Family doctor finds house calls a good fit for Florida island

After leaving an office-based practice, one physician saw an opportunity for cash-only services.

By Mike Norbut, AMNews staff. Dec. 15, 2003.

Unless you count a corner in her house with a computer and space for medical records, family physician Andrea Brand, MD, doesn't have an office. Because she only cares for patients in their homes, she doesn't need one.

Dr. Brand operates a cash-only, home care practice in Longboat Key, Fla., an island in the Gulf of Mexico, not far from Sarasota. Since starting her practice in January, she has established a base of about 100 permanent patients, while another 50 or so have called for one-time medical attention.

On an island with a population of about 8,000 -- a figure that nearly triples when snowbirds return during the busy winter months -- Dr. Brand said her objective was to create a practice with low overhead and start-up costs that could also cater to the people who don't live there all year.

Dr. Brand, who moved to Longboat Key from Clinton, N.Y., in 2002, spoke with American Medical News about her new practice.

Question: Why did you decide to create a home care practice?

Answer: I originally moved down here to work in a traditional office. What happened was a doctor purchased a practice and hired me to run it. But after six months, he sold half the practice to another physician, who decided he wanted my job. That left me without employment.

I didn't really have the means or the desire to start a new practice, but I wanted to stay on the island. So I decided I was going to start a home care practice, where I would try to offer affordable care to people. The reason I thought I could make it affordable was I wouldn't have the overhead you would have with a traditional practice. I wouldn't have rent. I wouldn't have any staff. I wasn't going to have any [liability] insurance, which is really expensive in Florida. I just use my cell phone.