HealthWatch: Doctors’ House Calls Making A Comeback In San Francisco
SAN FRANCISCO (CBS 5) – Housecalls by doctors, an old idea that many thought had seen its day, is gaining new traction in San Francisco.
Driving the resurgence is an in-home medical care program developed by the University of California at San Francisco. The Housecall Program was launched in 1999 to teach medical students about home care, but it has since expanded, providing services to a growing number of elders in San Francisco.
“We have 130 active patients, and about 100 on our waiting list,” said Dr. Rebecca Conant, who directs the program.
June Hagosian is one of the beneficiaries. The 79-year-old teacher is bedridden due to a brain tumor that left her paralyzed on the left side. That makes it tough to get to a doctor — but now the doctor comes to her.
“Hi June, how are you?” asked Dr. Conant as she walked through the door of Hagoasian’s bright yellow house in the Richmond District.
“Very good, very good, come in,” said Hagosian from her hospital bed in the living room
Conant went on to perform a thorough examination – just as she would have done in an office – chatting with Hagosian about how she felt, listening to her heart and lungs.
“That all sounds good,” Conant reported.
“Good, I’m good for another couple of weeks,” Hagosian replied
Conant said demand is high for this type of service.
She noted that people have trouble getting to the doctor for a variety of reasons, many of which are structural. “We have a wonderful old town here with lots of staircases, lots of hills, not very many elevators, not very many accessible buildings and all of those are barriers for people who have physical mobility issues,” she said.
In addition, Conant explained, there may be emotional or cognitive issues.
“Perhaps they have mental illness or dementia and it’s very hard to get them out of the house and to a clinic appointment. They don’t understand what is going on or they are easily agitated by what’s going on.”
Still others are just too ill to go the clinic, suffering perhaps from congestive heart failure, another heart condition or shortness of breath when moving.
Conant considers making house calls a privilege that lets her see first-hand how patients are doing.
“I’ve learned amazing things about people, about their lives, how they’ve existed, and yet I also see the dysfunctionality, people who have troubles with cluttering and hoarding,” she said. “I see people who can’t manage their medications, I see people who are in great poverty, I see people who do not have enough food to eat.”
By keeping tabs at home, Dr. Conant says she’s better able to manage medical problems and help avoid trips to the ER.
“Imagine if I had to take her to the hospital,” said Hagosian’s husband, Monte.
“That would be hard,” answered Conant softly.
But it’s easy to see why this program means the world to people like Hogosian
“The doctors,” said Hogosian, “have been like angels. They’ve been terrific.”
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