By Dulcy B. Hooper | Photographed by Joanne Maisano
Whether you are sheltering in place, social distancing, self-quarantining, or simply taking the time to explore new ways of doing things, Doc At Your Door has much to offer.
Founded in 2018 by William L. Simpson, MD, Doc At Your Door couldn’t be more timely and relevant. “Staying at home to receive care, particularly wellness and preventative care, keeps you from getting exposed to contagious bacteria and viruses present in physician and hospital waiting rooms, exam rooms and restrooms,” said Simpson.
The doctor speaks from an abundance of experience. Prior to founding Doc At Your Door, he had cared for patients for over 25 years in the traditional setting of a physician’s office. In the course of that experience, Simpson increasingly found that patient care was suffering from the burdens of an ever more complex healthcare system.
“It got to the point where a 15-minute patient visit boiled down to five minutes of irrelevant data collection, five minutes with the patient, and five minutes of cumbersome computer documentation and coding,” he said.
The traditional code-based reimbursement system imposed by insurance companies on the medical profession “forces providers to jam more and more patients through their offices in shorter and shorter amounts of time,” he said. “These were all obstacles to providing quality care.” Simpson believed that along with the system-driven necessity to treat higher and higher volumes of patients, insurance companies, government and healthcare systems were all requiring more and more tasks, many clerical in nature, that “robbed even more precious care time from each patient encounter.” Simpson believes this traditional arrangement is a “no win” for physicians and patients alike.
“I wanted to get back to focusing on quality of care over quantity of care,” he said. “I wanted to focus on prevention over treatment, delivering care over documenting that care, and optimizing health over maximizing profits.”
All of the services Simpson provided in his earlier practice are available through Doc At Your Door – onsite testing and treatments; medication management; wellness care, such as physicals, labs, vaccinations and screenings; illness care, including acute illness, acute injury, or chronic illnesses. Simpson said that studies are currently underway confirming that home-based care is of higher quality and that individualized, rapid, on-site intervention available to home patients when they become ill can reduce expensive hospital visits.
“This new model allows me adequate time to focus on what matters to patients and to me, without the unnecessary distractions and burdens.” There is no medical office, no brick and mortar. Rather, Simpson sees patients in Loudoun and Fauquier Counties and “every county that touches Fauquier” exclusively at their homes or offices, providing a full spectrum of portable care for patients in the location they prefer.
“Hundreds of people in the region have enlisted my mobile services for their primary care needs – some acute, some chronic and some preventive,” Simpson said. “Some appreciate these services due to immobility, but far more seek them out for the privacy, convenience, and personalization they offer.”
Simpson said around 70 percent of his day is spent seeing patients in their homes or offices, and the other 30 percent in providing telehealth services via phone, text, fax, email and video exchanges.
Regular services provided by Doc At Your Door include wellness care, treatment of acute and chronic illnesses, on-site testing and treatments, and medication management. Simpson says that not all care requires a site visit, particular given modern, widely-available technology that allows patients to communicate with their physician by telephone, text, e-mail, and video. (His telehealth services are available only to established patients who have been seen at least once in the previous 12 months.)
Dr. Simpson with his wife Patty Simpson
“We charge for the care you receive based solely on time, so you are in control,” said Simpson. Doc At Your Door can provide all of a patient’s primary care or work with a patient’s office-based primary care provider. “Any combination works, and if another provider is involved, we pledge to do an excellent job of keeping them informed about any care we provide.”
Simpson also offers transitional and navigational care. “One of the biggest challenges patients face in our current health care system is the changing of care settings, such as from home to hospital or hospital to rehab facility,” he said, “Doc At Your Door provides patient care that can be fully coordinated and managed from one setting to another.”
Simpson also wants to debunk four common myths about house call practice:
- Patients do not have to be homebound to be seen – most of my patients are fully ambulatory.
- Patients do not have to give up their office physician. Many of my patients keep their office doctor and just call on me when needed.
- Patients do not have to pay concierge fees to see me.
- Patients do not have to forego insurance for labs, X-Rays, medications and therapies that I order. Only my time is private pay.
In these days so dominated by coronavirus, Simpson says he is even busier and the response to Doc At Your Door has been tremendous. “I am not really seeing many people suspected of being infected with CoV-2,” he said, “but rather seeing a lot of patients who simply want to avoid medical offices, urgent care facilities and hospital emergency rooms in an effort to limit exposure to others who may be infected with the virus. There is a lot of reward in being able to offer this kind of community care.” ML
Dr. William L. Simpson founded Doc At Your Door in 2018. He is board certified in internal medicine and has been providing general primary care since 1993. In addition to serving for 25 years as Medical Director for Piedmont Internal Medicine, Simpson has also provided leadership to the Fauquier County Medical Society and served for over ten years as a volunteer for the Fauquier Free Clinic.
Simpson was born in the Shenandoah Valley, grew up in Fairfax County and attended the University of Virginia for both college and medical school. Between college and medical school, he paused to obtain a master’s degree in health services administration. Simpson has advanced training and experience in geriatric care, wound care, nursing home care, rehabilitation care, home care, and health services administration. Simpson’s wife, Patty, operates her own geriatrics care management company and provides him with her insights into home-based medical care.
The benefits of Doc At Your Door include a licensed, board-certified physician in your home for as brief or as long a visit as desired or needed. While physicians have been converting to concierge practices in numerous urban areas around the country, Simpson reports that many of his patients say Doc At Your Door is better than concierge care – and without the concierge fees. Simpson offers 24/7 access via telephone, text, email, fax and video and responds to messages within hours. His model is based on “billing for time,” which he says is consistent with how most professionals receive compensation in exchange for their services. Pricing is based on time spent, with fees typically ranging from $25 to $500, at an average of under $100.
This article first appeared in the May 2020 issue of Middleburg Life.