Home Visits: A Necessary Evil or a Real Opportunity?

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By Sean McKale, CO, LO

There was a recent discussion on the OANDP-L listserv about home visits. In general, the comments were fairly negative. Colleagues expressed the inefficiency of both extensive travel time between appointments and the lack of necessary equipment on hand, claiming each would compromise their practice's reputation. I found these comments to be frustrating and maybe even a little short-sighted. Due to the nature of our profession, with a number of our patients homebound, hospital bound, or juggling the rest of life, home visits become a necessary part of our practice. Sometimes, home visits are simply a good way to serve the community in which you work-not to mention that home visitation is common practice with other healthcare professionals. While home visits do present certain challenges, when properly incorporated into a practice, they are an incredible opportunity to provide quality service while effectively marketing your business.

Home Visit vs. Hospital Visit

Somewhere along the way, we clinicians created a distinction between home visits versus those in hospitals, senior living facilities, or clinics. But in reality, they all represent off-site visits unless, of course, the clinician is located in one of those facilities. A key distinction hinges on whose time the patient is on. In the case of a hospital call, the patient sometimes doesn't even know that the physician has asked for your services. Since the patient isn't necessarily expecting you, whether or not you arrive on time really isn't a factor. When we do a home visit, we are expected to arrive on time. In our practice, we handle this with good customer service and organization, making sure that the patient or family is aware of the time we are scheduled to arrive. We keep in contact with patients from the road, alerting them when we are running behind or ahead of schedule. More often than not, there's a really grateful person who is excited about the services to be provided at the other end of the phone.

The Challenges of "Off-Site"

Off-site visits present two major challenges: time efficiency and access to equipment. The practice I work for tackles the first of these issues with close attention to scheduling. We regularly visit therapy centers, hospitals, and schools where we are able to see many patients in succession on the same day. To optimize travel time and expenses, we schedule home visits that are along the same driving route as our off-site clinic visits. A good day has us seeing upwards of 20 patients, and on average at least ten patients on the road.

We address the second challenge by bringing our equipment with us in the form of a van equipped with a mobile lab, which allows us to make professional, high-quality modifications to devices on location. The mobile labs are equipped with a printer/copier/scanner, variable-speed router, bench vise, work bench, fully stocked toolbox, air compressor, surplus straps, EVA foams, rivets, spare parts and components, and other necessary materials needed for repairs/adjustments. There was a time when I worked in the basement of a hospital that sometimes wasn't as well equipped. With the help of proper scheduling and our mobile labs, we are able to provide timely, high-quality, cost-effective service.

Grassroots Marketing

Once you've dealt with the challenges that home visits present, they become a unique "grassroots" marketing opportunity. There is no better way to sell your services than to demonstrate them in practice. Mobile clinics help to extend the reach of your practice so that you can continue to grow your business and work directly with your referral sources. Meeting simultaneously with patients, doctors, and therapists helps you to not only provide the most comprehensive service to the patient, but also to strengthen your relationship with doctors and therapists.

When faced with challenges, one can choose to do things the way they have always been done, complain about the challenge and attempt to avoid it entirely, or approach these challenges with innovation and enable them to strengthen your quality of service. Off-site visits, while not the only component of your business, are an integral part of it and, when approached with innovation, can become more than just an inefficient burden. While providing home-visit services will not necessarily make your job easier, it will improve your practice, provide increased opportunities, and help your business grow stronger.

Sean McKale, CO, LO, is the practice manager at Midwest Orthotic & Technology Center's Merrillville, Indiana, and Chicago, Illinois, offices.