Duke Takes Healthcare Checkups to Patients' Homes

DURHAM, N.C. — Some people still remember the days when doctors made house calls. Now, the concept is making a comeback.

Some people have problems getting to a doctor's office or clinic. They may never go until they're really sick and may require hospitalization. That's why Duke Hospital has health care providers knocking on doors again.

Physician's assistant George Kroner, who works with Duke Health and Family Medicine, knows his way around the J.J. Henderson Housing Center in Durham. He sees Ann Gunsalus and many of her neighbors about every six weeks.

Ann has a painful, arthritic knee, so she uses a motorized wheelchair. She can drive, but getting to the closest health clinic is a struggle.

“A lot of our patients have had strokes,” Kroner said. “Some have had amputations. Some are blind. Some have difficulty hearing.”

“We're looking at people for whom traditional health care doesn't work well,” said Duke physician Dr. Lloyd Michener.

Home visits through Duke's Just for Us program don't replace doctor's office visits. But the more frequent check-ups at home can catch potential problems earlier.

“The patients are doing better than they were with traditional medical care,” Michener said. “Their diabetes is better. Their hypertension is better.”

Kroner reviews each visit with Duke’s community health medical director Dr. Kimberly Yarnall, who can send dieticians or even psychiatrists to help patients. Updated medical information follows the patient to their primary care physician.

Gunsalus appreciates the close eye on her health.

“Because I've still got things to do,” she said. “At 70, there's still years ahead of me that I have things I want to do.”

The "Just for Us" program helps residents regardless of their ability to pay as part of Duke's outreach to the Durham community.

The program works best in a setup like a subsidized housing complex, where one team of health care providers can see many patients in a short amount of time instead of spending too much time driving to separate homes. Duke also sees the program as a great way to attract and train physicians that want to work in family medicine.