In the early 1960s, house calls by doctors were 40% of doctor-patient meetings. By 1980, they were 0.6%. Reasons include increased specialization and technology. In the 1990s, team home care, including physician visits, was a small but growing field in health care, for frail older people with chronic illnesses, until the Balanced Budget Amendment. Two thousand home health agencies went out of business. Although physicians romanticize the house call, an audience of homecare workers broke into uproarious laughter at the mention of physician involvement in home care. The reasons for fewer house calls include lack of physician education, concerns about providing low-quality care in the home, time inefficiency, inconvenience, and lower pay. Yet, there are an increasing number of doctors who like the idea of no office overhead. One "worth" of homecare is that it can provide safe access to care by people who are ill.
In 2012 as part of its Action Plan for Healthcare the province of Ontario actively expanded funding for access to house calls with its primary focus being on seniors and those with physical limitations making it difficult for travel outside the home. Residents of Ontario with valid Ontario Health Insurance Plan cards are able to take advantage of the house call system, and arrange for appointments with physicians at their home.
^Twain, Mark. (1905 & editor commentary 2010 & 2001) Autobiography of Mark Twain, The Complete and Authoritative Edition, Volume 1. Berkeley, CA: University of California Press. ISBN 9780520267190
^Leff, Bruce, MD; Burton, John R. (2001) The Future History of Home Care and Physician House Calls in the United States. The Gerontological Society of America: Journal of Gerontology: MEDICAL SCIENCES 2001, Vol. 56A, No. 10, M603–M608 Oxford University