In the 1880s, a few short years after the telephone’s invention, futurists envisioned a modern doctor unrestricted by time and space. “That specialist would sit in a web of wires,” the Johns Hopkins medical historian Jeremy Greene told me, “and take the pulse of the nation.” At the time, and for decades after, medical practice remained circumscribed by geography. Black bag in tow, packed with every tool a physician would need, roaming doctors traveled by automobile or horseback and tended to the bedridden wherever they lay. But by the mid-20th century, clinicians stopped trekking from household to household.
“The old-school home visit is just totally impractical,” Charles Owens, the director of Georgia Southern University’s Center for Public Health Practice and Research, told me. “It’s logistically kind of a train wreck.” Cars, public transportation, and sprawling hospital systems eventually converted home visits from a standard of care—40 percent of physician encounters in 1930—to a relic, just 1 percent by 1980. Patients, then and now, flocked to doctor’s offices.
Today, telehealth has resurrected the house call more than a century after it fell out of favor. This newfangled iteration of a bygone practice is less intimate than having a doctor sitting at your bedside, but more personal than sitting on your doctor’s exam table. For some people, virtual home visits are about as uncomfortable as being poked and prodded in a hospital gown, but they allow doctors to once again observe quotidian details of their patients’ health that they might not otherwise glimpse. “The doctor’s office is a stressful place for everyone,” Mark Fendrick, a primary-care doctor with Michigan Medicine, told me. “There are some things we look for that are more artificial in a doctor’s office and more real-world at home.”