CBS)  Years ago, doctors made house calls as a regular part of their practices. Today, the idea seems old-fashioned. But a growing number of doctors are getting back to basics, focusing on patient care, and, yes, making house calls. CBS News Correspondent Randall Pinkston reports for The Saturday Early Show.

When Stacy Hirsch and her husband leave for work, he goes to his office, but she carries much of her office with her. Dr. Hirsch is a modern-day foot doctor, returning to an old-fashioned practice. She makes house calls.

Patient Lissy Bender, a runner who plans to compete in an upcoming race, was a bit skeptical.

Says she, "I was a little nervous at first. You know, to have the appointment in the house. This was just new to me."

Dr. Hirsch began offering house calls a year ago to make life easier on her family.

"It's very convenient for me, because I schedule my patients around my kids' schedule," she says. "It cuts way down on overhead… You're not paying for an office."

She charges a flat fee of $250 for a house call, which covers minor procedures, like removing an ingrown toenail. Tina Schafer loves the convenience. She says, "I have two kids, I have a career. I write songs and I don't have time to be going you know for visits for what I consider an ingrown toenail."

Dr. Hirsch says she spends more time with a house-call patient than she would in an office visit. She explains, "I hate to be a doctor that sort of rushes people and that kind of thing. I know my patients. I know their kids."

Becoming familiar with a patient's home environment can give a doctor a better idea of the patient and the treatment that works best. This is especially important for elderly patients who are seriously ill and just out of the hospital.

Dr. George Taler, a geriatric specialist, heads the Medical House Call Program at Washington Hospital Center in the nation's capital. Dr. Taler's team is trying to restructure health care delivery to 300 elderly patients living near the hospital.

"One of the things that we've learned about this practice," he says, "is that we've been able to re-establish that doctor-patient relationship that I think has taken a beating over the past 10 years."

Families say patients respond better to house calls.

House calls are a revival of the past. But advances in miniature medical technology give today's traveling physicians diagnostic equipment once only found in the office.

The focus is on 10 per cent of Medicare patients. Dr. Taler's partner, Dr. Eric De Jonge, says high-quality home-based medical care helps the patient and holds down costs by reducing emergency room visits.

Says Dr. De Jonge, "The sickest, the frailest and most expensive.They expend and consume 70 per cent of Medicare dollars. The house call costs, on average, $100. The emergency room visit, plus ambulance, to Medicare, might cost $2,000 or $3,000."

But the most important benefit, say the doctors, is what a house call means to the patients and their grateful families.

Says Leona Offutt, "The home program is just great because we can see what kind of care she's getting. I recommend it to the whole world. Every city needs it!"

Many of the doctors who are now offering house calls are geriatricians. A growing need for home care in the elderly community is encouraging this trend. In fact, Pinkston found several geriatricians who do nothing but house calls. Through Medicare, doctors are reimbursed for home visits. Most private insurance plans do not cover the expense.

Still, the elderly haven't cornered the market on home visits. Doctors like Stacy Hirsch who provide a convenience for busy patients, for a price, are also on the rise.