How one physician’s home visits reveal a glimpse of healthcare in the future

The medical practice of Roberta Miller, MD, is reminiscent of the patient-physician relationship of decades past. Instead of asking patients to come to her office for medical care, she has put 250,000 miles on her Honda minivan traveling to their homes in upstate New York, according to a WBUR News report.

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Dr. Miller has been a home care physician in Schenectady, N.Y., for more than 20 years. She spends about an hour at each of her patient’s homes per visit, talking to his or her family members, noting which pill bottles are empty and taking vitals.

“You can evaluate the person as a whole,” she said of her home visits, according to the report. “You see everything that influences their health and well-being: the environment, the surrounding people, the support system, whether they had or didn’t have food.”

While her style of caring for patients may seem like a mere vestige of an earlier version of American healthcare, it may become the future of medicine.  WBUR News reported approximately 2.6 million Medicare claims were filed in 2013 for patient home visits and house calls, up from 2.3 million visits in 2009 and 1.4 million visits in 1999, according to Medicare statistics. The trend is expected to continue to grow as baby boomers age.

Many patients requiring home healthcare never leave their homes, rendering them more or less invisible, aside from their own family.

“That’s just the nature of the population we treat,” Dr. Miller told WBUR News. “They’re extremely ill. Homebound patients often have up to 12 or 13 problems, not just one.”

Unfortunately, home healthcare skills are rarely taught in medical education programs, but the need is still great, Dr. Miller told WBUR News.

Dr. Miller and her husband, also a physician, currently see a total of 300 patients and have a long wait-list for care. She said she’s seen a significant spike in new patient requests since the Affordable Care Act expanded insurance coverage beginning in 2014 and more low-income patients became eligible for Medicaid in New York.

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