A house call

Date: 3|6|2024

Blair Findlay, HCCI Development Associate, rode along with Dr. Paul Chiang, HCCI’s Senior Medical and Practice Advisor, for a day of house calls. Dr. Chiang also serves as Medical Director for Northwestern Medicine HomeCare Physicians (HCP), a suburban Chicago practice focused on delivering care to medically complex patients in their homes. In this series, Blair shares her experiences and insights from that day.

I had no idea what to expect from a day of house calls. But, by the end of my day with Dr. Chiang, I was even more excited about HCCI’s mission to create universal access to house calls. I also saw how house calls can break down barriers to healthcare access, providing compassionate medical care directly to those who need it most. Plus, I saw how important providers like Dr. Chiang are in the healthcare landscape.

But Dr. Chiang isn’t the only person involved in house calls — traveling with him is a medical assistant, Nicole, who helps him be as efficient as possible. Dr. Chiang has been working with Nicole, who is studying to be a nurse, for three years. She makes it possible for him to do the clerical tasks before and after each visit, ensuring that he has more time to spend face-to-face with the patients, and less time looking at the computer. Nicole also drives Dr. Chiang to each visit, allowing him to do follow-up from the previous visit and prepare for the next one. As you’d imagine, over time, the two of them have developed a strong rapport built on trust and anticipating each other’s needs. When asked about Dr. Chiang, Nicole remarked, “I’ve worked with over 30 providers and he’s the most incredible.”

The feelings of appreciation aren’t just one-sided — without Nicole, according to Dr. Chiang, the patient visits would take him twice as long. Nicole is able to check vitals and perform other tests while Dr. Chiang focuses his energy on the patient, something he does so well that he was named the American Academy of Home Care Medicine’s 2019 “House Call Doctor of the Year.”

It’s easy to see why Dr. Chiang received the award when watching him in action. Despite having seen more than 3,800 patients (and completing over 38,000 house calls) in his career, Dr. Chiang remembers personal details about each patient, whether it be vacations they’ve taken, grandchildren’s weddings they’ve attended, and deeper subjects like their end-of-life care preferences. As you’d imagine, Dr. Chiang’s patients often say that seeing him is “a bright spot in [their] day.”

Seeing patients in-person, in their own homes, also allows Dr. Chiang to see the whole person—not just the parts they show in the office. This allows him to look closer into the patient’s daily lives, whether it be the food they have in their fridge (he always asks their permission first!), the way they do or don’t take their medications as prescribed, or the stairs or other tripping hazards that might be dangerous for them. Being in a patient’s home also reduces logistical barriers that might arise with remote visits such as the patient’s or caregiver’s technology proficiency, Wi-Fi access, and technology costs.

Yes, it’s easy to see the impact of house calls after a day with Dr. Chiang. Home-Based Primary Care, or the “modern-day house call” is a beacon of compassionate and tailored medical care that transcends a traditional healthcare setting.

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