Finding the Unreached Patient

Current hospital and medical practice is based on the premise that the sick person seeks out and goes to the source of health care. In requiring the patient to take this initiative, however, we are ignoring those who are unable or unwilling to come to us. The medical community is not reaching the isolated, homebound, aged. A withering of physical capacity forces many old people in urban areas to suffer a hazardous existence alone in single rooms and welfare hotels. Poverty is a common additional disadvantage. Such people, out of contact with the medical care system, are often too disabled, frightened, or bewildered to seek help—nor does medical assistance usually go to them. Occasionally a neighbor may find a failing person and call an emergency ambulance. However, it is too late for effective treatment when a patient comes to an emergency room dying or in an advanced stage of disease.