Doctor house calls: Modern medicine looks to the past

OGDEN, Utah — For 65-year-old Joe Evans, simple chores are a struggle.

“It’s really, really hard,” he said. “I can’t even walk to the bathroom without getting out of breath.”

Evans, a former contractor, is on oxygen full time after being diagnosed with COPD five years ago.

He started smoking as a teenager.

“People told me it was bad for me, but I didn’t listen,” he said.

Evans is now mostly homebound. Trips to the doctor or dentist are risky and exhausting.

“And then, when I finally get home, I’m just so wore out. Just because, you know, not being able to breathe the whole time,” he said.

But his interactions with the health care community have improved.

“It’s just been amazing, since not only do they come here and take your blood pressure, check your lungs, but they brought equipment here to test my heart,” Evans said about Castell House Calls.

The program is a subsidiary of Intermountain Health. A professional now regularly provides care in his Ogden apartment.

Nurse Practitioner Gayle Mortensen keeps tabs on Evans’ well-being and medications, and makes sure concerns are dealt with before they become a bigger problem.

“We found that people were using InstaCare and emergency departments as their primary care because they were waiting until they’re really, really sick before they addressed issues,” Mortensen said.

“The house calls program has helped decrease emergency room use by a significant number — 8 to 12%,” she claimed. “So, we save money by keeping patients healthier.”

Patients are referred to Castell House Calls through others in the medical community, such as their primary care or emergency room provider, hospital staff or a case manager at an insurance company. Intermountain Health’s own insurance company, SelectHealth, helped create the house calls program.

Back in the 1930’s and 40’s, doctor house calls were so common that 40% of patients saw doctors at home. By 1980, only about 1% of visits happened in people’s homes.

While society won’t ever return to those good old days, it’s clear that for patients with limited mobility, house calls dramatically improve quality of life.

“And they do a wonderful job,” Evans said. “It saves me time. It saves me heartache and pain. Oh man, it’s lifesaving.”