Episode 53: Dr. Omar Akhter (He/Him) of Madina Medicine - Austin, TX

DPC Doctor

Dr. Omar Akhter owns Madina Medicine in Austin, TX
Dr. Omar Akhter

Dr. Omar Akhter grew up in Pakistan and had exposures to medicine at an early age as he was born into a family of physicians. He followed the same path as the other physicians in his family and graduated from Aga Khan Medical School in Pakistan before going on to complete residency in Internal Medicine in New York City at Presbyterian Queens. He has been board-certified in Internal medicine since 2017.

He practiced hospital medicine for a few years in a large hospital system in New Jersey before eventually settling in Austin, Texas with his wife and children. Working in that system made it clear to him that he wanted to work with patients in a more meaningful and holistic way. That is why when he moved to Austin, he started a Direct Primary Care practice. He opened Madina Medicine in Jan 2020.

In toady's episode, Dr. Akter shares his passion for functional medicine and how he is able to bring his expertise to the community of Austin, TX. Hear how he transitioned from his medical training in Pakistan to New York and how this transition opened his eyes to his love for primary care and preventative medicine!

Get Out & Stay Out: starting a cash based medical practice - a presentation by AAPS President Juliette Madrigal-Dersch, MD at AAPS Feb 1, 2013 meeting in Austin, TX

Resources Recommended by Dr. Akter:

- American Holistic Health Association

- Loom (video recording platform for video messaging)

- Institute for Functional Medicine

- Austin Wellness Collaborative

- Free Website Guys


- Doctors Pharmacy by Dr. Mark Hyman

- Dr. Ruscio Radio by Dr. Michael Ruscio

- The Drive by Dr. Peter Attia

- Solving the Puzzle by Dr. Datis Kharrazian


- Food Fix by Dr. Mark Hyman

- Why Do I Still Have Thyroid Symptoms by Dr. Datis Kharrazian


phone: (512) 601-8952

fax: (512) 382-7270



Welcome to the podcast, Dr. Akhter thanks for having me. I'm excited to speak. I think the Texans are really dominating the podcasts because, we have people from Wichita falls and Burford nuts and Houston and Austin, and this has been fantastic.

So I'm really excited to speak with yet. Another Texan in terms of you guys are really proving that DPC can thrive in a large state and in large communities. Yeah, definitely. And in Austin, there's quite a few of them and, it's so great to see how they help each other out, despite being literally in the same town.

And for those who aren't aware, what is the population size of Austin and its suburbs? Austin is about 2 million people, roughly. And ever-growing now I want to start, with your roots because as was mentioned in your bio and your credentials. You are originally from Pakistan. And I wanted to ask how is the medical system there in Pakistan compared to the U S So the medical system is quite different there.

The primary way is that you really have you go into medical school after high school. So essentially after 13 years of schooling, you go directly into a five-year medical program. So there's no real undergrad the way that they have here. So people are really making the decision to go into medicine at the age of about 18 or 19.

And then that's when they get into medical school. So it's very different in that way. Versus people here who are generally starting medical school later in life and they're much older. And then the other thing is that, we're still dealing with a lot of third world illnesses and diseases in Pakistan.

And so you're going to get a whole different way of practicing with much fewer resources. So the clinician over there really has to be a very astute clinician in terms of diagnosing and treating because you really don't have all the resources you have available here. And I think that it makes for great clinicians because you have to often diagnose pneumonias and abdominal issues without the luxury of imaging and a whole lot of blood tests.

I think that the emphasis on making it an accurate clinical diagnosis and using affordable medicine is definitely huge there. And then obviously we're dealing with different illnesses in general.

When you were in your training, having gone from high school to medical school, basically how was that emotionally for you? Because like you're saying you're younger when you go into medicine versus having, the four or five plus whatever years a person takes to go to undergrad.

How was that emotionally when you were seeing things like. Death and severe illness, especially how you described, you're dealing with serious medical illness, serious medical diagnoses with limited resources. Yeah. It's very, eye-opening for someone who's literally finishing their teenage years and then going into this type of environment especially the ER and those types of places, which are very different from the way they are here because of the nature of where you are.

In that sense, it's very different. I think, emotionally you get into the role of the physician after you get into medical school. I think here because of how difficult it is to get into medical school and all the prerequisites you have to do before.

The people who get into medical school are the ones that are generally very determined to go down this path. Whereas sometimes in, in medical school, over there, you end up, you enroll them there, you get in there. And sometimes then you're lost and it takes some time to grow into that role.

Just given the age you are and stuff. So I find that it's something that, you get into medical school first and then you soon realize what that means, what your role is and stuff. Very different. And for you, what did that journey look like before you made your transition to the states?

Just going back to my family, I think it'll make a lot of sense. So both my parents are physicians and my father has three sisters. My aunts were all, three of them are physicians and all three married physicians. So growing up really medicine is just what I saw, what I knew I was the eldest child.

And I really didn't have any exposure to anything else. And so when it came time to that age of 17, 18 I really, felt very acutely that medicine was my destiny and and I excelled at the sciences required for it. And so I entered medical school in that way. And, I think the transition was tough in some ways, because in, in some ways I didn't feel like it was my own decision.

If you know what I'm saying it was like, it's your destiny and you felt that it wasn't, it was a choice. But it was sometimes it felt like it was made for you, and so it took me a while to grow into that. And just realize how I can still carve my way in doing it the way that I want to despite having all a family that was very involved in medicine,

did you have any particular experiences that, made you realize?

Wow, this is not just my destiny, this is my calling as well. Yes. I had a number of experiences throughout medical school, it's hard to pinpoint necessarily which I think there were different feelings that you get at different times. And I think that it was.

No, it was a gradual process. It wasn't that overnight type of thing that, this is my calling. It was that gradual learning the medical system and learning myself more and more, and then getting to that point eventually. And I don't think that point came until I got late into residency, to be honest with you.

Cause you know, you go through the motions a little bit and you go through medical school, then you go to your residency and sometimes it feels like you're just doing the next step, which you're meant to do. And it may not be your calling. So that kind of came later in my career.

I, I feel and the other thing to know in Pakistan is that there's a heavy emphasis on specialty care. If you think about a primary care physician over there, you're essentially thinking about the person who is really treating poor people with lack of resources. And so they get that little clinic in the side of the hospital.

Not as fancy as the specialists, the cardiologists and the surgeons and all of them yet. And so it gears your mind towards understanding that if I wanted to Excel in the chain of the hierarchy of medicine, then becoming a specialist, a board certified specialist is a prerequisite to that.

And so that always was in the back of my mind. It's not it wasn't like, am I going to specialize? It was like, what am I going to specialize in? And it was only later in my journey that I realized that I wanted to remain general, remain holistic and then not specialize. And that really was very strange.

When you talk about being in general practitioner, you know, I I just light up because I'm like, yes, family medicine You are an internal medicine doctor. So what was your transition like from Pakistan to an, a residency program in the states? And I asked a specifically, because if there is a foreign grad who is listening or somebody who is applying from a foreign medical school, I would love for you to share that part of your journey specifically for those people and all the other listeners as well.

Yeah. So medical school there, as I imagine it is here is fiercely competitive. And especially in the school that I went to, which is considered the best one over there. It, you start at an early time , in your in your schooling, starting to study for USM LEDs, and it's very different.

Then cause here U S Emilys are considered your final exam for your second year and your fourth. Over there. Us, Emily is a choice. And sometimes for people it's a privilege because the idea that you're going to be going to the U S after medical school is not necessarily something everyone can do because of DCIS status because of affordability and those types of things.

So automatically it becomes like that's the the goal to achieve almost, so you have a lot of competition, you have a lot of people wanting to do like they Excel and do better than others. And there was a little bit of peer pressure, I think, to to get into a good residency program here in the U S and that really you know, you kind of made it if you did that as a graduate from there.

And I think that while it's a great thing. And I did that myself. I think that. Foreign grads should also realize that not everyone needs to leave their country of origin and go to the us and there's such a high need for because over there's such a brain drain where you have the brightest minds that are, physicians and others that are leaving the country for looking for other places.

And so there is that need for physicians to stay there. So I think that if I could tell a medical student right now, like in their fourth or fifth year it's like just try to carve out your own journey and not necessarily get sucked into that peer pressure of, I have to do things a certain way.

Cause I kept doing that. Throughout my entire career that, oh, this is what I have to do. I have to go into residency. I have to go into fellowship. I have to do, so it was just that pressure that kind of kept me going. But when I finally broke away from it, that's when I felt that liberation of, I don't really need to do this.

I can just carve my own weight in a way that I feel comfortable. So that's really my advice that I try to give, not only to foreign grads, but to grads here, that just try to carve your own path question, the things that you learn in medical school, because you're not necessarily learning, everything in the right way.

You're learning a model of care, just like we do DPC. We, we consider rebels in the society. And and that's. You're just taught one way, whether it's a way of practice or whether it's a way of the way medicine is just one model. And so I think that's what I, and I wish someone could teach me that at that time, but you learn in your own journey.

And so I tried to tell all medical students and pre-med students right now that just be aware that there's more out there than, you may be exposed to. Yeah it's so true. And I'm really glad that for all the reasons that the number of people who are choosing to do DPC out of residency is just amazing.

With you sharing what you did, that you never know, somebody will listen to this podcast, the week it comes out or two years from now, and that your words will sit in their mind to mull over and potentially impact their journey. One of the things that is present on your website in terms of your, why was the fact that you. Saw in New York and New Jersey, the type of medicine that you did not want to practice. So can you flush that out for us and share what happened in those states where you saw the medicine that you did not want to practice?

When I was going through medical school, there was this real sense of your helping people and the community. Especially those folks that can't really afford care and that really poor. And you may do something to save their lives or, better their lives, something like that, that I could do everyday in Pakistan.

You really can, whether it's medical related or otherwise. When I got to the U S I felt that lack of authenticity in the hospital system where the system does not allow you to have that kind of. That pure physician humanity that we all start off with because of just various things related to documentation and EMR and systems and, metrics and all of those things.

It just devoids that physician of that pure reason that they got into this field. And so as I started here I, it w it was a lot of hard work, a lot of hours, just a lot of the grind, but with very little, or that feeling that I used to get back home that in which I really felt that I was helping someone making impact in lives.

And at some point it just felt like I was going through the motions. And so there were multiple times during my residency, admittedly, that I did not want to do medicine anymore. Because you put all that effort into it and you really don't feel that, that satisfaction at the end of it. And that was really a, a point of reflection for me. And that's, I think definitely an impacted what I wanted to do later. And after residency, you chose a very different locale for your practice. So how did you go from where you practiced in the east coast to moving to Austin?

So I first I moved from New York to New Jersey after my residency. And it was following my wife because she was doing her psychiatry residency in New Jersey. And so I was working in the hospital system over there as a hospitalist carrying on that residency type of practice in the hospital system.

And when I was in that big system, I, it was just more and more chance to burn out basically. And finally my wife got a fellowship, a position in child psychiatry in Austin, and she happened to match here and that's what brought us here. And we were very happy to be here now we consider it home.

Definitely. But that's really how we came here. I just want to say, I love to be the toddler in the background cause that's it. Was that your kid or was that my kid? I like that's awesome. No, I love it. That's this is legit parenting in 2021, so I absolutely love it. now how did you come to learn about DPC?

I came to learn about DPC from Josh umber in one of his videos, as well as Dr. Magical. I think in marble falls or was there, and I saw one of her videos on YouTube, which was just talking about cash pay practice, and, the concept of DPC.

Wasn't really something that I had heard. And I really didn't think about a cash pay practice, really that much as just because, I never really thought about primary care. Because as I mentioned, we, when you go from medicine to residency was always internal medicine. And even when we did internal medicine, we did Three weeks in the hospital.

And then we did one week in the clinic. And so everyone felt that clinic week was just like their little break that they'd get, see a few patients much lighter, less shift work and all that stuff. It was, it never crossed my mind that, Hey, this could actually be a career, even though I really enjoyed speaking with patients and interacting in that way.

But when I was in that kind of hospitalists system and going through the grind and finally starting to wake up, then I started doing my research and that's how I came across these videos. And then it was like this whole world opened up and it was just direct primary care and functional medicine and just holistic.

And I'm like, wow, this is definitely something that now I can start understanding my calling. But you have to go through that to get to that, that, to that. when you moved to Austin, because as you mentioned, Austin is DPC rich in terms of numbers of practices, did you find the transition easier because there were existing practices who you could commiserate with and who could guide you as you opened your own?

I would say it's been a great help, I've chosen a very central Austin location, so there isn't a ton of DPC practices around me. They're more scattered around Austin, but I think that feeling of like everyone is connected, everyone who genuinely wants to help each other out that's been fantastic.

And so I've learned many things along the way. I've learned many things on my own but it's definitely helped to have people doing it.

when you chose your central location, what was your mindset when you went after the location that you chose? To be very honest it's not a profound answer.

I just wanted it to be close to home and not have a big commute. So that was really it. I may not have known all of where the DPC practices were when I got to know about them. I realized I'm in this catchment area that really other physicians aren't. , but it was really just to be close to home.

That's not a bad reason whatsoever though, especially in a city, you know, I can imagine because you have two little ones and your twins are a week younger than my son and my youngest son. And then you have a toddler who's also. Correct. Three and a half. Yeah, literally we had kids at the same time.

So I think that was a great way to plan your practice around your family because that at the end of the day we all have to balance with our work now, how did you choose the name Medina medicine?

So that's a great question. So when I went through medical school and residency, the institutions that I went to had a religious foundation, both in Pakistan and in New York, I went to New York Presbyterian hospital. So a very Christian foundation and a lot of the hospitals.

That I was exposed to have that solid kind of Judeo-Christian foundation. Not Sinai in New York. My monities you St. Mary's St. David's St. Joseph's. I've literally every hospital I've worked at, has had these names and these, these foundations in being someone of faith. I wanted, you know, Muslims in the U S I think are very sometimes because of social political, economic, or social political reasons tend to keep their religious lives and their public lives very separate, and so they're like the, they're the physician and then they go home and they're like the Muslim. I wanted to not do that. I wanted to merge the two and have. My practice have a component of my faith mixed with it. And so that people know that not just that they're going to a physician or a good physician, but they're going to a Muslim physician and, have that presence in the community that reflects the faith and hopefully, advances people's Muslim