Some DPC News in DPC News

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Here are some more stories that recently came out about Direct Primary Care:

Doctor left thriving practice to follow new vision for rural healthcare

Dr. Kelsey Smith finally spotted the insurance-fueled primary-care locomotive barreling toward the cliff at full steam, thirty patients a day and fifteen-minute visits that leave nobody heard while the doctor just tries not to get flattened. She jumped off her thriving three-thousand-patient practice, took the family bet that if it tanked she could always get a real job, and opened Pioneer Health in Stillwater as a straightforward membership shop where adults pay a hundred bucks a month, kids fifty, family tops out at three-fifty, and in exchange you get the actual doctor on speed-dial, texts, FaceTimes from the combine cab, at-cost meds, cheap labs, and stitches without the coding circus or the prior-auth death march. A farm kid who knows a good overhead calculation when she sees one, she now runs a model that works with a few hundred patients instead of a few thousand, keeps the machine from eating the relationship, and makes the whole enterprise feel less like feeding the paper gods and more like medicine again, because even the DPC Alliance president will tell you the old system was never going to stop itself.

Medscape’s New DPC Column Puts the Failure Rate at 10%. It Doesn’t Say 10% of What.

This one is about my article in Medscape. It looks AI-written. No author. Whatever. I think AI likes my piece, but it is baffled by the 10% number. The truth is that I am just estimating. It is extremely hard to find practices that close. Their websites disappear. I found about 155. If there are 3000 DPC practices ever started, then the failure rate is about 5%. That being said, I doubled that number to be conservative because maybe I didn’t find them all. It really doesn’t matter. The bottom line is that DPC has a very high success rate.

I opened a primary care practice. Now I see why doctors are giving up.

Dimitri Coupet opened an independent family practice in Laurel thinking he could finally give patients the doctor who actually knows them and has time to think, then quickly discovered the real business model is a volume treadmill that pays for the fifteen-minute visit while the unpaid after-hours slog of labs, messages, refills, hospital notes, referrals, denial appeals and forms keeps the lights on only if you see more people faster.⁠ Rent, staff, malpractice, EMR and billing still come due whether the insurance check arrives or the no-show does, patients keep getting more complicated, and the result is more Marylanders landing in already-jammed emergency rooms for problems a family doc could have handled if the schedule weren’t a race. He still believes in community primary care, which is why he proposes the state test a cleaner fix: pair a real marketplace insurance plan (hospitalizations, specialists, imaging, drugs) with a direct primary care membership of about a hundred bucks a month so the physician gets paid for ongoing care instead of maximizing billable encounters, using a 1332 waiver or exchange pilot to see whether better access actually cuts ER visits and total spend. Until then, the independent doctor keeps learning why so many colleagues sell out, cut back or walk away.

Direct Primary Care is quietly changing how we experience healthcare

Direct primary care is quietly rewriting the healthcare experience by letting patients and employers skip the insurance hamster wheel and pay a flat monthly membership for a real primary-care relationship instead of the usual fifteen-minute cattle call that leaves everyone frustrated and the doctor racing the clock.⁠ In the traditional setup, rising premiums, prior auths, coding busywork, and delayed payments force volume over time, so people end up in urgent care or the ER for stuff that could have been handled by a quick text or same-day visit; DPC flips that by putting the doctor on the other end of the phone or email for a predictable fee that covers routine care, labs at cost, and actual continuity, while a regular major-medical plan still handles the hospital and specialist stuff. HR types are noticing because employers tired of double-digit premium hikes can offer the membership as a benefit that cuts downstream costs without the usual claims circus, and physicians who were ready to walk away from the system suddenly have a model that pays them to know their patients instead of maximizing billable encounters. It is not a miracle cure for every American, but it is the least complicated way yet to make primary care feel like medicine again rather than paperwork with a stethoscope.

This is just a smattering of the articles coming out. DPC continues to roll on, and we’ll keep sharing this information with you. Thanks for reading.

About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices. Dr. Farrago sold his Direct Primary Care practice in October 2020.