To my patients:

For as long as I can remember, I have been an inquisitive person, not being satisfied with the answer alone, but to know how and why. This is part of what called me to medicine, to truly understand how the body worked and to apply that knowledge to alleviate the suffering of others. I enjoy working out the solution and spending time discussing with the patient, how their body works, the problem I see, and how we could fix it. I love to apply medical knowledge and common sense to patients’ concerns and to come up with practical solutions that truly meet people’s needs.

This describes the art of medicine that drew me to my profession, but unfortunately, it requires the one thing that mainstream healthcare systems absolutely cannot provide:  more time with patients. The financial sustainability of the current insurance-based, corporate healthcare structure is built on continuously increasing the number of patients in primary care physician panels. This has led to a situation where both patients and physicians feel as if they are on an assembly line with poor satisfaction on both sides and suboptimal quality and efficiency of care. The push to increase panel size leads to significantly decreased availability which has caused multiple problems in my own practice:  patients unable to get in with me needing to frequently go to Urgent Care or the Emergency Room, multiple specialist referrals for things that I could otherwise have managed, inability to spend the time needed to comprehensively evaluate and educate on all health problems and the treatments being prescribed. 

Despite all the issues with the current system, I don’t think the hospital systems themselves are entirely to blame for this but are merely trying to survive the rules, red-tape, and payments imposed by the current public and private insurance regime. I think the system with all its problems is mostly a result of the presence of the insurance industry in every healthcare interaction. While I have constantly tried to do my best for my patients within the system for several years, the deviation from the lofty ideals I described above has increasingly weighed on me throughout this time. As a result, I have decided to pursue another path toward providing the high-level care that I believe is ideal.

Effective January 1, I have resigned my employment for OSF and will be starting a new practice in Ottawa called Holy Family Direct Primary Care. It is based on a new payment model called direct primary care which does not rely on billing insurance but instead on a transparent, affordable subscription pricing model. It limits the physician panel to no more than 500-600 patients which opens up availability for providing a much broader scope of care, same/next day appointments, 40-60 minute appointments, certain medical procedures, and physician availability for urgent issues by phone/text nearly all the time. The monthly fee would cover the cost of all care provided in the office; blood testing and medications would be offered at wholesale cash prices if desired. This is medicine as I have always wanted to practice it, as a vocation, with the emphasis on building a strong relationship with your doctor, not simply as your provider of health services, but as your trusted professional, like having a doctor in the family.

While I am very excited to be moving into this style of practice for all the reasons I mentioned above, my greatest uneasiness has been that my current panel size is close to 4000 patients and the new practice will only support 500-600 people. I also know that some may feel unable to afford the subscription fee. I am intentionally designing the practice to be as affordable as possible and it is my hope that some may actually save money through the wholesale priced medications and laboratory testing that will be offered, but I do understand that this won’t be an option for some.

Thank you all for entrusting me with your health during the time that I have been in Ottawa. I have been truly honored by your confidence in me as your physician and I look forward to this next step and continuing to be a member of this community.

Sincerely,

Austin Martin, MD