If you haven’t experienced it, be glad. Those who experience this on a regular basis know what a complicated situation it is. If the patient is unable to walk independently, an escort and often a wheelchair is needed. However, it does not necessarily have to be only elderly people at an advanced age. Even relatively young people can find themselves in a wheelchair, e.g. as a result of a stroke, multiple sclerosis or an accident. They all need regular medical care, often quite intensive. Of course, it is easiest if there is someone in the family who will take the patient to the doctor by car. And that’s the problem. Once in a while it can be managed. But if you have to take time off from work every week as an escort, after a while you will find that it is no longer bearable. You will start to run out of physical and mental strength, and your employer will run out of patience. Does the doctor have an obligation to come to such a patient’s home? The willingness of doctors is usually not great. They cite time-consuming and allegedly low reimbursements from health insurance companies as the reason.
Practitioner and visiting service
The obligation to visit patients at home is established by law for general practitioners for adults and also for general practitioners for children and adolescents. This problem is regulated by Act 372/2011 Coll., on health services, specifically in § 7 paragraph 3, which explicitly states: “Part of the primary ambulatory care provided by registering providers in the field of general practice and pediatric practice is always a visiting service.” However, the condition for providing health care in the patient’s home environment is the fact that there is no need for special examinations that the visiting practitioner is unable to perform, e.g. ultrasound, X-ray.
Filing a complaint
If a doctor refuses to provide a visiting service to his registered patient without a serious reason (or otherwise violates his obligations), it is possible to complain to the health service provider (e.g. the hospital director), the regional office, the Czech Medical Chamber or the health insurance company.
Transport by ambulance
The second option is to agree with the doctor that the patient will be issued an order for medical transport (i.e. transport ambulance) if the patient’s health condition does not allow transport to the doctor in the usual way. However, after the examination, the patient often has to wait in the lobby of the medical facility for other patients to be transferred. While waiting, he may catch a cold or need to go to the toilet, but he cannot do it without assistance. For infirm patients, this transport is often very stressful.
Specialist visit
The law only mentions general practitioners, not specialists, which is a big problem for immobile patients. It is understandable that a dentist in the patient’s home environment will find it difficult to treat without a dental chair, while this idea is possible for a dermatologist. Some specialist doctors offer a visit to the patient, but according to their current tariff.
According to the annex to Decree No. 134/1998 Coll. a doctor’s visit to a patient can also be reported to the health insurance company by a specialized doctor, but only on the basis of a request issued by the patient’s general practitioner.
Visitor Service vs. ambulance
In urgent cases, when there is a sudden serious deterioration of the state of health or a serious injury, it is not advisable to request the visiting service of a general practitioner, but it is appropriate to call the medical emergency service.
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