Bring back house calls, say elderly patients

When Sangeetha S, a resident of Besant Nagar, was looking out for a doctor to treat her diabetic father’s bed sores, she had to scour the Internet and make several calls to various clinics and hospitals, in vain. 

She later contacted the doctor in the critical care unit of the hospital, where her father was treated earlier. “He readily agreed and we were spared more running around. Till then, I never knew it was extremely difficult to find a doctor who can attend patients at their house,” she says.

Doctors who came on house calls – from checking the vitals of the elderly to looking at the younger one’s deworming needs, apart from exchanging the regular updates about the family - are vanishing, with probably just a few operating in rural areas and the suburbs, say doctors. 

“The trust deficit is one of the main reasons for it,” says Dr R Sundararaman, an Internal Medicine Specialist and Diabetologist. 

“I come from a family of doctors and have seen my father go on regular house calls during the nights. But today this is not possible, for doctors do not have security and we don’t know if they would even be paid. I have been on house calls and had to ask the patients for the fees. It is an awkward situation for the doctor,” he adds. 

Dr S Sivaram Kannan, Senior Consultant, Internal Medicine, Kauvery Hospital, says that dynamics of treatment has changed. 

“Today, if a doctor walks in to the patient’s house with just a stethoscope and a bag, the patient is not satisfied. We therefore ask them to come to the clinic or hospital in case of an emergency,” he says, though he agrees that the home setting can be extremely helpful for the patients recovering from an illness. 

Meanwhile, for the benefit of the elderly, Dr VS Natarajan, renowned Geriatrician, has come up with a list of doctors, 35 of them, who are available on house calls for the elderly. 

He says, “It is needed the most now because family medicine has vanished from the healthcare chain. On the other hand, doctors don’t want to spend a lot of time looking at one patient, when in that time, they can attend three patients. But with increased longevity there is a wide array of diseases like dementia and Parkinson’s disease that needs attention at home. Many doctors on house calls have saved the lives of patients. For a junior doctor offering the service, it also helps in building his or her experience.” 

Home healthcare providers have managed to penetrate on the house calls front. Dr Kannan adds that many hospitals too are trying to bring it back through their packages. “But it has come back as a costlier option. What could have been offered at Rs 100 or Rs 200 comes at Rs 1,000 or Rs 2,000 now,” he points out.