Is there a doctor in the house?

By Posted on Aug 03 2018 | By

Doc At Your Door launches in-home medical practice 

On August 15, residents throughout the Fauquier County region will be able to receive modern medical care in a yesteryear environment: their home.

And if it’s a bit difficult to conjure up a doctor ringing your door bell, just go with it. It’s a leading-edge trend that may well gain momentum in the coming years.

The traditional insurance-based model of health care began changing in the 1990s and was largely centered on wealthier patients who could afford what was termed “concierge care”. The service cost thousands of dollars a year and offered patients a personal physician available whenever they needed one.

While the model still exists, a growing number of physicians are blending conventional patient care with the concierge model. Some even sign on with concierge practice firms who managed the program for the physician.

The advantages for participating patients are the ease in scheduling appointments and personal care in an era of overburdened medical practices that increasingly are unable to provide quality health care due to patient overload.

Concierge plans can range from $100 a month up to $20,00 or more annually. But typically, they run from $1,500 to $2,000 a year and the costs are not covered by insurance. A significant out-of-pocket expense for the average patient.

Physicians are attracted to fee-based services because it enables them to reduce their panel of patients while providing better care with less administrative insurance work.

But there is another approach to fee based medical care that does not require monthly or annual membership fees. And it’s coming to the Fauquier area in mid-August.

Dr. William L. Simpson

Dr. William Simpson

Dr. Simpson, 58, is a familiar face to thousands of local patients. He was founder and medical director of Piedmont Internal Medicine and practiced there until earlier this year when he left to create Doc At Your Door.

What drives an experienced physician to abandoned a successful practice and strike out on his own?

“After 25 years of playing the insurance game, I’ve witnessed first-hand how our nation’s health care industry impedes the delivery of high quality health care,” said Simpson. “It focuses more on treatment than prevention, more on specialty care than primary care, and more on volume of care than quality. And frankly, more on saving money than saving lives.”

Like a growing number of private pay doctors, Simpson elected to focus his energy and skills on patients rather than insurance guidelines, pre-authorizations, denials, appeals and other obstacles to quality care imposed by insurance plans today.

However, unlike most private pay physicians Simpson’s practice has no monthly or annual fees. In fact, no fees at all other than what he specifically charges patients for each home visit.

It’s a business model that might be perceived as radical except for its simplicity.

Perhaps the best way to envision how it works in real time is to think of the conventional billing practices of attorneys, accountants, tax advisers, lawyers, consultants and a host of other professionals. In fact, plumbers, electricians, carpenters, auto glass installers and more bill the same way.

Under any of these scenarios an on-site service is provided, a bill rendered and a payment made. Doc At Your Door will use the same model.

And what services will be offered?

All of the services provided in his previous practice will be available from his new business. Physicals, labs, EKGs, nursing home and assisted living admissions, screenings for diabetes, high cholesterol, hypertension, heart disease and cancer. Whatever ails a patient will fall under Simpson’s skillful eyes and stethoscope.

Insurance will still be employed for screenings and medications but the patient will file those claims directly with their carrier. The practice will not act on their behalf, reducing its overhead costs.

The service model has two components: traditional and premier.

Traditional covers all health care issues. The premier category expands on those basic services to include, among other services, the TELEHEALTH system that allows patients to communicate with their physician by phone, text, email, fax or video.

The premier service is only available for patients who have been seen at least once in the previous 12 months. But consider: what would it be like to have direct electronic contact with your doctor and receive prompt feedback? Ahhh…you get the picture.

The pricing structure for the new medical practice is straight forward:

$5/minute (6 a.m.- 6 p.m.)
$7/minute (after hours, weekend, holidays)

(Out and back from Main Street, Warrenton)

As incurred (meds, vaccines, bandages, etc.)

A possible 15-minute daytime home visit for a patient who wants a flu shot and a cholesterol test and lives eight miles from Simpson’s start point would cost $75 for the visit and a $32 travel fee, or $107. The blood test, if covered by insurance, would be filed by the patient.

Anyone considering the service would weigh that bill against the time and effort to make a conventional office visit, take time out of their schedule to go, and incur any associated costs such as gas.

For busy career professionals the cost/benefit trade-off may make sense considering no other fees and retainer charges would be involved.

In addition to harried workers, Simpson sees homebound or limited mobility patients especially benefiting from his services since there is an estimated five million such individuals nationwide.

“My wife is a geriatric care manager and I’ve heard for years how it’s such an ordeal for these patients to get out of their house. Often a family member has to take a day off from work and hire transportation. It can cost hundreds of dollars just to get these folks to a doctor’s office.”

Simpson can solve those problems, reduce costs, and more importantly, improve the level of care by coming directly to a shut-in’s home.

Mobile doctor’s office
Once Simpson launches his service he will have no brick and mortar office. “I will be completely mobile,” said Simpson. His initial intent is to service all counties bordering Fauquier County but will evaluate his geographical reach based on case load.

The intent is to provide prompt service so reframing his service area would be driven by the number of patients he sees daily.

“I can’t tell you how many of my previous patients would come in with a list of eight or 10 items they wanted answers to. In reality, we often only had time to cover two or three. Now I will have adequate time to spend with all my patients.

“I will be able to expand my scope of care. I can sit down with patients right after their hospital discharges and help them figure out their doctor’s instructions, how to dovetail new meds with existing ones, figure out follow appointments and doing all this outside the restrictions of insurance companies,” Simpson emphasized.

“This is how health care was provided decades ago. Over time is got consolidated back to office visits. Now there is a trend to going back to the home. I’m excited to be embarking on this in our community. I don’t think its offered here at all.”

For a comprehensive description of the services and fees of this innovative health care practice visit


Published in the August 2, 2018 edition of the Fauquier Times.

Categories : HAGARTY TALES