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Not what the doctor ordered, as house calls dwindle

HOUSE calls from doctors are in danger of becoming a thing of the past.

Older GPs are nine times more likely than younger, female and urban-based GPs to include routine house calls as part of their practices.

The key differences are age, gender and geography.

The trend emerges in a survey of 12 GP training practices in north Donegal that cover nearly 25,000 patients.

Although the survey was confined to a county whose rural make-up reflects a higher incidence of GP house calls than the national average, the downward trend in the frequency of home visits by GPs is reflected across the country, according to Dr Paul Stewart, the GP behind the research.

He said that GP home-visiting rates in Co Donegal had been declining steadily for the past 25 years.

"We were interested in seeing how much it has declined and we were also aware that there was quite a difference between the different practices.

"What we found was an average home visit rate of 143 per 1,000 per year but rates varied from a low of 45 per 1,000 to a high of 305 per 1,000," he said.

Dr Stewart, who is a strong advocate of the importance of home visits by GPs, said there was a real danger the decline would continue.

"What we are saying is that house calls are alive and well in Donegal but we are heading downwards. The best international comparison is Australia, where their number of house calls halved in the past 10 years," he said.


The rural doctor insisted that house calls gave the GP a valuable insight into their patient's state of health.

"You can learn a lot about people's circumstances by visiting them at home. You can see how they are managing their medical condition," he said.

He revealed that he had a large number of patients, or "old pals", whom he visited on a monthly basis.

"I call in just to see them, check their blood pressure, that kind of thing. These are largely people who would be house-bound, lonely and elderly. This visit is very important to them," he said.

Time efficiency has also become an important factor today where GPs can see five or six patients in an hour in a surgery compared to one in a home visit.

Irish Independent