It is possible in many instances to avoid invasive procedures in the home:ġ) topical ketoprofen gel 20 % instead of joint injection especially of steroidsĢ) low dose torsemide every hour for 4 to 5 hours will mobilize even malignant ascites.ģ) topical soaks with aluminum acetate to remove proteinaceous debris and then chlorhexidine for anti staph coverage then keep wound surface serially moist plus use of negotiating to facilitate microvascular blood flow facilitates wound care in the home that secondary care givers can give McKoy, MD, is associate professor of medicine and preventive medicine at Northwestern University Feinberg School of Medicine, where she directs the geriatric medicine fellowship program. O’Brien, MD, is a geriatric medicine fellow at Northwestern University’s McGaw Medical Center. Once that happens, house calls may no longer be a part of your grandmother’s past but a viable solution for your new president’s health care, and yours. But making home care a reality will require training programs to provide future doctors with the skills to provide proper home care. Home visits can be an effective way of providing medical care to the burgeoning senior population in the US. It might even be necessary for interns and residents to do three to six months of extra training to really master the complexities of taking care of patients at home. Simulation centers would give residents the ability to really practice with experts, without major disruptions to the current curriculum. Many physicians-in-training already spend time on rotations in which they learn to perform procedures, though these have traditionally been limited to ones needed for in-hospital practice. Many large academic medical centers already have simulation centers where residents could spend time working with experts to hone essential skills like removing fluid from a joint or draining it from the abdomen (abdominal paracentesis). To keep seniors living independently, sensors track their home habits If the house call is to truly make a comeback - and it should for both patient convenience and cost - training programs and the organizations that oversee them must revolutionize their curricula to help young physicians develop the skills necessary for home care medicine. Young doctors must then rely on simulation centers or shadow specialty doctors to gain the out-of-hospital skills they weren’t able to master during their training. However, as the scope of medicine has widened, those in today’s training programs often forego mastery of these basic procedural skills in favor of procedure-oriented services, such as interventional radiology. In the past, such procedures were familiar to most young physicians in all fields of medicine largely because there had been a generalist, competency-based approach to medical education. He or she may have a feeding tube that malfunctions, or arthritis so bad that an injection of steroid into a joint is needed. The patient may be on a breathing machine or ventilator with a tracheostomy tube that needs to be changed.
When doing a house call, a doctor does not have the luxury of sending his or her patient to a specialist for immediate attention. Exclusive analysis of biotech, pharma, and the life sciences Learn More