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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 persons 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.
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