Dr. Varys is a family and lifestyle medicine doctor at Carytown Direct Primary Care, a membership practice in Richmond that she opened with her husband, who is also a family physician. She names women's health and menopause care, weight loss medicine and pediatrics as her main interests, and she sees patients of all ages. The practice treats low estrogen in women with hormone therapy and also prescribes weight loss medication. Members get unlimited visits and can call or text their doctor directly, with same or next day appointments. IUD insertions and a few other procedures are done in the office. She went to medical school in Prague and says she opened the practice because care should be a real conversation rather than a rushed appointment.
Next Chapter Women's Health is a solo, physician-led practice Dr. Middleton founded in 2025 after more than twenty years in family medicine, focused specifically on peri- and post-menopause rather than general women's health. All visits are currently conducted by telehealth and patients must be physically in Virginia at the time of the visit. The site says in-person visits are planned to begin in summer 2026. The first visit is a one-hour consultation covering history, symptoms and goals, with labs and studies ordered when indicated, and follow-ups run up to thirty minutes. She works alongside a patient's primary care provider or gynecologist and explicitly does not replace them for annual gynecologic and breast exams.
