In British painter Samuel Luke Fildes' 1891 work "The Doctor," a physician keeps watch through the night over a sick child in a poor fisherman's cottage. A dim lamp lights the child's face as dawn seeps through the window. The painting is said to have been inspired by the devotion of a doctor who stayed by Fildes' side and cared for his young son when the boy was dying.
Modern Western medicine in Korea also began with doctors visiting patients at home. Horace Newton Allen, an American medical missionary, traveled to the residence of Min Yeong-ik to treat him after he was gravely wounded by the sword of a reformist during the Gapsin Coup of 1884. Having won the trust of the royal court, Allen proposed establishing a Western-style hospital and played a driving role in the founding of Jejungwon in 1885. As recently as the 1970s, it was not unusual to see a neighborhood doctor arrive at a patient's home carrying a visit bag packed with a stethoscope and a blood pressure monitor. There were many heartwarming stories of doctors who spent decades traveling to remote villages and other underserved areas to treat patients.
House calls grew rare as a hospital-centered medical system took hold, but they are drawing attention again in a super-aged society under the names of "visiting care" and "home-based medical care." The problem is that medical staff are not reaching the places where visiting care is most needed. According to a survey on community integrated care released by the Ministry of Health and Welfare on the 13th, 59 of the country's 229 cities, counties and districts had less care capacity than demand, and 40 of those were areas with declining populations. In those areas, supply met just 10.7% of demand for visiting care, less than half the 25.5% rate in other regions.
The government plans to increase the number of home-based medical care centers to 650 by 2030 from 463 at present. But raising the number of medical institutions alone is not enough. The time and cost that medical staff spend traveling must be properly reflected in reimbursement rates. It is also important to provide support so that doctors, nurses and social workers can deliver visiting nursing and long-term care services together. Today, house calls are an essential service not only for older adults but for anyone who has difficulty getting to a hospital. The hope is that visiting care will stand firmly by patients, much like the doctor in that painting 135 years ago.