243 Church St., NW 100C
Vienna, VA 22180
About Dr. Joffee
I think all doctors have a vision when they make up their mind to pursue medicine. Mine was always clear: Help my community. I loved the idea of getting to know my patients well, sharing my knowledge with them, encouraging them, and supporting them when they needed it most.
In my training I saw that my personal Vision was near impossible to achieve in the academic practice setting. It was a giant medical practice and patients saw whoever was available that day. In my experience, seeing your own doctor in a time of need was rare. I thought for sure that when I started my first job in private practice that this would change, and it did some, but not entirely. In my first job there was also pressure from management that prevented the Vision from becoming reality. I did not have the freedom to make changes to the practice that I thought would be beneficial for my patients.
So with my Vision in mind, in 2006 I opened my own solo practice. For the first few years it was great! I spent as much time as I wanted with patients and, being in solo-practice, my patients and I got to know each other well. However I realized over time that I needed to expand my panel of 1500-1800 patients to work in the insurance world. And this is what I did. I still spent a lot of time with patients at their appointments, 25-45 minutes per visit, but with so many patients there just wasn’t enough time to meet everyone’s needs. I had to send patients to urgent care frequently because my “same day slots” got filled up, and patients had to wait over 6 months to get a physical appointment.
Next came the dominance of a new insurance payment model where the insurance company decided they would literally pay me, or take money away from me, depending on whether I saved them money. Insurance companies and Medicare also incentivized “quality measures” that were meaningless diverting my attention from you, the patient. The large patient panel and heavy handed interference in patient care made it impossible to maintain the Vision.
Finally in January 2018 I converted my practice to a pure model of medicine called Direct Primary Care. In this model you, the patients, and my relationship with you, are again top priority. I now work with a reasonable number of patients again and have ended all my agreements with insurance companies and so they no longer have any power over me to interfere in your care. I am available for you when you need me and I am free to encourage, teach, and support you. I am now as prepared as ever to be your doctor and serve the community I love.