My grandson, Chris, his wife Silvia, and their baby daughter Vik, were visiting the other day when my podiatrist, Dr. Harry Prywes, came to call.  Dr. Prywes has a practice in Westchester but makes house calls as well.  This opened up a whole discussion between Chris and myself about why family doctors stopped making house calls and how HMOs became prevalent.

There used to be a personal relationship between patient and doctor; they didn’t need to look you up on their computers to remember who you were and what your ailment was.  Years ago when people were hospitalized they would be cared for by their own doctors.  Now, in many places, we are put in the care of ‘hospitalists’, physicians who practice only in a hospital, have no personal relationships with the patients and know them only through their symptoms.  How sad!  What most of us really need is the old fashioned doctor whose familiar touch and recognizing smile gives us the security to deal with whatever the problem is.  

Specialists are important in many cases but work better when aided by the doctor of record.  

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The practice of medicine has expanded from one-on-one care-giving to big business.  Groups of doctors gather together, I think, for protection.  We live in a litigious society where now malpractice suits are filed every day.  Gathering in a group probably gives the doctor a break in malpractice insurance; it also alleviates him/her from billing and loads of other paperwork.   This does, of course, put more layers between doctor and patient.

As a Seasoned Citizen I know how helpful it is to have Dr. Prywes see me at home.  Perhaps if a group of geriatric specialists got together they might also be able to make house calls, keeping a close personal relationship with the patient while still protecting themselves.  

“Boutique medicine” is now available where an agreement between doctor and patient allows home visits and assures 24-hour availability to that particular patient.  It is, though, very expensive and most of us cannot afford it.  

I don’t long for the past.  If I did I’d be losing antibiotics, tranquilizers, CAT-scans, MRIs, open heart surgery, arthroscopic surgery…actually, everything predicted in Star Trek and other science fiction which is no longer fiction.  I don’t want to give up the future, I just want to temper it a little with good things from the not-so-long-ago past.  A combination of Jimmy Kildare (get Alexa or Siri to tell you who he was) and Leonard McCoy (Star Trek) would be just the right prescription.

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