How to Make House Calls As a Medical Professional
Introduce yourself appropriately., Choose an appropriate setting to conduct the history., Conduct the patient history., Determine an appropriate setting for the exam., Take the patient’s vital signs., Perform the exam., Evaluate your patient's...
Step-by-Step Guide
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Step 1: Introduce yourself appropriately.
If this is your first visit with the patient, and if someone else (such as your nurse or your receptionist) has set up the appointment, it is key to take time for a proper introduction and to develop rapport with the patient.Introduce yourself, and explain a little bit about your medical practice (if the patient is new) and what this particular visit will be about.
Ask the patient how they prefer to be addressed.
For example, “Do you prefer to be called Mrs.
Jones, or may I call you Mary?” Make some small talk with the patient to create rapport and make them comfortable.
Consider asking about your patient's job, their kids, or their hobbies. -
Step 2: Choose an appropriate setting to conduct the history.
Let your patient know that you need to ask them a few questions about their health history before you begin the exam.
Ask where they would be most comfortable doing this.
During a house call, the history can normally take place in the main room (the living room), or occasionally in the kitchen.
Choose a location that is quiet, free from distraction, and will allow you to easily take notes. , Ask the patient about any relevant background health information, as well as any current health concerns that form the focus of the day's visit.
Sometimes the history is based on a specific concern the patient has, and sometimes it is the result of a concern that you, as the physician, may have about your patient.The history can be done with the presence of other people, if this helps with data gathering.
For instance, especially with elderly patients, having others there, such as the patient's children, can provide collateral information that the patient may not have remembered or been able to provide themselves. , This will depend in part on the nature of the exam.
Decide whether you can conduct the physical examination with the patient sitting (which is possible if it is an examination of the heart or lungs, for instance), or if you need to have the patient lying down (such as for an abdominal exam).
Try to choose a comfortable, quiet location where you will have enough room to work and set up whatever equipment you need.If you need the patient to be lying down, they may be able to do so on a sofa.
Alternatively, they may need to lie on their bed, especially if the patient is older and/or frail and you want to offer them maximum ease and comfort. , Measure and record the heart rate, the respiratory rate, the patient's blood pressure and, if applicable, their oxygen saturation.
You may also wish to get the patient’s weight and height at this point.Be sure to wash your hands prior to commencing the physical examination., Be sure to explain the steps of your exam to the patient prior to performing them.
This way, the patient will be prepared and not surprised as to what is coming next.
Be prepared to answer any questions the patient or their family members may have during the exam.Address your patient in a polite, respectful manner.
Ask (rather than tell) your patient to do whatever is required of them during the exam.
For example: “Would you please raise your right arm for me?” rather than “Raise your right arm.” , The unique benefit of a home visit is that is offers you an ability to evaluate (and to see first-hand) your patient's ability to perform daily tasks around the house.
You can ask about their ability to bathe themselves, to get dressed, and to cook, clean, and complete tasks around the house.A house call will also give you a chance to assess home safety.You can look for things such as railings where needed if your patient is unstable, and evaluate other safety issues such as whether your patient is capable of climbing stairs. , When you have completed all you need to in terms of both history-taking and the physical exam, you are ready to finish the appointment with your patient.
Allow the patient privacy to get dressed again (if the physical examination required removing any clothing), and then ask them to sit down with you to discuss your findings.
Inform the patient of what you found during the exam, and what your thoughts are with regards to their health, any potential diagnoses, or treatments that may be needed.
At this time, you can also discuss any investigations (such as blood tests, urine tests, or imaging) that may be helpful for your patient.
If your patient is on board, you can fill out the forms for these tests now.
Be sure to ask your patient if he or she has any questions for you at this time.
You want your patient to have a sense of completion and understanding of their condition when you close the appointment.
Allow time for questions so that your patient is not left with worries on their mind. , Make sure you document your findings in your notebook or on your laptop (in your patient's electronic medical record) prior to leaving the appointment, or shortly after leaving.
Recording all the relevant medical notes sooner rather than later will help to ensure that you don't miss any important details or results in your patient's medical records., A few days after your appointment, it is wise to check in with your patient (or to have your assistant or nurse check in with them) to ask how they are doing and if there are any additional concerns.
This follow-up portion is optional, but it is an easy way to show your patient that you care about them and want to provide optimal healthcare.
Once you have established rapport with your patient and done a few house calls, you can give the patient the responsibility of calling your office if they have any follow-up concerns. -
Step 3: Conduct the patient history.
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Step 4: Determine an appropriate setting for the exam.
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Step 5: Take the patient’s vital signs.
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Step 6: Perform the exam.
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Step 7: Evaluate your patient's overall functioning at home.
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Step 8: Finish the appointment.
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Step 9: Document appropriately.
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Step 10: Follow-up with your patient.
Detailed Guide
If this is your first visit with the patient, and if someone else (such as your nurse or your receptionist) has set up the appointment, it is key to take time for a proper introduction and to develop rapport with the patient.Introduce yourself, and explain a little bit about your medical practice (if the patient is new) and what this particular visit will be about.
Ask the patient how they prefer to be addressed.
For example, “Do you prefer to be called Mrs.
Jones, or may I call you Mary?” Make some small talk with the patient to create rapport and make them comfortable.
Consider asking about your patient's job, their kids, or their hobbies.
Let your patient know that you need to ask them a few questions about their health history before you begin the exam.
Ask where they would be most comfortable doing this.
During a house call, the history can normally take place in the main room (the living room), or occasionally in the kitchen.
Choose a location that is quiet, free from distraction, and will allow you to easily take notes. , Ask the patient about any relevant background health information, as well as any current health concerns that form the focus of the day's visit.
Sometimes the history is based on a specific concern the patient has, and sometimes it is the result of a concern that you, as the physician, may have about your patient.The history can be done with the presence of other people, if this helps with data gathering.
For instance, especially with elderly patients, having others there, such as the patient's children, can provide collateral information that the patient may not have remembered or been able to provide themselves. , This will depend in part on the nature of the exam.
Decide whether you can conduct the physical examination with the patient sitting (which is possible if it is an examination of the heart or lungs, for instance), or if you need to have the patient lying down (such as for an abdominal exam).
Try to choose a comfortable, quiet location where you will have enough room to work and set up whatever equipment you need.If you need the patient to be lying down, they may be able to do so on a sofa.
Alternatively, they may need to lie on their bed, especially if the patient is older and/or frail and you want to offer them maximum ease and comfort. , Measure and record the heart rate, the respiratory rate, the patient's blood pressure and, if applicable, their oxygen saturation.
You may also wish to get the patient’s weight and height at this point.Be sure to wash your hands prior to commencing the physical examination., Be sure to explain the steps of your exam to the patient prior to performing them.
This way, the patient will be prepared and not surprised as to what is coming next.
Be prepared to answer any questions the patient or their family members may have during the exam.Address your patient in a polite, respectful manner.
Ask (rather than tell) your patient to do whatever is required of them during the exam.
For example: “Would you please raise your right arm for me?” rather than “Raise your right arm.” , The unique benefit of a home visit is that is offers you an ability to evaluate (and to see first-hand) your patient's ability to perform daily tasks around the house.
You can ask about their ability to bathe themselves, to get dressed, and to cook, clean, and complete tasks around the house.A house call will also give you a chance to assess home safety.You can look for things such as railings where needed if your patient is unstable, and evaluate other safety issues such as whether your patient is capable of climbing stairs. , When you have completed all you need to in terms of both history-taking and the physical exam, you are ready to finish the appointment with your patient.
Allow the patient privacy to get dressed again (if the physical examination required removing any clothing), and then ask them to sit down with you to discuss your findings.
Inform the patient of what you found during the exam, and what your thoughts are with regards to their health, any potential diagnoses, or treatments that may be needed.
At this time, you can also discuss any investigations (such as blood tests, urine tests, or imaging) that may be helpful for your patient.
If your patient is on board, you can fill out the forms for these tests now.
Be sure to ask your patient if he or she has any questions for you at this time.
You want your patient to have a sense of completion and understanding of their condition when you close the appointment.
Allow time for questions so that your patient is not left with worries on their mind. , Make sure you document your findings in your notebook or on your laptop (in your patient's electronic medical record) prior to leaving the appointment, or shortly after leaving.
Recording all the relevant medical notes sooner rather than later will help to ensure that you don't miss any important details or results in your patient's medical records., A few days after your appointment, it is wise to check in with your patient (or to have your assistant or nurse check in with them) to ask how they are doing and if there are any additional concerns.
This follow-up portion is optional, but it is an easy way to show your patient that you care about them and want to provide optimal healthcare.
Once you have established rapport with your patient and done a few house calls, you can give the patient the responsibility of calling your office if they have any follow-up concerns.
About the Author
Elizabeth Long
Brings years of experience writing about lifestyle and related subjects.
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