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Advocates push for house calls

With the new trend in drive-through hospitals and portable machines, the house call could make a comeback in the high-tech, cost-conscious world of medicine.

"Increasingly there's a need for home care services for the elderly, the chronically ill" and patients preparing for or returning home from ever-shorter hospital stays, said Dr. R. Knight Steel, director of the Home Care Institute at Hackensack University Medical Center.

Steel and his aides at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in Newark are working to design a model home care curriculum that the Association of American Medical Colleges can recommend to members. Steel and other leaders in home care will choose six U.S. medical schools _ each to receive $70,000 stipends _ to integrate home care training into their curricula, hopefully by fall.

Besides sparing the patient the hassle of getting to a doctor, home visitation "has an extremely humanizing impact on physicians" and helps them work better with other care givers, said Steel, a professor of geriatrics.

House calls became less common after World War II as medicine's cutting-edge diagnostic and treatment technology could only be accessed in hospitals. But as better medicine and treatments enabled people to live longer with chronic illnesses, many homebound patients became isolated.

Today, miniaturization of everything from X-ray and electrocardiogram machines to heart monitors and laboratory test kits allows access to most technology at home.

Still, the biggest obstacles to getting more doctors to make house calls are training and money.

"If you can just get the financing straight," said Joanne Schwartzberg, director of the Department of Geriatric Health at the American Medical Association, many more physicians would make house calls.

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