Dr. John Vigil, M.D., founder of Doctor On Call, believes modeling his practice after those same standards makes for a superior experience and better health for the patient.He
stands firmly behind the Doctor On Call
motto, "modern medicine, old-fashioned care," noting, "Today, doctors are trained in huge state-of-the-art medical centers, where technology is king.Doctors are taught to ignore their intuition.In my day, we were taught to rely on our senses: our eyes, our ears, our hands and our stethoscopes."
So how did such an obvious yet novel idea come about?Born and raised in Albuquerque, Dr. Vigil joined the U.S. Army right out of high school and later attended the University of New Mexico as a pre-med stu dent, graduating from UNM's School of Medicine in 1988.
After a grueling four-year general surgery residence at UNM Hospital
, Dr. Vigil
relocated to Dayton, Ohio and fulfilled his
surgical training in 1994.He
eventually went on to open a private, insurance-based vascular and transplant surgery practice in Ohio, as well as launch a free clinic for immigrant workers without access to health care.Soon after, Dr. Vigil
was initiated as a fellow into the American College of Surgeons
, one of the highest honors a surgeon can achieve.
Returning to New Mexico a few years later, he
continued to practice general surgery, but due to personal medical reasons, had to semi-retire in 2002.While working as a "locum tenens," an arrangement in which a doctor moves from hospital to hospital within the city, state or even nation, Dr. Vigil
began to think of a different approach to health care.Dr. Vigil
noted that most patients admitted to the emergency room shouldn't be there.At first, he
blamed the patients for what he
viewed as blatant abuse of the E.R., but later came to realize the practice was, in fact, being perpetuated by the system."People try to get in to see their doctors when they're sick, and when they're told the next available appointment is in two weeks, they go to the E.R."
Not only is the E.R. an inefficient and costly place for people to get basic primary health care or minor urgent care, but these patients also detract care from patients who have a true emergency, such as a heart attack, stroke or other major trauma.Dr. Vigil thought, "There's got to be a better way."
The scheme percolated in Dr. Vigil's
mind for barely six months while he
went to his
family and friends for financing.They loved the idea.
In January 2005, Dr. Vigil
leased a small office space and focused strictly on house calls.But he
quickly realized that many patients still desired to be seen in a traditional setting.So he
leased additional space next to his
office to create a walk-in clinic.As the sole practitioner, he
time between house calls and the clinic."The first year was slow, so it was fine," he
At first Dr. Vigil ran print ads and some radio spots to advertise his
new service, but now Doctor on Call primarily relies on word-of-mouth, as well as exhibiting at health care conventions and giving health-related talks at local assisted-living centers and nursing homes.Today, Dr. Vigil has a business partner, internal medicine specialist Dr. Steven Vaughn, two other general physicians on staff, Dr. Tom Tyson and Dr. Barry Maron, a physician's assistant and a nurse practitioner.
Although Doctor On Call
does not accept insurance, Medicaid or Medicare, Dr. Vigil
practice is not only more efficient than the E.R., but because he
has created a nuts and bolts infrastructure with extremely low overhead costs, he
is able to pass along those savings to patients."Over the last 40 years, we've allowed insurance companies to tell doctors how to practice.That's not right."Dr. Vigil
says that, in fact, over 70 percent of his
patients actually have insurance, but they would rather pay out of pocket for Doctor On Call
because of the prompt and personalized care.
Voicing a desire to provide "affordable, accessible and personal" medical services, Dr. Vigil
cites a Johns Hopkins University study showing that over 90 percent of diagnoses can be made through nothing more than a careful history evaluation and medical exam of the patient."Most primary care doctors see 50 patients a day.It's easier to send you for an MRI rather than spending 30 minutes with you to find out why you have headaches."Dr. Vigil
doesn't believe this is due to lack of caring or concern on the physicians part, but simply a "broken system."
Doctor On call is significantly cheaper than one would expect, charging a mere $68 for a basic clinic appointment or walk-in and only $88 for an in-home examination. (Currently, the average E.R. visit in Albuquerque, just to be seen by a doctor, is $175 or more.)Dr. Vigil
also points out the amount of time wasted by both patients and staff in the E.R. "When you go into the E.R., you see a clerk and tell your story to them.
Though Dr. Vigil
won't disclose revenues, it is obvious that Doctor On Call
has grown exponentially since its inception.Dr. Vigil
is even in the process of opening a clinic on Albuquerque's Westside."The growth on the Westside is tremendous and the available general health care is not adequate to support the patients' needs."He's
also contemplating expanding his
model throughout the state, and possibly eventually creating a national franchise."I already have a couple of physicians in Los Alamos and Santa Fe are interested in copying my model."
Even the film industry has taken notice of Doctor On Call
and is taking advantage of its services."Because of our mobile nature, the film industry is a huge part of our practice."
Due to medical privacy laws, Dr. Vigil
cannot disclose the names of patients, but he
does say, "Our service is great for film companies because if the star has to go to the hospital and wait several hours, it could cost $100,000 or more a day to shut down the production.