Boating doctor only makes house calls

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Brand’s patients call her on her cell phone when she is at home, at the grocery store, on her medical rounds — even when she and her husband, Jeffrey, are on the Gulf of Mexico sailing their 2003 Hunter 260 sloop, Serendipity.

In Dr. Andrea Brand’s family practice, the doctor is always in.

Brand’s patients call her on her cell phone when she is at home, at the grocery store, on her medical rounds — even when she and her husband, Jeffrey, are on the Gulf of Mexico sailing their 2003 Hunter 260 sloop, Serendipity.

Just as remarkably, Brand, 58, of Longboat Key, Fla., usually is the one who answers the phone — if not her, then Jeffrey. And when she does answer, she doesn’t schedule an appointment for her office. Brand doesn’t have an office. She arranges to meet her patients at their home or boat, usually that very same day. She comforts them, examines them, treats them and chats with them over iced tea in the saloon of their boat or the living room of their home.

This doctor makes house calls. Or, for the liveaboards on Longboat Key, she makes boat calls. She treats all her patients at home, or occasionally at work. She has scheduled doctor’s appointments with her banker — at the bank. Brand says house calls have revolutionized the way she practices medicine. Her patient load is low, the “face time” she has with each patient is high — usually a half-hour per visit. And she works COD, cash on delivery of service. There are no insurance companies acting as middlemen in the payment of bills. She fills out insurance forms for her patients, and they seek reimbursement directly from their insurer. She doesn’t carry malpractice insurance. She doesn’t have to. She says her practice is low-risk and based on relationships instead of insurance or HMO contracts.

“It’s a very traditional, old-fashioned way of practicing,” says Brand.

A 1974 graduate of the State University of New York Downstate Medical Center, Brand spent most of her medical career working in large hospitals or group practices. She says these modern practices are shackled by high office overhead and underwritten by insurance or HMO contracts that funnel a lot of patients through a practice to compensate for the low fees they pay. She rarely could spend more than 10 minutes with a patient. This assembly-line way of practicing medicine wasn’t what she envisioned when she went to medical school.

“When I was 6 years old, my dad died of a heart attack at home and the doctor came to our house,” she says. “I remember that very clearly. He was our family doctor. I remember him coming to the house a lot.”

That is more what she had in mind when she started medical school with the goal of becoming a family practice doctor. Brand lost her job to downsizing at a group hospital practice in Clinton, N.Y., and was replaced with a nurse practitioner because she wasn’t seeing enough patients. After moving to Longboat Key and working for a time in a clinic, she decided to follow her heart and start a house-call practice.

Longboat Key — a barrier island lying between Sarasota Bay and the Gulf of Mexico — is the perfect locale for the practice, Brand says. The island is just 10 miles long, with one major road running through it and a bridge at each end carrying traffic to neighboring keys. Its population of 8,000 swells to 24,000 during the winter tourist season and includes — besides resident homeowners and tourists — marina liveaboards and visiting cruisers. They all are potential patients, and the island is so small she does a lot of her medical rounds by bicycle.

“My biggest expenses are my telephone bill, Internet access and gas for the car,” she says. “And I only fill my [gas] tank once a month.”

Brand gives every new patient a T-shirt with a dolphin printed on it, along with a short advertisement: “Dr. Brand — House Calls on LBK (Longboat Key). Brand’s approach to medical practice resonates with islanders. Last year the Chamber of Commerce named her “Rookie Small Businessperson of the Year.”

Brand says she intends to keep her practice small because it gives her and Jeffrey time to enjoy the island lifestyle, which includes year-round sailing and kayaking.

“I’ve shoveled my last snowflake,” says Jeffrey, a retired high-school science teacher who works part time at a liquor store. “I love it here.”

The couple owns a home on a canal on Longboat Key and keep Serendipity at a dock in their backyard. The dock is two blocks from the Intracoastal Waterway and 15 minutes from the Gulf. The couple sails on the Gulf or bay, and kayaks to nearby Beer Can Beach, where they walk the white-sand beach and go swimming. “It’s a wonderful lifestyle here,” she says. “We have a very flexible schedule.”

Moreover, Dr. Brand is actually enjoying doctoring again. That fact is reinforced daily “when I have a patient who says, ‘I’ve never had a doctor [make house calls]. I’ve never had a doctor call me back. I’ve never had a doctor spend this much time with me,’ ” she says. Or, when she gets up to leave after a house call and the patient hugs her.

That’s what she envisioned when she set off for medical school.