House calls return to Sask. medicine
REGINA — House calls by family doctors: it’s back to the future, says Dr. David McCutcheon.
“Except that in this case, we’re talking about members of a health care team, which would include a family doctor. But the visit might be done by a nurse practitioner, by a paramedic, or it could be done by an occupational therapist or a social worker, depending on the assessed need of the individual,” said McCutcheon, vice-president of physician and integrated health services for the Regina Qu’Appelle Health Region.
In Wednesday’s throne speech, the provincial government proposed that health-care providers make house calls on some seniors
PAMELA COWAN who have complex needs.
“We know that in the last fiscal year, in Regina and Saskatoon’s emergency departments, 20 per cent of the visits were by seniors and a percentage of those were non-emergent issues,” Health Minister Dustin Duncan said.
The house call program will likely be piloted in one urban and one rural location. But before it’s developed, there will be discussions with physicians and other health-care providers, he said.
“The size and scope of the program will be more clearly defined as we get through the budget process.”
The inability of some seniors to access primary care has led to expensive alternatives, such as emergency department visits. Seniors account for 37 per cent of all hospitalizations.
McCutcheon believes the program will relieve some pressure on hospital emergency departments, but added there is a much more important payoff.
“The individual concerned will have a much better quality of life and better-quality health care,” he said.
McCutcheon noted that some seniors who seek treatment at emergency departments have cognitive problems.
“If they are managed at home, then they know where their own bathroom is, there’s not all of the distraction of a busy ward, it’s a whole lot more comfortable and easier for the individual,” he said. “They are less likely to fall when they are in their own physical environment — there’s some huge advantages.”
The aim of the house call program is to keep seniors independent and in their homes, with supports.
That sits well with Betty Pickering, president of the Saskatchewan Seniors Mechanism. She said seniors with complex needs require greater access to a team of health professionals, which in turn will lead to better care.
“If you go to the hospital as a senior, you know that the resources are there,” Pickering said. ‘You will have all of the professional support people and equipment to do all of the testing and that sort of thing. The alternative has to be viable and long-term and funded so the senior feels safe and comfortable and confident.”
The house call program is based on a home-based seniors’ house call program at Mount Sinai Hospital in Toronto, which involves physicians, nurses, paramedics, physiotherapists and occupational therapists.
Dr. Clare Kozroski, president of the Saskatchewan Medical Association, believes the house call program has merit.
“If we can unload the emergency rooms of people who are really not bestserved there and who ought to be seen at home, then we should make that happen,” Kozroski said.
She noted that not all patients require the services of a doctor.
“If we have the right resources invested in change so we have a forward-looking health-care delivery system, then physicians are going to be happy ... Recruitment and retention are really assisted by a provincial promise to improve patient access to appropriate care,” Kozroski said.