A house call is medical consultation performed by a

doctor Doctor, Doctors, The Doctor or The Doctors may refer to: Titles and occupations * Physician, a medical practitioner * Doctor (title), an academic title for the holder of a doctoral-level degree ** Doctorate ** List of doctoral degrees awarded b ...

or other

healthcare professional A health professional, healthcare professional (HCP), or healthcare worker (sometimes abbreviated as HCW) is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physi ...

s visiting the home of a

patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, op ...

or client, instead of the patient visiting the doctor's

clinic A clinic (or outpatient clinic or ambulatory care clinic) is a health facility that is primarily focused on the care of outpatients. Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs ...

hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...

. In some locations, families used to pay dues to a particular practice to underwrite house calls.

History

In the early 1930s, house calls by doctors were 40% of doctor-patient meetings. By 1980, it was only 0.6%. Reasons include increased specialization and technology. In the 1990s, team home care, including physician visits, was a small but growing field in health care, for frail older people with chronic illnesses. The reasons for fewer house calls include concerns about providing low-overhead care in the home, time inefficiency, and inconvenience. Yet, there are more and more doctors who like the idea of no office overhead. Also, it can provide safe access to care by people who are ill. Today, house calls may be making a revival among the wealthy through

concierge A concierge () is an employee of a multi-tenant building, such as a hotel or apartment building, who receives and helps guests. The concept has been applied more generally to other hospitality settings and to personal concierges who manage the e ...

telemedicine and mobile apps.

Canada

In 2012 as part of its Action Plan for Healthcare the province of

Ontario Ontario is the southernmost Provinces and territories of Canada, province of Canada. Located in Central Canada, Ontario is the Population of Canada by province and territory, country's most populous province. As of the 2021 Canadian census, it ...

actively expanded funding for access to house calls with its primary focus being on seniors and those with physical limitations making it difficult for travel outside the home. Residents of Ontario with valid Ontario Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home. Currently, this service is only available in

Toronto Toronto ( , locally pronounced or ) is the List of the largest municipalities in Canada by population, most populous city in Canada. It is the capital city of the Provinces and territories of Canada, Canadian province of Ontario. With a p ...

United States

In the United States, leadership such as

George Washington George Washington (, 1799) was a Founding Fathers of the United States, Founding Father and the first president of the United States, serving from 1789 to 1797. As commander of the Continental Army, Washington led Patriot (American Revoluti ...

were known to receive house calls. Upon his deathbed in 1799, President Washington received a house call prior to his passing. Presently, the United States' leadership retain a Physician to the President on staff.

Midwifery

The US rate of out-of-hospital birth has remained steady at 1% of all births since 1989, with data from 2007 showing that 27.3% of the home births since 1989 took place in a free-standing birth center and 65.4% in a residence.

Outcomes

A 2007 randomized trial of in-home palliative care demonstrated increased patient satistifaction and decreased costs.

USSR and post-Soviet Russia

In the Soviet Union the national government established a nationwide free outpatient polyclinic system, where each health center covered a part of a city, a neighbourhood, and this system has been preserved in post-Soviet times. Each

general practitioner A general practitioner (GP) is a doctor who is a Consultant (medicine), consultant in general practice. GPs have distinct expertise and experience in providing whole person medical care, whilst managing the complexity, uncertainty and risk ass ...

''(therapeut)'' out of some 10 to 20 working in each state outpatient health centre serves his patients on weekdays both in his room during his 3–4 reception hours and spends another 3–4 hours on house visits (which become most numerous during flu and colds epidemics and can reach 40 per day) on his assigned block of streets with a standard number of residents. Unlike Soviet times, however, each patient now has to produce apart from his citizen ID (''pasport'' with place of residence stamp showing his registration on the clinic's precinct) a now uniform medical insurance policy of obligatory medical insurance provided by a number of medical insurance companies through either financing by employers for working people or by the state – for children as well as old age and disability pensioners through regional funds of medical insurance. The purpose of such visit is primary diagnostics and prescription of treatment and mode of conduct as well as prescribing blood, urine and other tests to be carried out at the polyclinic. The doctor also supplies the patient with a sick leave from work or study for a number of days and the leave is to be closed by the same doctor or his/her substitute and sealed at the clinic on the patient's recovery and checkout. If need be, the GP may arrange a visit to the sick person from one of specialist physicians from his/her clinic and of his/her nurse for giving injections. There are two identical state systems of outpatient clinics running parallel – for adults and for children. With the rise of private enterprise since 1990, city dwellers may place a phone order for a house call from a private medical facility (to be paid for out of patient's own money).

References

{{reflist Practice of medicine