"If Mohammed won't come to the mountain, let the mountain come to Mohammed''. The practice of doctors going to the homes of patients is probably not as old as the proverb itself, but home visits have been the norm over the years, only a tad out of fashion just now.
The government-run health care programme is the ideal example of a hub-and-spoke model of healthcare, where one large hospital serves as the hub and several smaller units diverge from there, getting closer to the community, the last leg being the home visits. While the primary health centres run by the State go into the community to provide health care, the village health nurses or currently, AASHAs appointed under the National Rural Health Mission are the ones that actually perform the outreach function.
The Voluntary Health Services Hospital in Taramani was one of the initial players in introducing this concept in contemporary practice. They have about 14 community health centres — the nearest about three km from the VHS hospital in Taramani and the furthest about 50 kms away, according to E.S.Krishnamoorthy, its honorary secretary. These centres serve defined populations between 5000 and 10,000 people, where doctors visit regularly, and two people from the community have been trained in the role of village nurses to go from home to home. For more complex cases, referrals are made to the main hospital.
A similar, but slightly different model is filling up gaps in existing health care services. In the case of the Geriatric Housecall programme, it is to provide services right at the doorstep of senior citizens. In operation for the past couple of years, the group of professionals who have committed their time to taking care of the elderly in their homes have treated over 300 patients.
V. S. Natarajan, senior geriatrician who also authored the programme, says, “The calls for help come from people who have had falls, high fever, chest infections and dehydration in summer.” The consultants charge a nominal fee, but fill up an intensely-felt need in the community, he adds.
Organisations that provide palliative care also send caregivers home to take care of patients who are terminally ill. Camps by larger medical organisations held in semi-urban and rural areas are also seen as outreach services.
That is precisely what the bunch of Star clinics in the city are trying to do, but offering a wider gamut of medicare services. About eight clinics established throughout the city are the first contact points, says Solomon Wilson, chief executive officer. On payment of Rs.2,400 for a year, the person who registers will get 2 home visits by doctors, six nurse visits, wellness counselling, a discount on drugs, delivered free at home, at their pharmacies.
Another plan, priced at Rs.3,600, will buy a few more services. There are add-on services like doctor's call and nurses' call paid for per visit.
