My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
One of my first chances to be "heroic" was when I got a call to help a man in his late 50s with severe spasms in his lower back. Mr. Kopopkins couldn't stand and walk more than a few steps, and he couldn't rise from a chair without sharp, debilitating pain. He was in so much pain and so dysfunctional, I couldn't imagine how he would respond.
I swung open the treatment table and carefully helped him to lie face down. But that position made his low back spasms worsen so much that he pleaded for me to help turn him on his side. It seemed to take an hour just to get him to turn on his right side, with gasping and muffled screams all the way. But that didn't help. Any pressure I put on his back elicited a quick, spastic pain, making him break out in a James Brown-like "cold sweat."
I solemnly waved a "best wishes" gesture as the ambulance sped away to the hospital ER with Mr. Kopopkins. His wife was about to get into her Volkswagen and follow when she glanced at me with a look of, Oh well. I felt defeated, incompetent and a few other adjectives relating to failure. I felt even worse when I finally thought, what am I going to charge for this house call?
Many years later, I was living with my family far out in the country when an elderly neighbor, Ms. Carrie, called me to help get her husband off the floor. Ed, probably age 80 or so, had been there for two days with low back spasms anytime he moved. She had been taking care of his vital needs and keeping him hydrated, but was close to calling the 911 people.
When I got there, Ed was in his underwear, lying face-up on the floor reading a Zane Grey paperback novel. But he still couldn't move, kneel, or stand up without serious pain.
Without stretching the story out too long, I ended up being the "hero" this time. I got Ed off the floor with some movement strategies and just plain reassurance. Then I got him in a chair and adjusted him there. He responded nicely. When I left, he was marching around with some cockiness. Carrie and Ed appreciated his recovery so much that they have referred many friends and family ever since.
Over the years, I have learned more about which patients I can probably treat or help in their homes, and which ones need medical intervention. I have gone to nursing homes, trailer homes, attics and even pontoon boats. But in every house call, I have realized I could take better care of the patient in my own office, where I have appropriate equipment.
These days, I might still meet up with an acute-pain patient on a Sunday at my office. But that is up to me, and it is not as stressful as doing a house call during which I am trying to treat a patient on a sofa, in their home, with too many small, yipping and jumping dogs. (By the way, that was my last house call.)
If you believe the Internet, a surprising number of chiropractors and medical doctors are doing "cash only" house-call services. A large number of medical physicians are doing house visits, often under the umbrella of a corporate medical entity. "Doctors Making House Calls", operating in the Southeast U.S., states that it has more than 75 clinicians who have done over 85,000 house visits to date!
Among the DCs doing house calls, the Web shows specially fitted motorhomes with full-sized adjusting tables. One of my friends says he has an agreement with a large corporation to pull his big RV into the parking lot and treat the employees. In the space of an afternoon, he does well financially.
I understand the "cash only" trend in the chiropractic profession, but is the "house call" trend still trending?
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