Question: As a doctor who likes to “go the extra mile” for my patients, I'm considering starting a house call program. What are the benefits and risks of this practice model?
by Keith Henaman in Patient Interactions on Saturday, July 29, 2017
Answer: The return to the house call concept of yesteryear seems to be a trend across the healthcare spectrum. USA Today indicates about 4,000 physicians make house calls in the United States,* and this number is expected to grow.
From a patient perspective, elderly patients or those with physical constraints often find house calls beneficial. Other patients like the convenience or comfort of being treated in their homes. Many Doctors of Chiropractic appreciate being able to treat these patients according to their wishes, as well as the potential to reduce their overhead expenses, such as staffing.
Nonetheless, it’s important to remember that the customary protocols of taking a history, performing an exam and keeping comprehensive records apply. Additionally, HIPAA requirements are in force, and the doctor must follow state guidelines to be in compliance with his or her state scope of practice.
That’s why, at a minimum, Doctors of Chiropractic who are thinking about starting a house call program should identify how they will handle the following aspects:
- Equipment—What equipment will you need (e.g., treatment table, electronic stimulation, traction, ice and heat)?
- Privacy—Is there a private room away from other family members to ensure doctor/patient confidentiality during chiropractic care?
- Imaging—How will X-rays and other diagnostic studies be obtained?
- Documentation—How will contemporaneous notes be taken during treatment and transferred to the office’s paper or electronic recordkeeping system?
In the event of a malpractice case, it’s imperative to your defense that you can explain what symptoms the patient exhibited, what your care entailed (along with any modalities used) and why you chose this course of care. Proper documentation is always essential to validate what occurred before, during and after the chiropractic care, and it may be even more important when care is provided outside the office.
Although starting a house call program may sound appealing, your protocol should be no different than what you would do in your office, which is to provide the best care possible to your patients.