Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

A house call is worth a dozen tests. And then some.

Hans Duvefelt, MD
Physician
January 28, 2015
Share
Tweet
Share

Flossie Marks used to complain now and then about shortness of breath on exertion. She never had chest pain and, after all, she carried firewood from the basement to feed the wood stoves and fireplaces in her large Victorian house. At 81, who wouldn’t be a little short of breath doing that?

Last summer, she finally sold the house where she and Eli had raised four children and hosted nine grandchildren for holidays and summer vacations. After Eli died three years ago the large house had become a millstone around her neck, and she had lowered her asking price by more than half before it finally sold. She had confided in me last spring that she didn’t think she could handle another winter there.

She had been so excited when she told me about the cute little apartment she would be moving into in September.

Then in November, I saw Flossie with a concern about nighttime coughing. She had gained some weight, but of course, she wasn’t running up and down three stories and down in the basement anymore.

She confided in me that she wasn’t thrilled with the apartment complex she had moved into. There was loud music and neighbors’ late night arguments sometimes kept her awake.

Her EKG and chest x-ray were normal, and she wasn’t anemic, but her BNP was mildly elevated. I ordered an echocardiogram. That was normal. As I contemplated my next move, Flossie ironically broke her ankle slipping on the wet bathroom floor. She never injured herself feeding the fires in her Victorian, but a wet tile floor put her in a cast boot and crutches.

I needed to proceed with my assessment of her cough and shortness of breath so I offered to do a house call.

The first thing I noticed when I arrived at dusk for my visit was that several light fixtures outside and inside the building weren’t working. I also heard the music Flossie had told me about as I walked down the dimly lit carpeted hallway.

Entering her ground floor apartment at the back of the building, my nose instantly registered a strong smell of mold, and my mucous membranes started to burn.

Flossie was sitting in a recliner with her injured foot elevated, and as we spoke, her conversation was interrupted now and then by a dry cough.

“Did you see all the broken lights and did you hear the thumping rock music coming in?” Flossie asked. “I should have moved into the Leblanc Apartments instead — they have more people like me there. My best friend Norma Beck lives there, you know her. The superintendent there has said I can have an apartment close to Norma’s that becomes available the first of next month.”

“Sounds like that could be a good change for you,” I said, and I thought to myself as my eyes watered from the mold in the air. “It might stop our breathing workup right there.”

“A Country Doctor” is a family physician who blogs at A Country Doctor Writes:.

Prev

To the doctors who have lost patients. This is for you.

January 28, 2015 Kevin 2
…
Next

Top stories in health and medicine, January 29, 2015

January 29, 2015 Kevin 0
…

Tagged as: Geriatrics, Primary Care

< Previous Post
To the doctors who have lost patients. This is for you.
Next Post >
Top stories in health and medicine, January 29, 2015

ADVERTISEMENT

More by Hans Duvefelt, MD

  • The art of asking where it hurts

    Hans Duvefelt, MD
  • Thinking like a plumber when adjusting medications

    Hans Duvefelt, MD
  • The American food conspiracy

    Hans Duvefelt, MD

More in Physician

  • Health care market distortion: How government intrusion hurts medicine

    Allan Dobzyniak, MD
  • Securing physician autonomy with employer-sponsored direct primary care

    Dana Y. Lujan, MBA
  • The mathematics of merit: Quantifying bias in medical malpractice

    Howard Smith, MD
  • Medical relevance and evolution: Why physicians must reinvent themselves

    Adam Bitterman, DO
  • Navigating the patchwork of CME requirements by state

    Vladislav Tchatalbachev, MD
  • Unfinishedness in medicine: When a good visit feels incomplete

    Alan P. Feren, MD
  • Most Popular

  • Past Week

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The future of U.S. medicine: 10 health care trends in 2026

      Richard E. Anderson, MD & The Doctors Company | Physician
    • The quiet paradox of physician mental health and medication

      Timothy Lesaca, MD | Physician
    • The Platinum Rule in health care: Moving beyond the Golden Rule

      Harvey Max Chochinov, MD, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
  • Recent Posts

    • How to master a new health care leadership role [PODCAST]

      The Podcast by KevinMD | Podcast
    • Medical school endurance: lessons from training for a 10K

      Riya Sood | Education
    • Health care market distortion: How government intrusion hurts medicine

      Allan Dobzyniak, MD | Physician
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Securing physician autonomy with employer-sponsored direct primary care

      Dana Y. Lujan, MBA | Physician
    • The mathematics of merit: Quantifying bias in medical malpractice

      Howard Smith, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The future of U.S. medicine: 10 health care trends in 2026

      Richard E. Anderson, MD & The Doctors Company | Physician
    • The quiet paradox of physician mental health and medication

      Timothy Lesaca, MD | Physician
    • The Platinum Rule in health care: Moving beyond the Golden Rule

      Harvey Max Chochinov, MD, PhD | Conditions
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
  • Recent Posts

    • How to master a new health care leadership role [PODCAST]

      The Podcast by KevinMD | Podcast
    • Medical school endurance: lessons from training for a 10K

      Riya Sood | Education
    • Health care market distortion: How government intrusion hurts medicine

      Allan Dobzyniak, MD | Physician
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Securing physician autonomy with employer-sponsored direct primary care

      Dana Y. Lujan, MBA | Physician
    • The mathematics of merit: Quantifying bias in medical malpractice

      Howard Smith, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A house call is worth a dozen tests. And then some.
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...