Breaking Ground: Dr. Kristine Martens’ Trailblazing DPC Practice in North Dakota

Maryal Concepcion
Jun 29
7 min read

DPC Doctor

Redefining Primary Care in a New Frontier

For those in the Direct Primary Care (DPC) movement, hearing stories of colleagues carving their own path can ignite both inspiration and action.

Dr. Kristine Martens, co-founder of Resurgent Health in Fargo, North Dakota, shared an authentic, deeply reflective account of launching the state’s first DPC clinic. Her journey—marked by highs, lows, candid vulnerability, and lessons learned with each step—offers invaluable insights for any physician contemplating how to chart their own DPC future or respond to unique geographic and cultural challenges.

This comprehensive reflection draws on Dr. Martens' story as a lens for your own DPC practice—regardless of your location or stage on the DPC journey.

Embracing Uncertainty: The Roller Coaster of Being a Trailblazer

“Honestly, there have been, it's like a, been a roller coaster.”These words from Dr. Martens set the stage for the realities of opening the very first DPC in a state—an endeavor that combines initial exhilaration with sustained self-doubt and occasional dips into anxiety. While early excitement was buoyed by patients eagerly following her to the new model, the lack of a blueprint for DPC in North Dakota meant learning the business intricacies of practice management purely by doing.

For those considering launching in an untested market, recognize that the initial patient surge from your existing relationships may stabilize, but consistent growth will require patience, creativity, and continual community education. Expect emotional whiplash—but also, let each new patient, each positive experience, reconnect you to your why. Dr. Martens’ honest depiction is a reality check and a reassurance that the roller coaster is normal, manageable, and, ultimately, rewarding.

Takeaway: Embrace the unpredictability—and let every high fuel you through the lows.

Mapping the Journey: Education, Geography, and Returning Home

Dr. Martens’ trajectory is emblematic of the winding and often unexpected paths of many DPC docs. Having trained in multiple states, including DO school in Florida and residency in South Dakota, she ultimately settled in Fargo due to family and spouse’s career aspirations—a reminder that personal and professional life are always intertwined.

Her move back wasn’t simply about returning home; it was driven by a desire to build relationships with patients rooted in trust, continuity, and deep understanding—a core DPC principle. The willingness to re-anchor in a smaller, less saturated market was, whether consciously or not, an initial step toward being a pioneer. Her experience reinforces: Location matters, but connecting with your community matters more. Whether you’re eyeing a rural county, underserved city, or your own hometown, the impulse to serve where you’re needed most is a powerful DPC motivator.

Reflection Point:Where does your calling intersect with your community’s unmet needs?

Surviving and Thriving: Loss, Burnout, and Rediscovering Meaning

Before DPC, Dr. Martens’ story mirrors that of countless colleagues: increasingly long hours, intrusive after-hours EMR work, and growing emotional burdens eroded her passion for medicine. Even after switching from system-based practice to private insurance-based models, she realized “it wasn’t sustainable for life for me.”

Her epiphany regarding physician compensation in insurance-driven private practice—a common DPC origin story—came with the harsh awareness that great care isn’t always valued, and systems game reimbursement via volume, not quality. Dr. Martens’ blended experience of burnout and resilience speaks directly to those physicians seeking “permission” to prioritize joy, purpose, and connection over RVUs.

“I was losing my love for taking care of people and this has really ignited that for me again,” she shared. In DPC, her relationship-based care had space to thrive.

Lesson:If you’re hitting professional walls or feeling the cracks of compassion fatigue, DPC offers not just survival, but renewed purpose.

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Building the First DPC in the State: Logistics, Partners, and Practice Design

Partnership and Planning

Dr. Martens didn’t go it alone—her partnership with PA-C Alyson Dahl (a trusted colleague trained under her mentorship) was key. Together, they structured a 50/50 ownership business, with clarity around medical directorship, salary, and the mental (and actual) ‘ego checks’ required to build mutual respect and trust.

Legal and Logistical Structure

They sought local legal and accounting help, ultimately forming a PLLC, and reached out to nearby DPCs for precedents on contracts and operations. A reality check for anyone launching in DPC isolation: Expect to be your local “expert,” and budget time for research and peer mentorship.

Staffing Up from Day One

Atypical for fledgling DPCs, Martens and her partner brought two RNs with them from their previous clinic. While this move increased overhead, it offered immediate trust and workflow efficiency—provided you have a solid, collaborative culture and are prepared to float early costs through loans or salary sacrifice.

Pro Tip:
If you bring legacy staff, cultivate a growth mindset and involve them as true team members in building workflows from scratch.

The Hunt for Space

Finding a move-in-ready clinic was crucial. Their eventual “mini-mall” location, previously used by an insurance office, minimized buildout costs and fostered good relationships with neighbors—including another primary care office. Transparency with landlords and adjacent businesses helped ensure their DPC was seen as a community asset, not a threat.

Patient Relationships and DPC Value Propositions

Transitioning Old Patients and Welcoming New Ones

Many patients followed Dr. Martens simply because of trust and relationship, with little need for detailed DPC explanation. Others, despite excellent insurance, became frustrated with access or rushed care elsewhere, ultimately returning because “nobody cares” for them like a DPC physician.

Key Message:
Never underestimate the draw of authentic patient-physician relationships; this is your most durable value proposition.

Educating the Community

Despite their loyalty, even many early adopters did not fully grasp DPC—confusion about copays, insurance, and membership persisted well into the first year. Martens and her team found themselves repeating, “No, you already paid, nothing more is due,” and demystifying the separation of insurance and primary care.

Persistent, patient education—often one-on-one—will be necessary, especially when introducing DPC to markets where fee-for-service and insurance mindsets dominate.

Find marketers, lawyers, tech partners and more wherever you are in your DPC journey!

Balancing Overhead and Growth: The Staffing Equation

Martens and her partner’s commitment to two RNs was both a strength and a challenge. Early on, they took minimal salaries and relied on business loans to support staffing. However, leveraging RNs’ skill sets—such as by building in aesthetics revenue streams (microneedling, dermaplaning, cryotherapy)—helped offset costs and allowed them to offer expanded services without diluting their primary care focus.

Practical Consideration:
You must continually balance your clinical vision with fiscal pragmatism. Consider cross-training, auxiliary services, and creative revenue streams that align with your skills and values.

Practice Operations: Roles, Workflows, and Meeting Patient Demand

The clinic’s internal workflows emerged organically. Nurses triaged calls, scheduled, and managed communication, while Martens and Allie focused on clinical growth and business development. Weekly business meetings, mutual “brain dumps,” and willingness to rework protocols were vital.

Though it felt disorganized at times, intentional transparency and flexibility allowed the clinic to continually refine its systems, leveraging each team member’s unique strengths. Knowing your team and your culture matters as much as printed policies.

Growing the Panel:While early weeks were marked by few patients and abundant downtime, word-of-mouth success and gradual education led to organic growth—sometimes peaking at weeks when both clinicians wondered, “How am I supposed to do this with three times the number of patients?” Being open to fluctuating capacity targets (initially aiming for 350–400 each) and adjusting as processes and demand evolve is crucial.

Beyond Primary Care: OMT and Aesthetic Services

As a DO, Dr. Martens harnessed her OMT skills—including direct and subtle techniques—providing added value for her members and rekindling her hands-on clinical confidence. She used her patients’ openness as “practice” to rebuild her skills and then extended OMT access to non-members at premium rates.

Procedures such as aesthetics and cryotherapy further diversified offerings, with an intentional balance: “I don’t want to be a spa… I want our old farming men to come in and not feel like they’re going into a spa.” Aesthetics, while lucrative, should never eclipse the foundational mission of strong primary care—but they can be a lifeline in a high-overhead environment.

Reflection Point:What unique clinical offerings can you leverage to simultaneously serve your patients, exercise your passions, and sustain your practice?

Employer Partnerships: The Learning Curve and Growth Accelerator

Signing their first employer group—facilitated by existing relationships in insurance—unlocked new lessons. Even employer clients “think they understand” DPC but don’t fully grasp the difference from insurance-based care. Enrollment, onboarding, and resetting expectations (“No, your staff owes nothing extra!”) must be proactively managed.

Strategic Insight:
Employers are a powerful growth accelerant in underpenetrated DPC markets. However, build in extra time for education, transparent processes, and patience as both owners and employees adapt.

Marketing and Community Presence: Podcasting and Beyond

While traditional marketing felt unnatural, Dr. Martens and Allie leveraged their podcast, The Direct Effect, both as a patient education tool and a vehicle for authentic storytelling. Discussing DPC differences, their personal journeys, and community wins, they aimed to build trust and familiarity—helping patients “meet” their doctor before committing.

For DPC doctors wrestling with self-promotion, consider: your personality, expertise, and mission are the best marketing tools. Letting your voice be heard—via podcasts, community events, or social media—cultivates the relationships that form the bedrock of your panel.

Advice to Fellow Physicians: Lessons, Mindset, and Action

Dr. Martens’ message to those “stuck in the system” is both compelling and compassionate:

Have Faith:
If you’re craving change, there are always people who need your care—even if they don’t live next door. Explore virtual capabilities; geography is less a barrier than you might think.
Lean Into Community:
The DPC community is generous and collaborative. Seek out mentorship, advice, and resources—you’re not alone in this.
Don’t Wait for Mastery:
“If I can do it, you can do it.” Confidence grows by acting, not by knowing all the answers before launching.

Owning Your DPC Story—Where Do You Go Next?

Launching a DPC—especially as the first in your market—is a profound leap into the unknown. Dr. Kristine Martens’ story is a roadmap for tenacity, humility, collaboration, and creativity. Her journey reaffirms: the power of direct care lies not just in a better financial model or niche services, but in restoring the soul of medicine—the joy of really knowing your patients, serving your community, and reclaiming agency as a healer.

As you reflect on your own DPC journey—whether you are just dreaming, making the leap, or already in the thick of it—ask yourself: What does your community need most? What unique gifts do you bring? And how can you craft a practice that brings you, and your patients, back to the heart of why you became a doctor in the first place?

Let Dr. Martens’ “firsts” inspire your own next steps—for your patients, your profession, and, most importantly, yourself.

For more inspiring stories and practical pearls, subscribe to the My DPC Story podcast and join the conversation at mydpcstory.com.