House calls making a comeback?

House-Calls-Logo.gifDespite the drag that America’s highly-regulated health care finance system places on the delivery of medical services, glimmers of entrepreneurial hope still shine through occasionally:

A new kind of medical practice is flourishing nationwide that offers to go to where the patients are ó whether a home, an office or a hotel ó to treat ailments as diverse as a sprained ankle or a bad case of bronchitis. Some services may even wheel in a mobile X-ray machine or an ultrasound machine, depending on the ailment, or perhaps pull out kits to test for strep throat or to draw blood. They may dole out medication on the spot or arrange for pharmacies to deliver prescriptions.
ìWhen you call, you can speak to a doctor in five minutes, and that doctor can be there with you within the hour. Where else do you get that kind of delivery?î said Walter Krause, founder of Inn-House Doctor. The company says it has 40 physicians on call in Boston, Chicago, Dallas, Houston, Las Vegas, Phoenix, Philadelphia and Washington; some of the doctors are in private practice or work in hospitals, and they make house calls during their time off.
The convenience comes at a price. Appointment fees can range from $250 to $450, with additional tests and medication extra. And payment is due at the time of the appointment.

The website for the service is here. Critics will contend that this service amounts to house calls for the rich, but it is nevertheless a good example of how medical service markets will respond to patients controlling the funds that they are willing to spend on medical services. Frankly, my bet is that that this type of service would already be available at a much lower cost but for the fact that most patients have been insulated from the true cost of medical services and the expenditure of their health care dollars for decades now.

2 thoughts on “House calls making a comeback?

  1. Tom,
    I’m not sure I understand the basis for your surmise that this particular service would be offered at a lower price but for the inefficiency of third party payors. Why would eliminating or reducing such arrangements exert significant downward pressure on the price of house calls? I don’t see that, honestly.
    I actually think house calls and boutique practices in general are a great idea, but, as you note, they are an exemplum of our two or three tier health care nonsystem.

  2. Daniel, you may be right — that’s the thing about less regulated markets. It’s not easy to predict how they will react.
    However, my sense is that this type of service would rarely, if ever, be covered by third party payor services. Consequently, if the purchaser was actually paying for the service, my bet would be that many buyers would opt for the convenience of the service over other alternatives. If that’s correct, the market would eventually respond to the increased demand with greater supply of the service, resulting in more competition and downward pressure on price.
    But you’re right — we’ll never know for sure unless we give it a go.

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