Last year’s issue of “Reader’s Digest” stares at you from a neat side table. Adults shush their children as they absently play Fruit Ninja on their phones. On the whole, everything seems a bit too hygenic. We all know this environment well: the doctor’s office.

Now rewind a couple centuries. You’re in your own house because the doctor comes to you. He brings his things and checks up on you in the comfort of your own home. This practice was quite common, and as a middle class or wealthy individual, you would have found it to be nothing unusual.

So why is this custom of doctors making house calls such a rarity these days? There are several reasons, says Sharra Vostral, professor of gender and women’s studies.

“The hospital structure was really dodgy,” she says about the hospitals in the past. “You were sure to pick up some other illness if you went to the hospital.”

All irony aside, most people — based on their income level — chose to have their babies in their own homes mainly for this reason.

While today’s hospitals boast the highest cleanliness standards they can manage, past hospitals were not nearly as sanitary.

On top of that, today’s hospitals are large businesses. There are many who work in hospitals’ laboratories, pharmacies and more behind-the-scenes in areas such as finance, public relations and management.

“Physicians back in the 1800s were really much more independent than they are today,” Vostral said. “So they weren’t associated with group practices … and a group practice does offer protection.”

Doctors who made house calls, moreover, had a looser system to work with — now, for example, they are a concern of insurance companies and others who question their viability.

As the business of medicine expanded, the science aspect did so as well — significantly, in fact.

“The science of diagnosis has really changed over the past 150, 175 years,” said Vostral.

The patients were accepting of doctors coming into their homes because their expectations were much lower at the time, she added.

Doctors can do much more today than they could in the 19th century. Technology has evolved immensely — so much so that the modern medical services available simply cannot be carried to individuals’ homes.

The slow demise of doctors making house calls is the effect of more than the technology influx and hospital cleanliness; transportation plays a key role in the shift, says Clinical Medicine professor Nasser Gayed.

“If you go further into the past, patients did not have good transportation,” he said. There is a high dependency on “how mobile the patients are in areas that have cars.”

Nowadays, people arrive at hospitals quicker in cars, ambulances and helicopters, greatly limiting the travel time.

This begs the question: In third world countries, is this practice more common than in the U.S.? The medical systems are slightly different, and the transportation may not be as swift.

“I grew up in Egypt when as a child if I had a high fever, my parents would call the doctor and he would come see us in the house,” Gayed adds.

The bottom line is how quickly each country developed in each of the aforementioned areas of medicine, business management and transportation.

Now that the practice seems old-fashioned, it’s odd to think that some physicians still make house calls on a day-to-day basis. The television show “Royal Pains” depicts a modern-day “concierge medicine” business, complete with the small black doctor’s bag, but only for those who are willing to pay.

There is one major field, however, where the practice is still exceptionally common: the veterinary field, to be exact.

“I’ve been (at the University) for over 21 years and been doing house calls, or farm trips, for over 30 years,” said Clifford Shipley, clinical professor of the University’s Agricultural Animal Care and Use Program.

Shipley travels to farms around the area almost every day to tend to a variety of large and sometimes small animals.

“I take care of everything from chickens to cows, horses, pigs, sheep, goats, deer, elk, bison; I call on all sorts of farms and animals, (even) cats and dogs on occasion,” he said.

By travelling to each farm, he can create more personal connections with his clients and the animals themselves.

While veterinary farm visits aren’t the typical “concierge medicine” services, they are essential to all individuals who own farms. James Alfred Wight (pen name James Herriot), an author and rural veterinarian in England, chronicles decades of his farm visits with witty and heartfelt stories in his series of books.

All in all, doctors who make house calls can appear antiquated to some, but commonplace to others. Either way, they have come to be known as iconic images of the medical culture.