The Coral Gables Times

Are Suburban Doctors Dodging House Calls?

BY JOHN DRIVER Or if patients today are able to drive or be driven, are there sound reasons for them DR. NEWMAN had just risen from his 7:30 a.m. breakfast and was reaching for his little black bag when the telephone rang. "Doctor," said the worried caller, "my husband just had some kind of seizure. He looks like death, and he can hardly breathe. Can you come right away?" "I'll be there in 15 minutes, on my way to the hospital," said Dr. Newman, after asking a couple of quick questions. "Keep him still, and don't give him anything." Before the doctor got the front door open, the telephone shrilled again. "Doctor," said the worried caller, "Betsy is sick. She threw up her breakfast, and her temperature is over 100. Can you come right away?" "Give her a little warm milk to replace the lost breakfast," said Dr. Newman, after asking a couple of quick questions. "Then, about 10:30, wrap her up warmly and bring her down to my office. I'll see her as soon as I get in from the hospital." Why did Dr. Newman visit one patient and not the other? Since that identical question is bothering a lot of people who've had recent experience of illness in the household, I thought I'd put it bluntly to the man best able to answer it. Word for word, this is what Dr. Newman (for ethical reasons, he won't let me use his real name) told me: "From the first woman's answers to my questions, I suspected that her husband had had a dangerous heart attack. As it turned out, he had. The other woman's answers told me that Betsy probably had nothing worse than a mild upset, and indeed, when I saw her at the office later, she'd almost recovered." "You're saying, aren't you, that not all house calls are necessary, doctor?" "I'd rather put it a little differently," said Dr. Newman. "Most people who ask for house calls think they're doing the right thing. But whether they are or not is a matter of medical judgment. If a child's running a temperature, it's natural for his mother not to want to take him out if it's raining. And, to an adult with aching bones and a splitting head, lying down and waiting for the doctor is a much more attractive proposition than getting the car out and driving to the doctor's office. But here at my end, I happen to know that the trip will be harmless and that I can help both patients sooner and better at the office than I can at their homes later in the day." Suburban patients at a disadvantage Many people, though, believe that the issue is simpler than physicians will admit. They think doctors dodge house calls. They think, moreover, that in the suburbs patients are at a special disadvantage. City people, they say, are used to going to doctors' offices. They're plentiful and close at hand. Manhattan has a doctor to every 250 inhabitants, San Francisco one to every 374. "Whereas," says a Nassau County, New York, resident with a touch of resentment, "we have one to 800. And I've read that in many small towns in the South and the Midwest, it's one to 1,200 or more. With us, it's not just a matter of taking the elevator down to the ground floor of the apartment building where we live. The round trip to my doctor's office takes all of 30 minutes." Here are a few of the complaints I've heard in recent weeks: ■ "When I told my doctor my son had a temperature of 104 degrees, he said: 'Give him a couple of aspirins and bring him in!'" ■ "The doctor just flatly told me he didn't make house calls. He said that if I got to his office by 5 o'clock he'd see me. But at 5 sharp, he said, the door would be locked. I did finally locate a doctor who agreed to come. And he did—at 10 o'clock that night." ■ "When I asked him to visit my wife, the doctor said: 'It sounds like flu. Tell her to stay in bed and take plenty of hot drinks. If she doesn't feel better tomorrow, run her down here and we'll see if a shot will help.'" ■ "I explained to the doctor's nurse that I was over 60 and didn't have a car. She said: 'All I can suggest is that you call a cab.'" ■ "My son gashed his knee badly on the garden swing. The doctor told me to drive him round to the hospital emergency room. 'I have an office full of patients,' he said, 'and your kitchen is no place for surgery anyway.'" It's only fair to report some contrasting complaints I've picked up from the doctors: An overworked pediatrician was called at three in the morning by a woman who said her 18-month-old son had swallowed a coffee-can key. "I was just rolling out of bed," he said wryly, "when I asked: 'What was he doing with a coffee-can key at three a.m.?' She answered: 'Oh, he

8 Suburbia Today, April 1962