Saturday, 16 April 2022



For 23 years, we ran a “home ICU” for our son Nicholas. Nick was born with severe cerebral palsy and he is very medically complex. Moving from crisis to crisis with multiple diagnoses meant that I needed someone in our circle of care to be my close partner in assessment and medical decision-making. Luckily, that partner was our family physician. And he made house calls.


Before our GP agreed to take Nicholas on his caseload I would scan my son for frightening new symptoms, alone at home wondering whether I was witnessing early signs of a life-threatening crisis or simply a fleeting and insignificant manifestation of his disability. Should I call 911 or do nothing? I never knew.
One day, I asked our GP why he took on complicated patients like my son. He replied, “Oh, I guess I’m just OK with uncertainty.” I could have hugged him. When I asked him why he was willing to do house calls, he smiled and said, “Seeing you all at home, I get the information I need to make the right diagnosis. Plus in the end, it saves me time.”


This doctor was my partner in care and my co-assessor (he’s now retired but luckily, he trained his replacement to follow his methods of home-based care). The pandemic has added virtual visits to our menu of appointment options. But in our family, those virtual visits are very effective only because our doctor has made a study of Nick in his environment.


Our GP is sensitive to changes in my son’s affect – he can sense changes on a computer screen because he knows Nick in real life, at home. I can envision a better system for delivering care in the community – one in which the home is the examining room.


Of course patients must visit the clinic from time to time for various tests and procedures, but there is nothing like a home visit for a doctor to understand an illness experience in one’s own environment and in my own case as a caregiver, to explain it. In my opinion as a frequent user of medical services, patient and family centred care should be located in the patient and family home. It’s that simple.

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