Medical home visits are making a comeback!
Doctor's appointments in a patient's home - a medical home visit - were a thing of the past. Remember that iconic Norman Rockwell painting of the doctor examining a little girl's doll? It appeared on the cover of the Saturday Evening Post in March, 1929. That was the picture of healthcare in the 1930s. About 40% of patients were seen in their homes. Doctors charged a fee for service on a sliding scale. They saw some patients on a charity basis and passed those expenses along to other patients who could pay. But by the 1950s, medical home visits had started to go away. Advancing technology created large, expensive medical equipment and more care was given in hospitals.
But now things are starting to change. Advances in technology have made electronic health records, medical equipment and supplies portable. New regulations for reimbursement are based on patient satisfaction and reduced hospital admissions. These regulations combined with an aging population have changed healthcare.
New startup companies are starting to appear all over the nation. They meet patient needs by offering medical, on demand, home visits - and patients LOVE them. Companies like Heal in California, Pager in New York City, RetraceHealth in Minneapolis, and Mend in the Dallas - Fort Worth area are just a few.
The American Academy of Family Physicians expects the demand for home visits to go up - simply because there are not enough long term and assisted living facilities to meet the needs of our aging population. Home visits allow doctors to deliver care in the patient's home, so fewer patients need to be placed in an institution.
At Masterpiece Skin Restoration, we think house calls are a beautiful thing. And we’re not alone.
Now medical aesthetics practices are starting to offer home visits too.
There's one called Grace Medical Aesthetics in Manhattan. There's Beverly Hills Aesthetics in Beverly Hills AND a doctor named S. Mark McKenna is building an Uber-style app for scheduling "Botox House Calls" called OVME.
For people who crave privacy and convenience, these services are perfect. But there's a caveat. There's a premium price for personalized care - and not all doctors offer the service.
"The concept of house calls is antiquated for some, especially people who are really sick. But in this case, when people just need routine care, I think it's nice. If it takes 10 minutes for me or a nurse to go see a patient for a routine visit, and it's easier than having them drive here, I'm happy to do that."
- Dr. Jorge Perez, plastic surgeon, Fort Lauderdale.
Dr. Perez says house call patients make up about 10% of his business. He visits patients' homes for consultations and routine visits, not for treatments like Botox or fillers.
Dr. Jeffrey LaGrasso, another plastic surgeon who makes house calls in South Florida, visits as many as 30 patients a month. He does pre-operative and post-operative visits and gives injections.
How Much Do Medical Aesthetics House Calls Cost?
The prices vary. Dr. Perez estimates that patients pay up to 25% more than the price for an office visit. Sometimes house calls are bundled into a package. Other times they're sold a la carte.
Dr. Daniel Ahoubim, a neurologist with offices in New York and in Miami, also makes house calls. He charges $650 for 50 units of Botox if he visits your home. The same service in his office would cost $500.
Do People Like Aesthetic House Calls?
Dr. Perez says, over the past few years, word-of-mouth referrals have added significantly to his house-call business.
And Dr. LaGrasso has experienced similar growth. He says his house call business evolved over the past year because patients requested it. He doesn't advertise this service.
Home visits are great for patients.
Dr. Sam Kim, Pediatrician, MD, MBA, works part time for Heal in Los Angeles.
"With Heal, we can provide a longer visit and more satisfaction while meeting all a patient's healthcare needs," Dr Kim says. "By seeing the patient in the comfort of his or her own home, there's no apprehension about going to the doctor's office, and thinking, 'This is where all the bad stuff happens.' It makes the whole visit a lot easier and less stressful."
"This model allows a physician the freedom to really dig in and not only talk with the parents and the patients, but also to do true anticipatory guidance," Dr Kim says. "Even if the patient just has a cold or congestion, a minimum visit is half an hour. I end each visit by asking, 'Are there any other questions I can answer for you?' And then patients are thinking, 'Oh, there's one last question.' Until you get that full patient satisfaction, you don't have to leave. I really like that."
Will home visits last?
As always, the biggest factor in whether home visits will continue is money. Can startup companies make home visits profitable? One area of obvious savings is in office costs. Because visits are done in the patient's home, no office is required.
Doctors who make home visits can't see as many patients as doctors in an office. Travel time restricts the number of visits. Average for them is about 1 visit each hour. But in an office, doctors can see 4 or more patients per hour.
Another concern is whether visiting medical staff are safe going into unfamiliar neighborhoods and homes of people they don't know. Presently, there are very few doctors and medical staff comfortable with the idea of making home visits.
One house call program, MedStar’s Medical House Call Program, serves frail, elderly patients in Washington, D.C. Their 24 hour / day team of providers focuses on addressing small problems before they become big ones. They have significantly decreased hospitalizations and reduced costs - one study showed a savings of as much as 26% - by devoting resources to the sickest patients. Visiting the patient in their own home allows them to address problems that might otherwise be missed. The team consists of a geriatrician (a doctor trained to meet the healthcare needs of older adults), a nurse practitioner, social worker, and a licensed practical nurse. They work together to coordinate care, improve quality of life, reduce caregiver burden, and head off problems that can lead to high cost hospital or nursing home admissions.
The jury is still out on whether medical home visits will be profitable. One thing we can be sure of is that home visits are good for patients. Hopefully, this model will take off. RetraceHealth's Thompson Aderinkomi is optimistic.
"It's not surprising that there are critics," he says. "But they're singing the same song that has been sung about every major innovation since the beginning of time. They'll be silenced once the model takes off. Every new thing looks like it won't work at first—until it does."
Amy Takken, RN
Amy Takken is a registered nurse with 20+ years of experience helping people improve their health. Her in-depth skincare articles have been featured on Nazarian Plastic Surgery and The Palm Beach Center for Facial Plastic & Laser Surgery. She's also been quoted on Dermascope.com.
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The Information provided on our website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some - like melanoma - can be deadly. If there is any doubt, please, please consult your physician. Thank you!