This is not meant to be a paean to the “Good Old Days”, nor is it a rant about the fact that doctors usually don’t make house call these days. What I’m trying to find out is how they were ever able to do that in the first place. When I was growing up in a medium size U.S. city in the '40s and '50s and one of my siblings or I got sick or had an injury, my mother would call a doctor and 30 minutes or so later a doctor would be at the house treating us. How were they able to do this? Did doctors in those days just sit around their office waiting for telephone calls? Didn’t they have patients with appointments? How did they make any money?
Of course old Time Doctors made house calls – they had TARDISes, and could go back to any time they wished!
Seiously, though, when I was a kid, I received an actual House Call from my doctor one time because I couldn’t walk. But he charged us for it, and my Dad was very mad. This was in the 1960s, and it was a special effort for the doctor – he almost always saw people in his office.
I remember a Dr. house call when I was young in the mid 60s.
There is at least 1 local Dr. here who does house calls. I think that’s all he does, he doesn’t have office appointments. He will also visit your office if that is your preference. I am not sure how he handles blood tests, he probably just sends you to a local lab.
I’m wondering (out loud, of course) if this is something that actually happens a lot less than is illustrated on Father Knows Best. Even in sitcoms as recent as the 90’s I can remember story lines that necessitated the arrival of a visiting MD. In the real world this probably happened almost never, even back in the day. And when it did happen, the doctor was probably a friend of the household or there was some other personal connection that facilitated the visit.
Here is the website for the local practice that does house calls:
http://doctorsmakinghousecalls.com/
They do it 12 hours a day 7 days a week.
In the past I don’t think it was anything special to get a house call, it was considered routine.
My family had a couple of house calls from our kindly not-quite-old family physician when I was growing up. IIRC, they were always late in the afternoon, so I’d guess he was finished with his office hours for the day and was more or less on his way home.
I also remember my mother’s doctor making house calls a couple of times when she was in the late stages of her cancer, but I think that fell in the category of “special exception.”
There wasn’t much a doctor could do on a house call. He carried a bag with the otoscope to look in your ears, the stethoscope to listen to your chest and a thermometer. I can’t remember if he carried any antibiotics with him – probably he just wrote a prescription right there. Any kind of tests that needed to be done, we still had to go to the office the next day.
My father (a GP/family practice MD) used to make house calls. As I recall, he did them after scheduled office hours. He also delivered lots of babies (in the hospital).
Both of these practices have largely disappeared due to economic and/or legal pressures.
I remember being “treated to” a house call as a child. It definitely was after normal office hours.
We also have a great veterinary clinic these days that will send someone out to euthanize a pet at home rather than in the sterile confines of the clinic.
Neither service was free, of course.
The world as changed so much since those days that it’s hard to summarize. But to give it a shot.
Doctors worked out of their homes and served their immediate neighborhoods. Take a working class neighborhood like the one I grew up in. The doctors generally had nice, larger houses sited on one of the major streets and on the corner of a side street. Corner houses and lots were larger, so that made it easier for a doctor to turn part of the house into an office and waiting room - two rooms plus a bathroom and storage room/lab were all that were necessary - or to add on an addition for this purpose. Most doctors didn’t have nurses either, unless their wives took on the role.
Doctors could afford to do this because they generally were more affluent than their neighbors. But they were seldom rich. The huge salaries doctors get today, especially specialists, were unlikely then. A family doctor made a good, respectable income but not much more. That was because fewer people could afford to go see doctors. Most people did not have medical insurance. They paid out of pocket for a doctor’s visit. That meant they went as little as possible, usually for their kids or for serious illnesses that would keep them out of work otherwise. Even so, the fees for a doctor’s visit were incredibly small by today’s standards, sometimes no more than five or ten dollars. When the Great Depression started, half of America earned less than $1000 a year, so even a few unexpected doctors’ visits could blow a budget.
That also meant that doctors simply weren’t as busy as they are today. Because of insurance people see their doctors for every minor complaint and get referred to specialists on a regular basis, also something that didn’t use to happen. Doctors had notoriously light schedules. There is a now forgotten joke about the impossibility of finding a doctor on a Wednesday afternoon because they were all out playing golf. That’s unimaginable today.
A doctor might see a few patients early in the morning at the hospital, have a schedule of visiting hours, and then see patients who couldn’t make it into the office. Again, this is hard to imagine today but there was a time when many families did not have cars or had only one car that the husband took to work, leaving the wife and children without anything but public transportation, which might not be at all convenient for getting across a neighborhood to a doctor. Doctors almost universally had cars, though, both because they made more money than their patients and because they needed them to get around as a business necessity. Therefore the doctor could much more easily see patients at home than the patient could get to the doctor’s office.
This would also be true for people in the country, in places where getting to town to see a doctor was a major trip - roads used to be terrible and cars weren’t much better - any time away from the farm work created a problem. It wasn’t unusual for a woman not to know how to drive so if the man was laid up there might not be a way to get to the doctor.
Although most house calls were after office hours or on an emergency basis, I’m sure many doctors did sit around some days waiting for the phone to ring. An individual practice took time to build up and a young doctor might not have a reliable clientèle at all. Nor would they have money. Residents lived at the hospital - hence the name, got minimal salaries for the years of training, and needed to invest large amounts of money into an office, a car, and medical equipment. A house call was cash money and a way to build up future good will.
When the majority of people moved to the suburbs and got cars and better paying jobs and medical insurance, this whole way of life died almost as instantly as the snap of a finger. It seems like something to associate with Dr. Watson, but it existed into the 1960s.
Just a couple of years ago now, when we were in the end game of caring for my Mother In Law, in our home, we quite regularly had her doctor come into the home.
Of course she was bedridden from a stroke, but still. No one seemed to think it was unusual.
He came every year and gave her a flu shot, and when the end neared, and her health took a turn, he came, usually within a couple of hours, to see her, sometimes even after hours. In fact, he came and signed the papers when she passed.
So it’s not yet a thing of the past, at least not where I live.
Our doctor in the 50s did house calls. Back then many people did not have cars, or they had one car that the husband took to work. It was more practical for the doctor to get around. At night the doctor would not have been at his office anyway, so house calls made more sense.
When I was a kid in the 50s, doctors made house calls . . . not only the family doctor but also our pediatrician.
My husband’s doctor still makes house calls. In fact, he’s just left a few minutes ago. There are a few doctors in the practice and they take it in turns to do the house calls, which are generally, but not always, in the afternoon. Dr L, who just saw my husband, saw patients in his rooms this morning but is now doing his round of house calls.
The doctor made house calls for all of the reasons already mentioned above. Sometimes he would come if there was an emergency and his clinic was already closed. And I do remember that he brought antibiotics in the form of shots. He may have had them in other forms, but five days of penecillin in the butt was memorable when you’re a kid.
There were two doctors for a town of about 2,000 people. Neither of them did this just for close friends and it wasn’t just for those who could pay immediately. The last time that I saw a doctor during a house call was in about 1966.
Up until about ten years ago, the husband of one of my friends was a physician who taught at Vanderbilt Medical School and also made house calls.
I can remember the doctor making house calls on more than one occasion when I was a kid in England in the 1950s and 60s. I do not know if the doctor was paid more for doing this than for seeing you at his surgery (“office” to you Americans), but we didn’t pay. It was all free on the NHS.
Probably, at least some of what would then be dealt with by a doctor’s house call would now be done by an ambulance and a couple of paramedics who will drag you to the hospital, to eventually be seen by a doctor there. Even adjusted for inflation, I suspect a house call would have been considerably cheaper than that.
I think the difficulties of transporting sick persons to the doctor were easiest overcome by making a house call. You also don’t want someone with a contagious disease leaving their house. Polo, German Measles, Chicken Pox, or Rubella are some nasty contagious diseases you want isolated, especially before vaccinations were available.
The local medical practice my parents signed up for does House Calls. But their speciality is geriatric care, my mother engaged them for my Grandfather when he fell terminally ill. Which is why I suspect that they do so. They will see other patients, but that seems to be the specialty.
I really loved it.
I’m just a medical student so I’m not “out there” yet, but I don’t think this is true. Lewis Thomas in his book The Youngest Science described growing up in the early 20th century with a father who was an old-time doc, and said that his dad basically worked every waking hour of every day, seeing patients in his home office all day and then heading out to do house calls from late afternoon into the evening. The “doctors playing golf on Wednesday afternoons” thing didn’t get its start until doctors started making the big bucks, giving them the luxury of taking more time off, in the 1960s and 1970s, when specialists became more common, and they moved away from home offices and into more institutionalized practices where they weren’t necessarily integrated members of the community expected to be at their patients’ beck and call.
Yes, residents are called such because they used to actually live at the hospital, but in the old-time era we’re talking about, when most doctors did house calls, most doctors never did a residency. You did a 1-year internship and then you went into practice as a GP. If you did a residency (of which there were a lot fewer pre-1960s), you were considered a specialist (yes, general internists used to be considered specialists and their role was not to be PCPs, but to be consulted by GPs for the management of particularly complex patients.)
I grew up in the 40s. Our family doctor had office hours 10-noon and 8-10 at night. No appointments at that time. People who worked could not usually take time off to see a doctor. His office was in his home. Before 10 AM he visited patients in a hospital. Afternoons, he made house calls. I am my siblings got all the usual childhood diseases (measles, mumps, chicken pox) and it was not considered wise to schlep over to the doctor. He would come in to the house, generally made a diagnosis by sniffing the air before even seeing the patient. He brought his bag, a large leather bag that contained a stethoscope, a few simple drugs, first aid stuff. In his car he had a small oxygen tank and mask (which I admistered to grandfather on the day he died). Some time in the late 50s, I think, he started insisting on appointments for his office hours and reduced house calls. I left around then, so I don’t know when he retired, but I know he started in the mid 30s.
There are a few doctors here who practice outside the government insurance and make house calls. I used one once. I had a broken leg and after I came home, a nurse visited every couple days. One visit, she noted infection and said I had to get antibiotics. (IMHO, she should have been able to prescribe it.) I tried calling the surgeon but it was a Friday and he had left for the weekend. I called the local walk-in health clinic but they were unable to do anything without seeing me. You have to understand that there was an inch thick layer of ice on my driveway that I would have had to negotiate on crutches even to get into a taxi. Finally the nurse at the clinic gave me the number of this doctor and I called him. He showed early on Saturday morning, examined me briefly, gave me the prescription for an antibiotic and asked for $125, which I was happy to pay. But it is a hole in our generally wonderful health system.
I made a few house calls back in private practice. Not many, and only for patients well-known to me, but I did make a handful over 18 years.
Since entering corrections medicine, I’ve done a few “cell calls”, too. 