I’ve put a lot of thought into how I’ve chosen to structure my practice, and it all comes down to one central goal: providing the best possible care for my patients. Let me show you why this is true, annual plans and all. I’ll start by telling you two stories.

Imagine being a fly on the wall of a family medicine office. A patient comes in for a follow-up on a medication start and the doctor notices a mole on their leg during the visit. They biopsy it and it comes back as melanoma. A scary, potentially fatal disease process is interrupted early. All that’s required is a simple, small lesion removal and yearly skin check.

Now you’re on the wall of an internal medicine ward in a hospital. You watch as a physician dawns a biohazard suit and passes through two doors to get to an isolated patient laying in a bed. They sit down on a chair by the patient and tell them that their persistent back pain, which they had sought care in walk-in clinics and emergency departments on multiple occasions, was, in fact, caused by an infectious disease. They explain that, unfortunately, it is now spread and while there is an aggressive treatment plan – the prognosis is poor.

Being a resident was, in many ways, like being that fly on the wall. You see the stark contrasts, the missed opportunities, and the devastating consequences.

Back pain with non-specific symptoms has a differential diagnosis as long as the list of things wrong with healthcare today. In a one-off evaluation (as in a walk-in clinic or emergency department), it’s almost impossible to diagnose back pain as this type of infection without an incredibly astute and descriptive patient. One who strikes a balance between sounding like they googled their symptoms and just providing the needed information.

What if the physician had the benefit of seeing the patient over time and multiple visits? What if the physician had the resources and staff to be available for appointments and weigh your patients at every visit? What if the physician had what is needed for organized, detailed notes and technology that makes seeing the change in weight over time easy?

Imagine if the physician’s brain was sharp during their visit and not numbed from hours of redundant paperwork. Maybe then it wouldn’t be impossible to diagnose. Maybe that patient gets diagnosed a year earlier. Maybe that patient survives.

And maybe I, when I was a resident on the internal medicine service, didn’t need to hold the hand of that patient’s family member while they shook with devastation and tears because their loved one was likely to die. Maybe I don’t have to look at them in the eyes without answers as they ask me why this was missed the other 10 times they presented for care.

If you’re looking at this website, if you’ve seen my enrollment process, if you’ve read through my annual plans, maybe you asked yourself “why” – and that would be a very good question.

Well, this story is, unfortunately, not unique in our system today. This is what happens when you don’t have a strong backbone of general practice physicians who have longitudinal relationships with patients.

The logical thing is to ask, once again, why? Why are we here? More importantly, how can we change it? And, if you were me years ago, maybe you’d have also asked yourself “how can I help change this?”

I can run a practice where sending in a request or message isn’t hard, time consuming or scary. I can run a practice where technology is leveraged to help me be thorough and organized, where electronic health records make it easy to track changes in a patient’s condition over time. I can choose a clinic that doesn’t shy away from innovation. I can maximize my resources so that I spend my time doing what I was trained to do – medicine. I can be honest about what I need to keep doing this work for decades to come, rather than burning out in year five. And, if I find a way, maybe I can advocate for change.

Change is not easy, but clearly, it’s necessary. By running a practice that prioritizes quality and efficiency, leverages technology, and values innovation, I believe I can make a difference. It’s not just about providing better care for individual patients, though that’s certainly at the heart of it. It’s about creating a system that supports and empowers strong family medicine. A system that would allow family doctors to do what they do best – to be there for their patients, to catch the subtle signs, and to prevent devastating outcomes.

The reality is that having robust financial resources is what allows a physician to run their practice in the way that maximizes their care. Without it? Well, all you have to do is look around your local ER to see the result. And no, the recent 7-10% raise for physicians the Ministry of Health was recently unwillingly ordered to pay doesn’t fix that a family doctor today makes 20-25% less than in 2002, despite increasing complexity in medicine.

So yes, as much as I wish I didn’t have to, I have a website, and I have annual plans. Yep, these plans help cover costs for services that the government doesn’t pay for, but it also helps me implement systems that improve my quality of care. It helps me help you. It helps me trial different ways of doing things so that maybe in the future things can be better, for everyone.