House calls a burden, but beneficial for older patients

Money is not the only reason doctors avoid house calls ("Bring back house calls"; Oct 17).

House calls take more time and entail travelling in between patients, which means that doctors might not be able to handle a large volume of patients.

Clinics, especially popular ones, are usually swamped with patients, and by the time the doctor has finished seeing them, he may be too exhausted to attend to house calls.

There are also logistical barriers, given that doctors need to carry their medical kits and common medicine along; often, they have to visit the patients again to dispense medication.

While some insurance companies do allow reimbursements for house calls, they do so only if there is a medical reason for the patient not being able to visit the clinic instead, which leads to time-consuming paperwork.

Doctors can charge for house calls, but it is hard to charge enough to justify the time it takes for such trips.

With the limited supply of established doctors and high demand from patients, doctors' time has become very valuable.

House calls can help to reduce re-admission rates at hospitals.

Some hospitals have implemented telemedicine, which should encourage more semi-bed-ridden patients to use this technology.

Home-visit recipients tend to experience less cognitive decline and have a lower mortality risk than those who frequently have to visit hospitals.

It is also an extreme burden for older patients to visit clinics, and is dangerous for high-risk patients, as clinics are full of sick people.

Singapore's healthcare system has done well with patient-centric medical care that includes options such as home care and assisted living but which are also costly and resource intensive.

The Ministry of Health should work with various partners to help needy families care for their infirm, elderly members through cost-effective and coordinated care services, as well as the provision of non-emergency transportation for rehabilitation patients.

Francis Cheng

This article was first published on October 27, 2015.
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