Family Medical Associates Is Bringing Back House Calls

When 80 year-old Leo (not his real name) needed to see the doctor, the very thought of the short car trip and potential associated hazards dramatically increased his anxiety – and changed his mind. He decided not to even attempt to go to his appointment.

Although Dr. Timothy Lowney, Jr., (photo) regularly sees patients at the outpatient offices of Family Medical Associates in Canton and Seekonk (MA), nowadays he sees many patients like Leo in a safer setting, arriving to appointments in a mobile office – his car – equipped with a smartphone, laptop and assorted medical supplies. He visits patients at home, in assisted living centers or nursing homes. This past year he joined the practice his father, Dr. Timothy Lowney, Sr., started 35 years ago.

“We’re going back to the future,” smiles Dr. Lowney, Jr. “In the old days, the family doctor was part of the community. That connection has been lost. Our vision is to serve our patients wherever they need us, focusing on community health and social support.”

Physicians probably made ‘house calls’ in ancient Egypt and Greece, and they certainly did in Victorian England. (photo: Victorian era physician’s buggy used for house calls). People of a certain age will remember when the family doctor’s house call was not so unusual. Until the early 1960s, house calls represented 40% of doctor-patient meetings. By the early ‘80s, modern medicine was centralizing, and primary care became more or an outpatient service. Home visits dropped to just one half of one percent.

Dr. Lowney says the house call concept isn’t old-fashioned; rather it’s a cutting edge idea whose time has come back. He thinks non-emergency medical problems should be treated at home before the patient deteriorates and needs to be rushed to the emergency room – a much more costly and traumatic experience. He says the need for home visits will rise as the population ages. By 2030, about 70 million Americans will be 65 or older. Many will live at home and have disabilities hampering their ability to get to a doctor’s office. Advances in technology have improved the logistics of house calls, making them easier and more cost-efficient.

A 2013 study by the noted Brookings Institution based in Washington, DC, calls home-based primary care “a win-win alternative that can reduce both cost and suffering… one of the big opportunities in health care.” Some of the most tragic and costly episodes of care at the end of life occur because people are either afraid to seek help for fear of being places in a nursing home, or are unable to access care due to lack of social support and decreased independence. It is this patient populations Family Medical Associates aims to serve.

Family Medical Associates has been offering house calls on a limited bases for the past year but are now ramping up the service. “We’ll see any age patient in their home, but multidisciplinary home care will gain popularity as millions of Baby Boomers enter old age,” says Dr. Lowney.

The Brookings study says, “The fastest-growing segment of the Medicare population are those over 85 with multiple chronic conditions. Of those 65+, about a quarter will need eight years of chronic treatment. A single individual may be struggling with, for example, heart failure, vascular disease, stroke, diabetes, hypertension, renal disease, dementia, and more.”

Dr. Lowney, Sr., notes the expense and dangers of transporting frail people when it can be much less expensive and safer to treat them in their familiar environment. “We can also recommend transfers as the patient’s condition changes, then see them again at their new destination. It’s part of the Transitional Care continuum model we’ve developed. It’s proven that this continuity of care helps people both mentally and physically. We strive to address any problems early in their course rather than wait until a medical crisis occurs.”

In addition to being on the staff at Family medical Associates, Dr. Lowney, Jr., serves on the staff at Norwood Hospital, part of the Steward Health Care System. He serves patients at the practice’s Canton and Seekonk offices as well as house calls in all neighboring towns.

Family Medical Associates is located in Canton Center at 709 Washington St. near the Canton Center MBTA Commuter Rail Station. For information and appointments: (781) 828-5351. Family Medical Associates, Seekonk, Mass., is located at 194 Central Ave. : (508) 761-6785.

- By Stanley Hurwitz / (508) 269-0570 / stanhurwitz@gmail.com