Yes, Some Doctors Do Make House Calls!
You may recall the days long ago when a doctor, carrying his black medical bag, visited patients at home to address everything from the measles to childbirth. Now, as a result of a 2001 change in Medicare benefits, physicians and medical groups specializing in house calls have again become available to older adults. Known as “visiting physicians” or “home care physicians”, these professionals can provide an array of services in the privacy, comfort and convenience of your own home.

Who are home care physicians?
Doctors who specialize in house calls are usually board-certified in family or internal medicine, and have extensive experience in adult and geriatric care. They operate much like an office practice, but they are dedicated exclusively to making house calls and do not see patients in an office. Home care medical teams may also include board-certified physician assistants or nurse practitioners.

 What services are offered by a home care physician?
Most home care physicians offer a comprehensive range of services, from routine checkups and on-going preventive care to diagnostic testing and treating serious illnesses. Improvements in medical technology may even allow home care physicians to perform electrocardiograms (EKGs) and other tests in your home. Typical physician house call services include: 

• Physical examinations
• On-going treatment of medical conditions like heart disease, lung disease, arthritis, osteoporosis, Parkinson’s disease and diabetes
• Portable diagnostic testing
• Medication management and refills
• Referral to physical therapy and specialized rehabilitation services
• Coordination of home care nurses, home health aides and medical equipment
• Physician review for authorization of therapy, home health care, medical equipment and diagnostic testing

Who might benefit from the service of a home care physician?
House calls may be especially helpful for older adults who experience the following challenges:

• Immobility
• Cognitive, psychiatric or emotional instability
• Need to involve home-based caregivers in consultation with my doctor
• Need for someone to assess the home situation 

Do I need to be homebound to receive the services of a home care physician?
No. With reasons like those noted above, Medicare will cover physician home visits even if a patient is not homebound. People who use the services of home care physicians are more likely to be “home limited” than “homebound”.

How do home care physician services differ from other home care services?
In addition to home care physician services, two other types of services are available to people in their homes. In-Home Medical Care is designed for people who require the services of a registered nurse or physical therapist for a limited time while they are recovering from illness or injury. This type of care is often covered by Medicare. In-Home Personal or Non-Medical Care is designed for people who need regular help over a longer period of time with feeding, dressing, bathing, homemaking or companionship. Services are provided by a home health aide. This type of care may be covered for a very limited period of time by Medicare, but usually requires out-of-pocket expenses in the longer term.

Home care physicians differ from these services in the type of services they provide and the qualifications of their personnel. Home care physicians can authorize and monitor in-home medical or non-medical care.

Can I still see my regular doctor if I use the services of a home care physician?
Having a primary care physician, who oversees all of your care and treats routine ailments like colds and the flu, is important for everyone at any age. Once people adopt home care physician services, they may choose the visiting doctor as their primary care provider. But if you prefer to visit the primary care doctor who has served you for years, and limit the services of a home care physician to portable diagnostic tests or routine check-ups or sick care, the two professionals can usually coordinate their treatments.

 I see a specialist. Will a home care physicians group provide specialty care?
Some home physicians groups can arrange for house calls from podiatrists, optometrists or even dentists. But if you require the on-going care of a specialist, you may still need occasional visits to that doctor’s office. A home care physician can arrange to manage the care that a specialist prescribes, and communicate regularly with the specialist’s office. But some specialty visits may still be required outside your home.

Are house calls covered by insurance?
Most home care physicians are participating Medicare providers and accept Medicare assignment. Medicare will usually cover 80% of the cost of a house call. Patients, or their supplemental insurance, are responsible for their annual deductible and the 20% not covered by Medicare. Most home care physicians also accept private payment for their services.

 How can I find a doctor who makes house calls?
Suggestions of where to find a home care physician include:

• If you are being discharged from a hospital, the discharge planner may provide you with a list of home care physicians.
• Your current doctor may have a list of home care physicians.
• Friends, family members and coworkers may have used home care physician services. Ask who provided the service and what their experience was like.
• Contact your local Area Agency on Aging.
• Visit the web site for the American Academy of Home Care Physicians at http://www.aahcp.org/. The site includes a provider locator for each state and identifies individual physicians who will come into the home, as well as some agencies that specialize in this service.
• Look in the Yellow Pages under headings such as "home health care services" or “physicians”. Look for names like “house call specialists” or “mobile doctors” or “visiting physicians”.

What questions should I ask if I’m considering the services of a home care physician?

Here are some questions to ask any physician who offers to come to your home:

• Is the physician board-certified?
• What are the physician’s qualifications?
• How long has the physician been in business in your community?
• What services does the physician provide?
• Does the physician provide an initial assessment to identify your needs and determine what types of services are needed?
• Is the physician part of a group practice?
• Who owns the practice?
• Is the practice owned by a physician who is present every day? Or has a medical director been appointed who is present every day?
• Does the practice do criminal background checks on their personnel before hiring?
• Is the physician bonded and insured?
• Does the practice have clear, professional-looking written materials about services, eligibility requirements and fees?
• Will you always see the same physician? Who will see patients if the doctor is out of town or not available?
• Can you still see your regular doctor?
• How often does the doctor visit?
• What happens in an emergency?
• How will specialty care be coordinated?
• Are physicians available for house calls during the day, in the evening or on weekends?
• How long does it take to get an appointment?
• What type of health insurance does the physician accept? What will be your cost for services?

• How quickly can the physician begin service?

 Article contributed by gerontologist Barbara Spreitzer-Berent

 Southeast Michigan Visiting Physician Resources:

Alliance of Home Care Physicians
2104 E. 11 Mile Rd., Suite 600
Warren, Michigan 48091
(586) 758-6222

Care For You Home Medical Service
751 East Nine Mile Road, Suite 1
Ferndale, Michigan 48220

Doctor House Calls
24567 Northwestern Highway, Suite 150
Southfield, Michigan 48075
(248) 799-0086

Drs., Inc.
4000 Town Center, Suite 370
Southfield, Michigan 48075
(248) 356-5534

Home Care Physicians
22301 Kelly Road
Eastpointe, Michigan 48021
(586) 443-5588

Med-Share Inc.
26222 Telegraph Road, Suite 100
Southfield, Michigan 48034
(248) 827-7200

Residential Home Care
11477 East 12 Mile Road,
Warren, Michigan 48093
(586) 751-0200

Visiting Physicians Association
21540 West 11 Mile, Suite 200
Southfield, Michigan 48076
(248) 352-2000

845 Michigan Avenue
Marysville, Michigan 48040 
(810) 364-5050

2755 Carpenter Rd, Suite 15
Ann Arbor, Michigan 48108
(734) 975-5000