Family medicine, home visits, and holistic care

Yipeng Ge is a medical student in the Class of 2019 at the University of Ottawa


Having completed a handful of family medicine preceptorships and a few electives, I have had the opportunity to gain exposure to talking to patients one-on-one — and I am beyond excited to enter this field.

Learning about another human being and immersing yourself in their stories and concerns is a privilege — a chance to be present and to be there for them. I was fortunate enough to tag along on many patient home visits for my most recent family preceptorship session. These visits certainly struck a different tone for me compared to when my family medicine preceptor and I met, greeted, and worked with patients in the clinic. We were warmly welcomed into people’s homes, their sanctuaries, to find out how they were doing. It was a truly humbling and eye-opening experience. For me, it brought the humanity piece of medicine completely into context.

The environment that someone lives in can tell you so very much about them.

Something a bit strange about patient home visits is that there is not always a clear “objective” for the encounter. This is in stark contrast to the classic patient interactions we are introduced to and taught in the classroom and even within the clinic. The electronic medical record system forces visits and patients into compartments. The main concern of the visit is clear and defined, described on the computer monitor in front of us, before we enter the room and address the patient. But patients — people — are more complex than this. A holistic and caring approach is what the patient home visit felt like. Even though there was no defined “objectives” to address with the patient, a brief interaction with them in their home could tell us so much about their current mental and physical status by uncovering things like their daily living habits and overall mood. Much of this could be explored through insightful conversation and objective observation of the patient and their surroundings; for example, a discussion on current topics in the news, or noticing the fresh food in their fridge or if they happen to leave a towel out for you to wash your hands.

My family medicine preceptor said something that will certainly stay with me for a long time. In my mind, it went something along the lines of, “I remember and think of the places, the homes, that my patients come from when they sit in front of me at the clinic. I remember that they live complex lives, and at the crux of it all, they are another human being with unique goals, direction, and worries.”

It is an incredibly humbling and insightful experience to learn about a patient and their life in the context of their own home. It is also an excellent opportunity that emphasizes the importance of the social determinants of health and the complexity of people’s lives that predisposes them to poorer or healthier states. As a medical student learning about the details and pathophysiology underlying various medical conditions, it is amazing to learn first-hand about the humanity in medicine that cannot be learned in a classroom.

From this experience, I come face to face with my own humanity and life. After all, we are all human beings, and need to remember this. The unique goals, direction, and worries that I have are not so different from what others experience — including our future patients and colleagues.