There was a piece in the Times last week about the return of doctor house calls. Part of this is virtual house calls via the technology you are using right now. http://opinionator.blogs.nytimes.com/2013/09/05/hi-its-your-doctor/?ref=opinion&_r=0

Now let’s start off with the obvious thing that no one has uttered in the last several decades. House calls make more sense. The idea of making the sick person get up out of bed and travel TO a doctor is, can we agree, sub-optimal from the patient’s point of view? I remember vividly, if perhaps a little floridly, going to a doctor twice in a week because I had a fever that kept spiking up to the 104 range. I especially recall sitting there feeling like death itself and trying to answer my doctor’s question, which was not about my condition, but where I got my cartoon ideas from. This is a question I can’t answer even when I’m healthy.

But back to the patient’s point of view. There hasn’t been one. Medicine became an assembly line of “patients” (read “slabs of diseased meat”) flopped up onto a series of conveyor belts and run through an insanely complicated and dehumanizing medical factory. And it was largely up to the reeling victim to see to it that he/she/(it) was on the correct conveyor belt at any given time. This was done in the name of efficiency, but it was anything but. It may have been efficient for the doctors, because there weren’t enough of them to make house calls anymore, but it was also insanely expensive compared to every other country on earth. Why weren’t there enough doctors? Cartel system, anyone?

This is all changing now because of technological advances, and the back-breaking cost has finally broken the back of business as usual. Internet housecalls are a start, but it only draws increasing attention to the fact that the bundle of skills a traditional doctor has no longer matches the changing landscape. Doctors’ knowledge-base is larger than required for a lot of routine care, and in the really hard cases, it’s not large enough, and computerized diagnostic assistance will soon be filling in there, and everywhere.

Change is coming. Take two aspirin and things will look different tomorrow.