Date: 7|3|2024

Doctor with man in wheelchairBlair Findlay, HCCI’s Development Associate, rode along with Dr. Paul Chiang, HCCI’s Senior Medical and Practice Advisor, and Northwestern Medicine HomeCare PhysiciansMedical Director, for a day of house calls. In this series, Findlay shares her experiences from that day. Read Part I, Part II, Part III, and Part IV.

The final installment of this series is a reminder of just how important it is for doctors to visit patients in their own homes. With the last patient of the day, Dr. Chiang was able to get a glimpse into Gary’s* life that he otherwise wouldn’t have had if the visit occurred in a doctor’s office.

Gary lives alone and recently broke both of his legs, leaving him homebound. To add to his condition, he is dealing with depression and high blood pressure. Without access to house calls, Gary would have had to ask his son to take off work to drive him to a doctor’s visit. During the conversation with Dr. Chiang, Gary revealed he had a general mistrust of doctors, but said, “It helps when you don’t have to be in the waiting room.”

Due to his state, Gary was limited to the first floor of his home, so he had a bed set up in his living room, where he remained most of the day. A crucial aspect of Dr. Chiang’s house calls involves inspecting the patient’s home for potential hazards, such as slippery rugs and uneven flooring. During the visit, Dr. Chiang explored the top floor of the house and noticed that the upstairs bed looked slept in. “Sometimes I cheat and go upstairs,” Gary later admitted to Dr. Chiang. This is a considerable risk in his condition and would have been overlooked in a traditional office visit.

Another key component of Dr. Chiang’s house call is checking the kitchen to make sure the patient has proper access to food. Upon opening the fridge and freezer, Dr. Chiang found that the only food Gary had available were frozen meals, which were high in salt and, therefore, less than ideal for those with high blood pressure. This was a moment in the house call when I realized that no matter how thorough and skilled Dr. Chiang is, he can’t solve all issues. “I can’t fix the industry of quick, unhealthy meals,” he said.

But Dr. Chiang didn’t reprimand Gary for going upstairs or eating unhealthy meals. He brought compassion and care into every aspect of the visit, which led Gary to open up and even joke a little, despite being reluctant at the beginning of the house call.

Throughout this series, we shared the story of five patients, Betty, Quang, Fazli and Ilma, and Gary, all with different backgrounds, socioeconomic statuses, and cultures. They are the lucky ones — 85% of individuals who need home-based primary care cannot access it. Your support of HCCI makes it possible for more individuals to receive this life-changing care.

Share and Get Involved:

  • Increase access to home-based primary care by donating to HCCI.
  • Refer healthcare providers and practices to HCCI.
  • Interested in having your own house call shadowing experience? Contact our development team to learn more.

*The name has been changed for privacy.