In San Diego County, residents are now enjoying something reminiscent of older classic television shows, harkening back to simpler times. Remember the old Marcus Welby, MD show?
The doctor, with a kind bedside manner, made house calls and was on a first-name basis with many of his patients. After his examination, he would console the family and announce, “Don’t worry, she’ll be just fine.”
But what’s old is new again as actual house calls are making a comeback, providing better access and improved outcomes here in San Diego County. Many older adults are now benefiting from programs being offered through many health insurers who bring nurse practitioners and their preventive care skills into the homes of older adults.
The nurse practitioners spend up to an hour with patients, checking their health and helping them make connections to other social services so they can live a better, more independent life.
San Diego County is faring slightly better than the average county in California for population health and well-being, and better than the average county in the nation, according to County Health Rankings & Roadmaps, a national study operated by the Robert Wood Johnson Foundation. In San Diego County, California, 16% of adults reported that they consider themselves in fair or poor health, compared to 18% for California.
One nurse practitioner who is a true believer of home house calls them has seen firsthand how the program is saving lives. She describes it as putting out fires before they ever start.
She fondly talks about Jack as an example of how the program is making a difference. One day, after Jack had finished doing his chores, he noticed that he was breathing a little hard. It worsened when he went inside the house.
Fortunately, his nurse practitioner was due for her visit to see Jack. She immediately noticed something wasn’t right when Jack’s blood pressure shot up dangerously high, at 217/110. She insisted that he go to the doctor and receive care. Jack admitted that if she hadn’t come over, he wouldn’t have gone to the doctor, saying, “They found my widow maker, my vein to my heart, and it was 97% clogged.”
The doctor placed a stent in his heart, preventing a massive heart attack. He calls his nurse practitioner his “guardian angel.” Jack credits his nurse practitioner for saving his life.
Colleen, another nurse practitioner who makes house calls, likes to get to know her patients by visiting them regularly in their homes. During a recent visit with her patient, Sue, she sensed there was a problem right away.
Sue was having bad pain in the back of her calf — to the point where she couldn’t walk. Colleen performed a pain assessment and used a screening tool to measure the blood flow to Sue’s legs and feet.
The screening showed Sue had poor circulation in her leg that, if left untreated, could have resulted in serious complications, potentially leading to the loss of her leg. Colleen sought proper medical attention immediately, which not only saved Sue’s life but also saved her independence.
Harkening back to house calls is something old that’s new again and improving the lives of older adults.
Dr. Damanpreet Jamarai is chief medical officer for United Healthcare Medicare & Retirement of California.
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