Throughout my third year of medical school, I moved through the hospital’s controlled chaos — ERs, operating suites, ICUs, and clinic exam rooms. Each setting had its rhythm, its hierarchy, its way of ordering the world. But stepping outside those walls for home visits with an internal medicine physician, I saw medicine in a different light — one not shaped by vital signs on a monitor or the sterility of a hospital room, but by the lived-in reality of a patient’s home.
Home visits were once a staple of medical practice, but today, they are rare. In an era where efficiency drives health care delivery, home visits are often seen as impractical — too time-consuming, too resource-intensive. And yet, while they may not be the most efficient way to care for patients at scale, there is something to be gained from them that cannot be found in a hospital or clinic.
On one visit, I met a patient who had been bedridden for over two years. Her family had arranged for her to stay in a small back room, where a large whiteboard hung on the wall. It caught my eye because it was filled with a neatly organized list of names — about 10 different family members, each assigned a time and a task. Morning shift, evening shift, overnight stay. Phone numbers next to each name. A system built out of necessity, out of love.
In the hospital, when we discharge patients, we talk in lists: PT, OT, home health. We assume these services materialize neatly into a patient’s world. But standing in that room, looking at that board, I understood just how much of a village it takes to care for a single person. The names on that board weren’t physical therapists or home health nurses. They were sons and daughters, nieces and nephews, cousins and neighbors, each adjusting their lives to keep this patient from being completely alone.
Then there was the man who was almost 102 years old, still walking around his home with a presence and independence that defied expectation. When we arrived for his visit, he threw his keys out the window so I could let myself in — an act so casual and self-assured that I had to remind myself of his age. Inside, his home was filled with a lifetime of memories, stories embedded in every object, every framed photograph. I watched him navigate his space with a confidence that told me this home was an extension of himself, a place where he knew every creaky floorboard, every misplaced paper, every sunlit corner.
It struck me how much I would have missed if I had only seen him in a hospital bed. In the hospital, he would have been, “102-year-old male, history of hypertension, history of falls.” But here, he was a man with routines, with habits, with a world carefully built over a century of living. He was a person.
Watching him move through his home, I understood that health is not just measured in lab values or imaging results — it is measured in moments like this, in the ability to throw your keys out the window, in the familiarity of home, in the simple act of getting up and walking to the next room.
Home visits are as much about bearing witness as they are about medical care. In the hospital, we treat acute illness with interventions that feel immediate and tangible — a diuretic for heart failure, antibiotics for an infection. But in a patient’s home, the challenges are quieter, more insidious. The elderly woman who is skipping doses of her medications not out of forgetfulness but because she’s rationing them to make them last. The middle-aged man with advanced COPD whose biggest struggle isn’t his lung disease, but the fact that he lives alone and has no one to help him get groceries.
There is a certain intimacy in stepping into a person’s home, in sitting on their couch, in hearing the sounds of their world — the humming of an old refrigerator, the distant chatter of a TV left on for company. It is a reminder that medicine is not just about the right diagnosis, the right prescription, the right procedure. It is about meeting people where they are — sometimes quite literally — and recognizing that the greatest barriers to health often have little to do with the diseases we study in textbooks.
Through these visits, I came to realize that clinical knowledge is only one piece of the puzzle, and that understanding a patient’s world outside the hospital makes you a better doctor inside of it. When I see a patient in the hospital now, I think about what happens when they leave. Not just whether their condition is stabilized, but whether they have someone to pick up their medications, whether they have food in their fridge, whether their home is even a place that allows them to heal.
Medicine is full of things we cannot chart. The way a home smells — stale air, uneaten food, a hint of something that tells you loneliness lives here. The quiet dignity of a woman, bedridden for years, as she listens to her grandson tell her about his school day. The way a man can hold onto his independence is not through a checklist of fall precautions, but through the simple act of throwing his keys out the window.
Home visits are not efficient and may never return to mainstream medicine. They are too slow, too impractical, too difficult to scale. They do not fit neatly into the boxes of a productivity-driven system. But they show us something medicine often forgets: Patients do not live in hospitals.
We discharge patients from the hospital, but they don’t disappear. They go back to real lives in real homes, surrounded by real challenges and, if they are lucky, real support. If we, as physicians, want to truly care for our patients, we must remember that their stories do not end when they leave our sight. In fact, that’s when the hardest chapters often begin.
Have you ever participated in home visits, and how did they influence your care? Share in the comments!
Andrew Mohama is a third-year medical student at Rush Medical College. He is passionate about health equity, innovative patient- and community-centered health systems, and transforming complex health topics into accessible, meaningful narratives. His interests lie at the intersection of science and intellect, research and narrative.
Image by GoodStudio / Shutterstock
