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JOHN BUNN: Dr. Alan Fleischman says he sometimes feels he was born in the wrong century. He's only 35 years old. But a paisley silk scarf protrudes from the breast pocket of his tweed jacket. And his thick mustache is waxed and twisted upward at the ends.

He and his family live in a house filled with antiques and centuries' old family portraits. Fleischman also practices old-fashioned medicine, old-fashioned, at, least in this country. Two evenings a week, he loads up his black bag and makes house calls.

ALAN FLEISCHMAN: I have my own style of medicine that I practice myself that it doesn't mean that my care of medical illnesses is different. But I'm talking about the care of people. And I must practice my medicine the way I feel right about doing it.

And other doctors can practice the way they feel right. But I don't believe it's beyond the call of duty. It's a normal part of medicine, for me.

JOHN BUNN: Fleischman, who was born and raised in Ireland, brought his family practice last fall from London to Caledonia, a town of some 2,600 in the southeastern corner of Minnesota. He'd spent a summer in the area 13 years before as an exchange medical student in nearby La Crosse.

When he was offered the Caledonia job by a La Crosse-based medical center, he jumped at the chance to raise his children in a small American town and to practice small town family medicine.

ALAN FLEISCHMAN: Hi, can we come in?

JOHN BUNN: It's 8 o'clock on a weekday evening at the home of Lyle and Lois Nelson in Caledonia. Lyle Nelson has terminal lung cancer. Dr. Fleischman has been seeing Nelson at his home once or twice a week for about four months.

ALAN FLEISCHMAN: How are you?

LYLE NELSON: Oh, about the same, I guess. Catching more cold now.

ALAN FLEISCHMAN: What do you mean?

JOHN BUNN: The Nelsons have decided not to fight Lyle's cancer with treatments like chemotherapy. Lois Nelson is taking care of her husband at home, trying to make his last months comfortable and happy. The Nelsons say having a doctor like Alan Fleischman, who's willing to come to their home, is important.

LOIS NELSON: It means a lot. It means wonderful because if we were to have to get dressed and go up to his office, it'd be pretty impossible for Lyle. He gets out of breath washing his face.

LYLE NELSON: He don't come any better than he does for coming out to see you. It don't make any difference what time of the night it is, or what time of the day it is. He's very good. He don't come any better. I really love him for being what he is.

JOHN BUNN: Dr. Fleischman got in the habit of making house calls during 11 years of practice in London. He says House calls have dropped off some in England, but are still the norm there.

ALAN FLEISCHMAN: The English family doctor is much more accustomed to looking at patients and trying to work out what's the matter with them by looking at them, and examining them, and talking to them with less backup from laboratories. And if you're accustomed to that, then doing house calls is quite an easy thing to do because all you're doing is taking that clinical situation from a clinic into a home.

JOHN BUNN: In making house calls as part of his routine, Dr. Fleischman is certainly unusual in modern America. But he's by no means the only American doctor making house calls. In fact, Lawrence Poston, who is president-elect of the Minnesota Medical Association, guesses that the majority of Minnesota family doctors make, at least, an occasional house call when the need arises.

Poston says there's relatively few patients who can benefit from house calls, those who don't need lab tests and are unable to make the trip to a doctor's office. But those who need medical care at home, Poston says, ought to get it.

LAWRENCE POSTON: I don't want to see the idea of home care as a major source of providing medical care for elderly handicapped. I don't want to see that die. It's still being done, but on a very limited basis. And I think that basis ought to be expanded.

JOHN BUNN: Poston has been an advocate of having a few doctors in larger cities making house calls full time. Though, the idea hasn't yet caught on. Meanwhile, back in Caledonia, Alan Fleischman's house calls have caught on. Patients like Lyle and Lois Nelson say the new doctor from England is the best thing that's happened to their town in years.

ALAN FLEISCHMAN: OK. Should I come on Thursday?

LYLE NELSON: OK.

ALAN FLEISCHMAN: All right, see you Thursday.

JOHN BUNN: I'm John Bunn in Caledonia.