May 5, 2015

House Call

Q:My parents often reminisce about their “BC” (before computers) lives. One of the things they speak of fondly is the doctor’s house call. Is there any value to this approach in health care?

A:House calls used to be an intrinsic part of a family physician’s way of operating. The daily routine of a busy general practitioner would typically begin with making rounds on hospitalized patients, caring for surgical procedures, then making house calls. Depending on whether one’s practice was rural or suburban (or both), this might include a more time-consuming farm call. One would have to brave all kinds of weather, poor roads, dogs and other animals—all in the quest of bringing some relief, perhaps a cure, but always reassurance, not only to the one who was ill but also to the worried family.

The encounters in the home setting varied from certifying that the patient was diseased or deceased, in need of resuscitation or resurrection (ultimately), in need of hospitalization, or just the usually welcome and almost universally curative “shot.” This injection could include anything from penicillin or subsequent generation antibiotics to anti-inflammatory or analgesic agents, or even a vitamin injection. Fever control, tepid sponging, mobility exercises, and the absolutely essential “lifestyle modification lecture” on issues such as smoking, drinking alcohol, obesity, and more were all part of the routine.

One learns much during house calls, particularly about the family, and in times past, lasting friendships and precious relationships and memories were forged.

House calls were never complete until the spiritual dimension had been tactfully and ethically approached as well. Indicators that facilitated addressing spiritual wholeness would be the presence of a well-worn Bible, a picture of Jesus, or an embroidered passage of Scripture hanging on the wall. Other times it would be the hand grasp that was loath to let the physician leave the bedside, or the pleading eyes desperately seeking solace beyond pills, potions, remedies, or instructions.

“May I pray with you before I leave?” I always asked. I can count on one hand the number of patients who refused that offer throughout a span of 35 years of clinical practice! The furrowed brow would relax, the handgrip would often firm in a signal of affirmation and appreciation, and many times a peaceful smile would eclipse the facial expression molded by pain.

As I would ease into the well-worn, friendly seat of my trusted car, a peace would settle over my frenetically busy frame of mind and overfilled schedule. The house call had hopefully made a difference for the patient, but it most definitely always did for me. I would move on with my day with the assurance that life was indeed worth living and that prayer makes the difference.

My prayer is that this regular “house call” into your life will touch and bring peace to every aspect of your life: physically, mentally, emotionally, and spiritually.

Until next time, “I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well” (3 John 2).