Stepping into Private Practice

Over the next few weeks, I will be transitioning away from Heart Spring Health (HSH) and into building something of my own.

This decision is layered and tender. I love the providers, staff, patients, and vision of HSH deeply. It has been an honor to practice alongside people who are thoughtful and committed to doing good work in a system that often makes that very hard. I will sorely miss this community and the relationships I have built here. This decision is shaped by both love and longing. I care deeply about what I am leaving, and I am also listening closely to the call to step into what comes next.

I am continuing to practice medicine and to care for patients. What I feel called toward now is challenging and reshaping the deeply flawed system that dictates how that care is delivered, valued, and sustained.

Insurance is Unethical and Unsustainable

I have spent years witnessing and participating in a healthcare system that is increasingly transactional. Care is compressed into time slots. Worth is reduced to billing codes. Access is dictated by contracts negotiated far from exam rooms and far from the realities of people’s lives. While many people advise keeping healthcare “non political,” the truth is that healthcare has already been politicized. It has become political because it has become transactional, because profit and bureaucracy now shape care more than relationship and trust.

This past week, as I began the re credentialing process for my new practice location, I spent hours on hold with insurance companies. Some have a ninety day wait just to review applications, despite a primary care shortage in Portland and across the country. During that time, patients wait. Providers wait. Care is delayed. The system moves on its own terms and we continue to play by rules that make no sense.

Insurance companies determine how much patients pay, how much providers are reimbursed, and whether providers are paid at all. I have patients whose monthly insurance premiums exceed what I receive in an entire year of providing their regular care. This is not sustainable. It is not ethical. And it is not a system I can continue to unquestioningly participate in.

People over Profit

Some of my inspiration has come from unexpected places - like Dropout. Yes, you read that right! The

comedy streaming platform formerly known as CollegeHumor. This is a company I genuinely love because of how clearly they center people over profit. In a world that feels increasingly divided and extractive, they remind me that it is still possible to build systems based on collaboration, transparency, and care. Seeing that matters to me. It gives me hope. And it reminds me why I believe we can do better, and why I feel compelled to try. It's a true GAME CHANGER!

At this moment, I am still practicing within the current healthcare model because that is how many patients are able to find me and receive care. That access matters deeply to me. My long term vision, however, is to build toward an equity based, cooperative, cash model of integrative healthcare. While that future will not arrive all at once, I am beginning now by embedding equity based pricing into my cash rate structure.

I have done the math on what is required for my practice to survive, to be sustainable, and to truly thrive. My pricing reflects a scale from just making ends meet to thriving with the capacity to give back into scholarship funds that further expand access. Patients choose where they fall on that scale. No proof required. No justification demanded. This is a system built on trust and shared responsibility.

I want to name that this model will feel unfamiliar to many people. Most of us have been taught that insurance is the only way healthcare works, even when that system is failing us. But across the country, more and more providers are stepping into direct care models and moving away from insurance driven systems. At its core, this is about cutting out the middle layer that has come to dictate care without being accountable to patients or clinicians. It can feel scary because it is different and because we have been conditioned to believe we need insurance involved in every interaction. I will still encourage people to carry catastrophic health insurance for emergencies and hospital based care. My goal with this model is to make integrative primary care more affordable and more humane. Some people will be able to contribute more when their means allow it, others will pay what they can. Together, that shared investment is what makes access possible.

I will always remain committed to taking OHP to increase access, as long as Medicaid will have me (that conversation deserves a whole other blog post!).

This transition is about choosing healthCARE.

My Radiant Oaths:

• People over profit.

• Trust over fear.

• Equity & Inclusion.

  
  

For those who have asked how they can support this transition, I have a GoFundMe. Thank you for being part of this community in whatever way feels right to you.

If you feel aligned with this mission and are interested in becoming a patient, please click the link to join my waitlist! I will reach out as appointments in the new space become available.

Join the Waitlist

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About Dr. Andy Turner, ND

Dr. Andy Turner is a licensed naturopathic physician practicing integrative primary care in Portland, Oregon. Her work centers on women’s health, pediatrics, and relationship based, trauma informed care. Dr. Andy is also an unapologetic nerd who finds inspiration in stories, systems, and communities that imagine better worlds, whether that comes from medicine, fantasy novels, or values driven creators who remind us that people matter.