The concept of a doctor visiting a patient at home, known historically as a house call, is no longer a relic of the past. Once standard practice before the 1950s, house calls largely disappeared as medical technology centralized care in hospitals and clinics. Today, portable medical equipment and new healthcare delivery models allow physicians and other medical professionals to bring care back to the patient’s residence. This modern resurgence offers convenience, comfort, and personalized attention, especially for patients with mobility issues.
The Resurgence of Modern House Calls: Provider Models
The return of the house call is driven by several distinct provider models catering to different patient needs and financial structures.
Concierge or Membership-Based Care
One prominent model is concierge or membership-based primary care, where patients pay a monthly or annual retainer fee for enhanced access, including unlimited home visits and extended appointment times. These practices focus on personalized, preventative care and often serve as the patient’s main primary care physician.
Episodic Urgent Care
Another model is the episodic urgent care service, which provides on-demand treatment for acute, non-life-threatening illnesses and injuries. These services often utilize mobile apps or centralized call centers for booking and frequently dispatch physician assistants or nurse practitioners. This model focuses on providing a rapid response to keep patients out of the emergency room.
Home-Based Primary Care (HBPC)
A third model involves government or insurer-backed programs, such as those targeting homebound Medicare beneficiaries with multiple chronic conditions. These programs focus on HBPC to manage complex health issues over the long term for patients unable to travel to a traditional office setting.
Medical Services Available at Home
Modern house calls are comprehensive, enabled by the portability of advanced diagnostic tools. Providers can perform a thorough physical examination, similar to an in-office visit, to diagnose common minor illnesses such as the flu, strep throat, and minor infections. They can also manage chronic conditions, including monitoring blood pressure, blood glucose levels, and respiratory status.
Medical professionals carry equipment for on-the-spot diagnostics, including rapid testing for influenza, COVID-19, and strep, as well as portable devices like pulse oximeters and point-of-care ultrasound machines. For laboratory work, they can perform phlebotomy (blood draws) at the home. Minor procedures are also possible, including:
- Stitching small lacerations.
- Draining simple abscesses.
- Providing wound care.
- Administering injections.
- Delivering IV fluids for hydration or medication.
Navigating Access, Costs, and Insurance
Accessing a modern house call typically begins by signing up for a membership with a concierge practice or utilizing an app or phone line for an on-demand urgent care visit. The cost structure varies significantly based on the care model.
Costs
Concierge models charge an annual retainer fee, which can range from a few hundred to over a thousand dollars, sometimes including unlimited visits. For episodic urgent care, the price is often a flat, cash-pay rate, which may be several hundred dollars per visit.
Insurance Coverage
Insurance coverage for house calls is complex. Many concierge practices operate outside of traditional insurance networks, requiring the patient to pay out-of-pocket, though some labs may be eligible for reimbursement. However, certain HBPC and urgent care services do accept Medicare, Medicaid, and private PPO plans, often requiring the patient to cover a co-pay or deductible, similar to an office visit.
When At-Home Care Is Not Appropriate
House calls are designed for non-life-threatening conditions and routine medical management, not for medical emergencies. Any situation involving severe trauma, sudden chest pain, symptoms of a stroke or heart attack, or significant difficulty breathing necessitates an immediate call to emergency services. These scenarios require the advanced diagnostic and life-support capabilities only available in a hospital emergency department.
Medical needs requiring complex imaging, such as X-rays, CT scans, or MRIs, cannot be fulfilled through a standard house call, although some services offer mobile X-ray capabilities. Situations demanding sterile environments for extensive surgical procedures or round-the-clock monitoring are also beyond the scope of at-home medical care.