BC doctor restricts practice to house calls CMAJ 1997;157:240 © 1997 Canadian Medical Association When Vancouver family physician John Sloan began providing geriatric care in 1980, gerontology was "a very young and growing field." Now, with the number of seniors surging in Canada and geriatric medicine a definite growth area, Sloan has stepped full time into house-call care. On July 1 his office moved to his 1984 Toyota and his practice consisted entirely of making house calls to elderly patients. Sloan aims to spend 20 hours weekly on the road, visiting 2 patients hourly. Restricting his driving on any 1 day to a specific area of Vancouver, he hopes to head off unnecessary hospitalizations for his frail patients who cannot make it to a doctor's office. Sloan, a cofounder of the BC Association of Geriatric Care Physicians, believes that maintaining these patients at home makes sense because some hospital beds may be kept open. As well, he says home visits allow him to observe a patient's function in a way that cannot be achieved in a doctor's office. For instance, he may pick up clues in the home that signal a need for extra services. Despite these benefits, Sloan says there are "major hurdles" for physicians who concentrate on house calls. One example is the province's 15% extra payment given to doctors who provide care to seniors; physicians can bill extra for office visits by patients older than 75, but not for home visits. However, Sloan says that he feels "morally and ethically happy" with his decision. Because his overhead costs will be reduced, he expects his income will be "about even" with that in his former office-based practice. He hopes to encourage other physicians to join him on the road. By 2016, an estimated 860 000 seniors will be living in BC. This means, says Sloan, that in the future "physicians will be working within multidisciplinary teams [that see] patients at home." -- Heather Kent Send a letter to the editor responding to this article Envoyez une lettre à la rédaction au sujet de cet article | CMAJ August 1, 1997 (vol 157, no 3) / JAMC le 1er août 1997 (vol 157, no 3) |