Since I was 12 years old, I wanted to be a small town doctor providing primary care to members of my community. Like the proverbial country doctor of days of old, I envisioned having the time to truly get to know and build lifelong relationships with my patients and their families. I dreamt of seeing my friends and neighbors in a comfortable welcoming office, making house calls, and greeting my patients as I walked down Main Street of small town America. Unfortunately, after completing my residency, my dream met the realities of America's broken healthcare system focused on insurance company profit instead of patient care. It became increasingly difficult to provide the time and care I desired for my patients due to burdensome administrative paperwork, oppressive hospital network policies and processes, and insurance-driven time constrained visits, quotas, excess documentation and coding requirements. I was spending more time on paper instead of patients so that insurance companies could make more profits and provide less care. As a father and Scoutmaster, I taught my children and Scouts that if there is a problem with a system, you can do one of three things:

• Accept the system the way it is and do your best to work and live within its confines.
• Try to change the system from within by bringing your ideas and proposed changes to leadership, or attain a position of leadership yourself to implement changes from within.
• Brave the unknown and go out on your own to try to make your own vision come to life.

So I followed my own advice. After 15 years of trying to accept, work and live within a broken healthcare system, failing in my endeavors to change the system from within, and ultimately not finding success in fulfilling my dream — I decided to birth my own small town family practice using a Direct Primary Care model. Thus, Barreto Family Medicine was born.