In today’s fast-paced medical environment, are house calls a thing of bygone days?
According to Dr. Scharmaine Baker, NP, not only are house calls still a practice in some corners of the nation, but when they are, they are often a critical component of the community’s well being.
Dr. Baker author of House Calls 101: The Only Book You’ll Ever Need to Start Your Housecall Practice and the Nola the Nurse series, says nurses who want to make house calls understand the importance of those services for people who live far from medical facilities or with limited transportation options or limited physical mobility.
“I was the first nurse practitioner with a house call practice in Louisiana in 2004,” says Dr. Baker. Although she began as a nurse practitioner in 2000, it was a physician’s retirement that started her house call career. The physician had about 15 house call patients that Dr. Baker was asked to take over. “Fifteen patients turned into 100 in a couple of months,” she says. “Once I started making house calls, I thought, ‘This is what I need to do.’ Then Katrina hit.”
When Hurricane Katrina devastated New Orleans in 2005, Dr. Baker says house calls became critical. Health care was hard to come by in the deserted city, but Dr. Baker returned in October and her practice swelled to 500 patients in four months. “I would go into a home and see five to 10 people,” she says of the intense post-Katrina months.
That kind of unpredictability is what makes a house call practice both rewarding and challenging. The house calls require nurses to use every skill they have. “It wasn’t a stretch,” says Dr. Baker. “In my nursing career, I had done just about everything from trauma to home health.” But that’s where the similarities to traditional medical-setting health care ends. Offering health care in someone’s home involves an immense trust and intimacy and often gives unprecedented access to what else is happening in a patient’s life.
House calls, of course, mean a nurse can’t see as many patients as in an office setting. Between the health care practices and the travel, a house call nurse might see 6 or so patients in a day. But the overhead is extremely low, says Dr. Baker.
But that isn’t deterring modern nurses who want to see patients in their home settings. Since 2008, Dr. Baker has taught a monthly house call course for nurses. “I teach others how to start a house call practice in their own state,” she says. “I’ve trained about 100 nurses from all over.”
And house call nurses have to have the breadth of training and experience to give them the confidence to make decisions as a sole health care provider. You can’t run down the hall and ask another provider’s opinion, Dr. Baker says. You are it.
Dr. Baker knows her work is appreciated even though it’s still often a surprise to some. She encourages other nurses to consider the career path.
“To this day there is a growing need,” says Dr. Baker. “But when I go a home, someone will still say, ‘I didn’t know people still did home visits,’” she says.