[Characteristics of urgent house calls in an urban clinic]

Urgent house calls during regular clinic hours constitute a significant burden on the family physician's workload. It is the impression of the staff of this clinic that many patients use this service incorrectly, so that ordering an urgent house call often leads to a direct confrontation between the patient and his physician. During a 4-month period questionnaires were filled out by the physician before and after every visit described as "urgent" by the caller. There was a huge gap between the physician's and the patient's concept of what constitutes an urgent situation. However, in many cases the physician justified the visit. This survey emphasizes the importance of house calls and justifies them, but not always as to their urgency. As a result of this survey, we are now designing a program to improve communication when an urgent house call is ordered, in order to minimize the gap between the physician's and his patient's understanding and expectations of the necessity and urgency of the visit.