“Doctor, could you take a look at this shirt?”
At around 9 a.m. on April 28, inside a rental apartment in Suwon, Gyeonggi Province, a caregiver held up a shirt she had taken from the closet for Dr. Kang Dong-hwa to inspect.
The caregiver was trying to figure out what had caused the sudden breathing difficulty experienced by the apartment’s resident, Oh Jung-soo, whose name has been changed for privacy.
The collar of the shirt was unusually tight and stiff.
“It may have been partly due to cold symptoms, but the shirt could also have been constricting his breathing,” Dr. Kang said with a nod.
Dr. Kang Dong-hwa, a physician dedicated to home visits at Ipbuk Samsung Family Medicine Clinic in Suwon, Gyeonggi Province, provides medical care during a home visit on April 28. (KBR photo)
It was the kind of “lifestyle-centered” medical insight that would likely never emerge inside a hospital examination room. Reassuring the worried caregiver, Dr. Kang also reminded her to watch for any recurrence of similar symptoms.
After graduating from medical school and considering her future career path, Dr. Kang began working two months ago as a part-time physician dedicated to home visits at the Ipbuk Samsung Family Medicine Clinic in Suwon. Teaming up with a physical therapist from the same clinic, she visits three to five homes a day -- nearly 100 house calls a month.
Most of her patients are elderly individuals with chronic illnesses who, like Oh, cannot walk independently or require ongoing care. Oh is attended around the clock by a live-in caregiver.
On the days when Oh must visit a university hospital for nerve treatment and prescription medication, mornings become “an all-out war,” according to those caring for him. In contrast, every other Tuesday -- when Dr. Kang visits the home -- feels like “a day worth living through.”
As Oh and his caregiver smiled, Dr. Kang briefly smiled back while packing away the blood pressure monitor. The caregiver, who remarked that “home visits are far more convenient for the patient,” even said she was considering transferring Oh’s care entirely to the neighborhood clinic.
In home-based medical care, the patient’s home serves as both an examination room and a rehabilitation center.
While Dr. Kang checked blood pressure and blood sugar levels and carefully reviewed the caregiver’s notes, the physical therapist guided rehabilitation exercises. When the team first entered the apartment, Oh appeared barely conscious, but fortunately, he soon regained clarity and actively participated in the consultation.
Even in a weak voice, he repeatedly chimed in on conversations among Dr. Kang, the therapist and the caregiver. The very fact that a doctor had come to visit seemed to provide the patient with joy and meaningful stimulation.
Dr. Kang reviews notes from a caregiver between consultations while listening to her questions and concerns. (KBR photo)
Discovering a reality that medical school never taught
“If I had only stayed inside clinic rooms, I would never have realized there are this many patients confined to their homes.”
After completing the visit, Dr. Kang reflected on both the value of home-based care and what she described as a blind spot in medical education.
The lives of people unable to cross the threshold of a clinic simply never appeared during six years of medical school training. It was only through home visits that she encountered these “invisible patients” and realized that “every household carries its own story.”
“Throughout medical school, I never once had the opportunity to experience home visits,” she said. “Medical education claims its main goal is to train primary care physicians, but in reality, everyone assumes doctors will complete residency training and become specialists. Yet most doctors ultimately end up working in primary care settings.”
Kang also pointed to the lack of education on welfare resources and caregiving policy.
Home-visit physicians witness vulnerable lives firsthand -- cluttered kitchens, complaints about being scammed again, or deep sighs over the suicide of a close acquaintance. Yet Dr. Kang admitted that, at first, even she “felt lost about how to connect medical treatment with caregiving support.”
Under the guidance of senior physicians experienced in home care, she gradually learned -- through trial and error -- what kinds of support services patients actually need.
As a medical student, she once believed that a great doctor was someone who could “extend life even by a single second.” Bad numbers had to be corrected, diseased tissue removed, illnesses cured. Concepts such as palliative care or “patient-centered medicine” felt abstract.
But only two months into home-visit care, Dr. Kang says she has begun to develop a new philosophy of medicine.
By entering patients’ lives, she began to see not just “numbers,” but “circumstances.”
Some patients in their 90s remain rigorously disciplined about their health. Others, despite living with constant pain, simply want to enjoy the things they still love without regret.
“I’ve come to believe that the most important thing is first understanding what the patient truly wants, and then presenting options accordingly,” she said.
That approach requires acknowledging the unavoidable limits of medicine and adapting care to the patient’s circumstances.
Even if blood sugar levels cannot be perfectly controlled today, “smiling while taking one more bite of a favorite fruit” may, for some patients, be “the better choice.”
Koh Jung Min
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