House Physicians: Are They Successful At Their Jobs?

Mount Vernon NY

15 March, 2021

12:31 PM

Description

According to usnews.com: 5.6 percent of the aged, community-dwelling population was entirely or mostly homebound in 2011. And the numbers are soaring! So much so that the number of people aged 65 and more will be approximately 83 million by 2050. Making the number of homebound and home-limited patients rise even higher. While only about 12 percent of the nation’s two million home-limited patients currently call a house call physician. House physicians are vital for these home-bound people that cannot even get up from the bed by themselves. For instance, if a person is incapable of traveling to doctor appointments until something catastrophic happens, resulting in an expensive ambulance ride and hospital stay. House physicians give them the relaxation of not going to the hospital and the hospital charges’ costs. As you dig beyond the numbers and into the patients’ lives, home-based primary care becomes a no-brainer. Two of the stories of such patients are: A 38-year-old woman having congenital cerebral palsy and epilepsy, she is nonverbal, has a feeding tube, and has had gastrointestinal bleeding in the past. Like many other homebound patients, she is looked after 24 hours a day by her relatives, often by the father. Because of this reason, the father works nights so he can look after her during the day. Her sole access to health care would be by the emergency room if she didn’t have home-based primary care, putting more pressure on her caregivers. Another example: A 82-year-old man has also been treated 13 times for ailments such as heart disease and pneumonia, with several recovery periods after each of these hospitalizations. He was dependent on his 80-year-old wife for treatment and hoped to stop being taken to the hospital once more. With having a house call physician, he only received one more hospitalization over the course of eight months, and he was able to die at home, just like he wished for. Home-based primary care benefits are countless, but hindrances must be addressed to ensure this care is accessible to all patients who could benefit from it. Reviving The House Call Primary treatment is provided to the most medically complex (and expensive) homebound patients in society by house call physicians. Usually, these patients do not undergo ongoing follow-up treatment, which spreads the trend of inadequate health management, making it much more costly and time-consuming for patients and their caregivers. The “house call” concept isn’t new. At one time in our country’s history, physicians were prevalent to make house calls, showing up with their iconic black bags. But with time, patients are moved to physician offices, hospitals, and emergency departments. Technological Advancement And Home-Care Technology is a crucial enabler in today’s home-based primary care. Patient charts are checked from anywhere via electronic medical records. Blood and lab testing can be completed in minutes at home, or blood can be drawn and run down in a centrifuge in the car before being delivered to a lab. Portable x-rays and ultrasound devices are also on the market. An electrocardiogram, an ultrasound console, a directory to medical references (such as textbooks and prescription databases), and a way of transferring documents through digital scanning and printing can all be achieved with a smartphone. Breaking the barriers One common confusion about home-based primary care is that it is the same as Medicare home health care, but the two are not the same. Nurses and physical, behavioral, and voice therapists offer home health services following a hospitalization. Home health coverage is also sporadic; people may have a Medicare-qualifying need and an approved license to be a house call physician. On the other hand home-based, primary care also provides effective palliative care services and commonly partners with palliative and hospice providers. A Path To Sustainability Despite promising benefits and convincing patient accounts, home-based primary care has been reluctant to gain momentum. This is due to the new fee-for-service pricing system, which prefers amount overvaluation. This is changing, however, as different value-based payment methods are being introduced like CMF (care management fees).