Today we’d like to introduce you to Azra Hussaini.
Hi Azra , we’re thrilled to have a chance to learn your story today. So, before we get into specifics, maybe you can briefly walk us through how you got to where you are today?
Hi- I am an Internal Medicine physician – at age 55, I was tired of seeing 4 patients/hr and held to ” productivity metrics. ” Working for others, I didn’t even have enough time to reassure the patient that it is going to be ok. This was subpar medical care as I was taught in medical school in Pakistan. My dream of being ” healing physician who could bring a smile to patient’s face no matter what ” seemed fading away.
I decided to open a house visit medical practice where I could spend as much time as necessary with patient like yesteryears physicians; even talking to the neighbors and having tea at times with patient at their house. I specifically wanted to focus on patients who had mistrust of health care system due to ” stigma attached to their condition.”
With just a car and stethoscope along with my medical licence – my daughter Alizay Jalisi ,right from the kitchen table, drew a logo with crescent and a car; launched the website of ” The Doc’s Here “- literally meaning ” healthcare when and where a patient wants.
As patients were added one at a time from zero, I still had to work for other practices/employers to run the household/pay bills which meant my daughter and I staying awake until 5am to submit claims for patients seen in our practice because we were not able to afford a billing team. My daughter was my front desk, medical assistant, driver, biller/coder and office manager for free.
As we made home visits with just 2 women team- myself and my daughter- people inquired about our office location and we thought we don’t have that kind of money. Soon enough, my friend Dr Qureshi of Rheumatology Express kindly lent me her custom designed office in Catonsville and left all exam tables and equipment moving into a bigger office herself.
Families of people who we had seen at home visits, started coming to the office who told their neighbors, who told their friends who told their cousins and others; and all gave us mostly 5 star reviews about our patient care.
My philosophy to care for patients is very simple- be respectful, allow autonomy and treat them like a family member. No matter how complex the diagnosis is, the answer comes easy with compassion and empathy.
This meant including and seeking caring for all those patients who are marginalized and slip through the cracks of ablest system- like patients of color, substance use, mental heatlh and trauma, obesity, elderly, dementia, gender dysphoria and home bound patients for any reason,
Our practice is all inclusive and has never refused a patient just because they can’t afford a doctor’s visit.
Using their guidelines for time based billing for commercial insurances and Medicare- the idea of spending reasonable time with patient has worked ! – we built a patient base from zero to about 1200 since 2019.
Today, our practice is very depective of patients who seek to call us or come to the office for very specific reasons of wanting personalized care and not worry about being judged or stigmatized/rushed.
My daughter is still my unpaid practice manager for it is her vision as the founder of the practice to take on the excluded patients – although through the revenue generated from practice, we have a full time front desk to help us.
I precept students of medical background from various institutions to teach them to embrace home visits/facility visits – do not ignore institutionalized patients and lead by example by acceptying patients who cannot pay and marginalized populations.
Alright, so let’s dig a little deeper into the story – has it been an easy path overall and if not, what were the challenges you’ve had to overcome?
Nope- We do not sleep well. Not just because of patient care. It is also because of low revenue because we didn’t start the practice to chase a luxury life style. The struggles include insurances pay rate being very dismal and around 30-40% only for a 100% service. Medicare is usually better but their rates are low to begin with.
We are enrolled in Medicare because the practice is geared for such patients and therefore cannot charge extra.
We use post it notes and write double sided as not to waste these. We don’t use paper cups.
Insurances cause months of delay of sending payments- my daughter is my practice manager for free and I don’t take a payroll sometimes to pay for my employee and other clinic expenses. This causes major chest pains while the CEOs of insurance companies make millions.
We are a small practice and there are many that have closed or are part of a conglomerulate or corporation of practices. But we don’t want to lose our custom approach or be bought by someone else telling us to see so many patients to make money.
Electronic health records systems are expensive, as are video platforms and website maintenance which are all necessary parts of running a practice; not to mention a very astute and expensive billing and credentialling team costing thousands each month.
The rate of reimbursement from centers for medicare and medicaid and commercial insurances is gloomy and insurances don’t want to pay for medications and include prior auth documents which are time wastsing paper work and red tape to patient getting a necessary medications.
Medications are expensive , few samples available and we are not able to bill for transport time or gas. Can only bill for visit/face to face time.
However, we are here to provide service and teach students to make it better for patients. We are not going to lose heart.
As you know, we’re big fans of The Doc’s Here LLC . For our readers who might not be as familiar what can you tell them about the brand?
We are a home visit /office medical practice with focus on home bound geriatric patients as well as some groups of patiets who either don’t feel comfortable going to offices or are feeling excluded or stigmatized.
There is only physician myself and one Physician assistant on Part time basis.
For example, we see all types of home bound patients in 50 mile radius of Catonsville as well as mental health, obesity, women’s health , LGBTQ, patients of color and so forth . We have video visit capability.
While we are not urgent care, we keep close communication with patients through patient portal and phone system.
We are a unique medical practice because we see patients for as long as it is necessary and follow time based billing guidelines of insurances which provides for better medical care and patient satisfaction.
We are a small, custom practice as we go to homes, facilities and engage not just in patient care but understand family dynamics and provide a wrap around type of service with medical equipments / wound care etc as necessary.
I am very pround of providing not just standard of care medical services but personalized attention, which is not rushed and is tailored to each patient and their family.
We literally say-The doc’s here – meaning the doctor is here! Our logo is very unique and is designed to show our compassion and enthusiam about patient care.
Where do you see things going in the next 5-10 years?
I think medical care is going to become more and more commercial with larger practices trying to eat up the smaller practices and dictate how many patients they can see and what types of patients to be seen to be profitable. This leaves all the older patients, dementia, mental health, LGBTQ, trauma , patients of color and home bound patients excluded.
I have strong stomach and sustained courage and I plan to maintain my practice in its original form because I believe in simplicity and providing love and care to patients. I am teaching it to my students as well.
Contact Info:
- Instagram: www.thedocshere.com
