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01/13/07
House Calls
Filed under: General, Rutherford & NJ, Medical
Posted by: Ken @ 4:24 pm

Black BagA few days after I completed my internship, Mary Lou and I moved from our apartment at 77 Grove Street in Montclair to a nice rental house on Louise Court, a cul-de-sac in Belleville, NJ. Mary Lou was expecting our first child within the month.

On my first morning in private practice, after I surprised myself by delivering the baby to the woman under hypnosis, I reported to my new office. It was on the first floor of a two story frame house in the Brookdale Park neighborhood of Bloomfield, NJ. Paul Fagan, my partner, saw a few patients by appointment while I was busy familiarizing myself with my new surroundings. (We soon moved into a newly constructed one story building nearby at 1310 Broad Street.)

Mrs. Russell, our office nurse, filled me in on policies and procedures. I learned that we charged $5.00 for routine office visits, and $10.00 for new patients who required a full examination. Daytime house calls were $7.00, with the rate going up to $12.00 after 7:00 PM. This was pretty much the going rate for Family Practitioners; Internists and Pediatricians charged about $5 to $10 more. We charged something like $25 for the first day of hospitalization and $10.00 per day thereafter, with extra charges for repeated or prolonged visits.  

That afternoon I saw a few walk-in patients. My first office patient was a young man in much distress with classic signs of a kidney stone. I admitted him to the hospital and arranged for an immediate urology consultation. Before going home I made my first house call to one of Paul’s elderly heart patients, just to check her blood pressure and general condition.

I was soon to learn that most house calls were simply performed as a convenience for elderly patients and anxious mothers. Others were warranted because a child had a rash and fever that might be signs of a contagious illness. The worse the weather, the more numerous the house calls.

The ethic of our medical community seemed to be that a doctor should not allow a sick patient to go outside on a cold night or in the rain or snow. Generally, if someone fell ill outside of regular office hours they seemed to expect a house call. If the night was pleasant, we might have patients meet us at the office. It was rare for someone to report to the hospital emergency room with anything but a major emergency.

We did not have beepers or cell phones in those days. Before ever departing from a residence, I always called the answering service to see if I had any more messages. On arriving home I often had one or two phone calls to return, and often this meant more house calls after dinner or before getting to bed.

Most of our patients lived within a couple of miles of the office, so it was possible to make three or four house calls in less than two hours. Our large black bags held all our examination equipment and were packed with injectable drugs such as antibiotics, painkillers, digitalis, mercurial diuretics and asthma medications.

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