During a recent PW Podcast episode, Patrick Goggin, MD, FACP, president of the Family Physician’s Group of South eastern Ohio, talked about his decision to bring back the house call. The following includes highlights from that interview.
Tell us about your decision to bring back house calls.
In our practice at the onset of the pandemic, many of our most vulnerable patients weren’t able to come to the office. Others were avoiding the office or other public areas to reduce their risk for exposure to infection. We were concerned that we were going to see declines in health because patients weren’t getting their regular health maintenance.
Some were not able to participate in disease management, and we were fearful that this was also going to lead to a decline in their health. We quickly onboarded virtual visits, but many of the most vulnerable patients didn’t have the technology they needed. They didn’t have computers or smart phones, or they were in an area without adequate cellular coverage. Therefore, we decided to resurrect the house call.
How did that work practically?
I knew a nurse practitioner from when my colleagues and I worked in the wards together. She had worked for several years as a registered nurse for hospice and had experience in making house calls, doing home visits for complex and sick patients, and palliative care. We reached out to her initially to start a home visit program for primarily seniors with complex medical needs and often palliative care needs.
Did you see improved outcomes from those patients?
It’s early yet, so the metrics are premature, but with many of the initiatives that we’ve designed specifically for our highest-risk patients, such as hospital follow-up appointments in either the office, virtually, or in the home within 2 business days, we’ve more than doubled that in 2022. We feel that house calls is just one of the initiatives that’s helping to drive down ED and hospital utilization.
Are some communities benefiting more from this initiative?
One of our chief goals is to fill in those gaps of inequitable care: patients who have transportation challenges, technology challenges, and limited social support.
Those are the patients that we’re really reaching out to, whether that’s a call from an RN care coordinator, a home visit by our nurse practitioner, or a consult with a social worker either by phone, virtual visit, or in the home.
