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  • Writer's pictureDr. Cashio

Home Visits Don't Just Happen in the Movies

I'll admit it. This scene in the Jack Nicholson movie, "As Good As It Gets" with the incomparable Harold Ramis, has always had a profound impact on me. Coming from a decidedly middle class home, the idea of a home visit from a doctor seemed like something that only happened in the movies. Watch the entire clip (~ 3.5 minutes) if you can, because it tells you how medicine should (and could) be*:

Gets me Every. Single. Time.

So. I started medical school with the highest of ideals and endless buckets of compassion. I imagined myself being the kind of doctor that not only saved lives but was also able to care for my patients where they needed me, including at home.

Yet by the time medical school and residency training was complete, the idea of being able to become that kind of doctor seemed like an unrealistic, fairy-tale dream. One that only the naive would believe in. After all, the Health Care System wasn't invested in allowing physician home visits into their vision of antiseptic "modern" health care delivery system.

Rather, the doctor is needed in the clinic (or the ER), seeing up to 20 patients per day in neat, 20-minute visits, "No extra time allowed and don't forget to capture all of the billing charges, doctor. If it's important then they can come back again." (and be charged again).

Do you think that truly excellent care can be delivered in a 20 minute visit IF that doctor spends half the time charting and staring into a computer screen?

No, neither do I.

One of the benefits of having a Concierge or Direct Primary Care practice is that I have the time to come and visit patients in their homes. It's immensely rewarding for me but more importantly, my patients are always amazed that their doctor would come and see them.

You may be asking yourself, "What kind of things can be done at home?" The answer is that with the current advances in medical care, "a lot." Here are just a few of the things that a home visit might entail:

  • Blood pressure checks

  • Evaluation for headaches

  • Shortness of breath (especially for asthmatics or COPD patients)

  • IV fluids for dehydration

  • Nausea and Vomiting evaluation and treatment.

  • Minor injury evaluation and treatment

  • Wellness checks

The best part? Code 1 Concierge members don't pay anything extra for this service.

* For the curious, the video encapsulates EXACTLY the kind of care that Concierge and Direct Primary Care physicians strive to provide our patients. Did you catch some of the things that are unheard of in modern primary care?

  • The attention of the doctor in your home, where it's convenient for you.

  • Labs drawn and resulted the same day

  • Time for a thorough physical examination

  • Time enough to hear the extensive history of the illness. As they say in medical school, "If you listen long enough the patient will usually tell you the diagnosis."

  • Your doctor's personal contact information. No added layers of office staff to get between you and your doctor.

Be well,

Dr. Pete

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