SENIOR POWER: House call medicine

Helen Rippier Wheeler,
Friday September 05, 2014 - 08:47:00 AM

Does anyone recall House Calls, the 1978 “comedy drama romance” motion picture? Walter Matthau played a middle aged lech-surgeon-widower. The talents of Glenda Jackson, Art Carney and Richard Benjamin were also wasted. It actually went on to one TV season.  

In 2004 there was Ron Hazelton's house-maintenance tips TV show. 

Thirty-six years later, when you explore the Internet for house calls, you’ll find a lot more stuff. News and advertisements. Like Ina Jaffe’s "House Calls Keep People Out Of Nursing Homes And Save Money" (U.S. National Public Radio blog, August 7, 2014). Bay Area House Calls Physicians declare “We started a new model of practice to bring back an old style of practicing medicine: We make House Calls.” The UCSF Division of Geriatrics Housecalls Program provides primary care to homebound elders in San Francisco.  

Wikipedia defines a house call as a visit to the home of a patient or client by a doctor or other professional. Families used to pay dues to a particular practice to underwrite house calls. Fifty+ years ago, house calls by doctors were 40% of doctor-patient meetings; by 1980, 0.6%. Reasons include increased specialization and technology. Until the Balanced Budget Amendment, team home care, including physician visits, was a small but growing field in health care for frail older people with chronic illnesses. Thousands of home health agencies went out of business. The reasons for fewer house calls include lack of physician education, inconvenience and lower pay. 

On the other hand, there are doctors who like the idea of no office overhead. And of course, a house call can provide safe access to care by people who are sick!  

In 2012 as part of its Action Plan for Healthcare the province of Ontario, Canada expanded funding for access to house calls with its primary focus being on seniors and those with physical limitations making it difficult for travel outside the home. Residents of Ontario with valid Ontario Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home. 

Peter Gott, M.D. (1935-2012) authored four books. His No Flour, No Sugar Cookbook, published in 2008, was a bestseller, but my focus here is his No House Calls; Irreverent Notes on the Practice of Medicine (Poseidon Press, 1986.) As far as I can tell, in California only Loma Linda University Library has a copy; you too can probably borrow it through your public library.  

In the early’80s, Dr. Gott began writing a very popular medical column for The Lakeville Journal. Regarding house calls, he wrote in 1986, “I am fortunate to practice medicine in a part of the world where most doctors seem to have their patients’ best interests as a primary concern. Perhaps that is an advantage of living in the country. For example, to my knowledge, all the doctors on the staff of our community hospital make house calls. What? Oh, you know, when the doctor calls on sick patients at home. Even surgeons here do it. And – hold on to your seat belt –so does our part-time dermatologist from Manhattan. Whatever is in the rural air must be catching. To say that we are bucking a national trend is like pointing out that birds sing in the morning.”  

Dr. Gott died in his Lakeville, Connecticut home, after a six-year battle with Parkinson’s disease. The Princeton University alumni association concluded his obit, “We always will remember this fine man.” 



A reader of August 22, 2014’s Senior Power column, which was mostly about the G Word, has sent news of Grandma Gatewood. Artistic Director of Eden Valley Enterprises Bette Lou Higgins, writes “I just finished reading your article in the The Berkeley Daily Planet. Grandma Gatewood is a lady near and dear to my heart! Her story is truly inspiring and I've been working with Eden Valley Enterprises and FilmAffects on documenting her life since 2009. We've already completed a storytelling program (with companion e-book and DVD) and a one-act play. In May of next year (in time for the 60th Anniversary of her record-setting hike), we'll premier a PBS documentary about her!” 

Nora Super, recently appointed executive director of the 2015 White House Conference on Aging (a more or less every-decade conference), will speak at the October 11, 2014 meeting of OWL: The Voice of Midlife and Older Women. The meeting is free and open to the public, 11:00 AM - 12:30 PM., held at Hyde Park's Hyatt Place Chicago-South/University Medical Center, 5225 South Harper Ave. The theme of the meeting reflects the Older Women’s League’s current campaign: "Our Women Mean Business: Encore Careers after 40." With 9 million+ women-owned businesses in the country, and women starting over 1,200 new businesses per day -- double the rate from three years ago -- they are a powerful force in the economy. [OWL 1625 K Street NW, Suite 1275 Washington, D.C. 20006 202-567-2606. OWL’s San Francisco Chapter is at 870 Market Street, #905 415.989.4422



"New law enhances residents' rights in residential care facilities for elderly," by Katie Nelson (Santa Cruz Sentinel, July 24, 2014). 

"Reuters (news service) says San Diego has best public pension plan in U.S." (XETV Channel 6 [San Diego] TV News, Aug. 22, 2014). 

"New Program Promises Coordinated Care for Low-Income Californians," by Elena Shore (New America Medica, August 23, 2014). 

“California to recover USD 300 million for pension funds in Bank of America settlement," (Contra Costa Times [San Francisco, California], August 23, 2014). 

August 26 was Women’s Equality Day. The gap in life expectancy at age 65 places California 39th. WalletHub conducted an in-depth analysis of 2014’s Best and Worst States for Women's Equality ( The United States ranks 23rd on the Global Gender Gap Index.  

"Audit finds some L.A. County nursing home cases prematurely closed," by Abby Sewell and Eryn Brown (Los Angeles Times, August 29, 2014).  

"After Ventura County court battle, pension tensions endure," by Austen Hufford (Pacific Coast Business Times [Santa Barbara], August 29, 2014).