They Keep Jumping On The Direct Primary Care Bandwagon

I just love it when nondoctors, executives, business people start jumping on the Direct Primary Care Bandwagon. The steps usually are:

1. Suddenly become aware Direct Primary Care is awesome.
2. Proclaim yourself an expert in DPC because you know how to do business and, obviously, doctors don’t.
3. Write articles stating the same stuff we have been saying about DPC for years but pretend it is your idea.
4. Hope no one looks at your past work history.
5. Create a company in the DPC “space.”

Here is a recent article on KevinMD called The smart way to transition to direct care. The author is Dana Y. Lujan, MBA, who, according to her LinkedIn, had nothing to do with Direct Primary Care until March of 2025. No matter.

As someone who supports both DPC and concierge physicians, I believe in the purity of the DPC model, but I also believe in practical pathways to get there. Hybrid models aren’t the compromise position; they’re the strategic bridge that makes the transition possible.

Umm, Mrs. Lujan, I don’t think you do believe in the purity of the DPC model. In fact, I don’t think you understand it.

I spent a year looking at why DPC practices fail and interviewed over 60 doctors. I did the keynote talk at the DPC Summit in 2024 on it. Not being committed to pure DPC was a MAJOR factor. That noncommittment was being a “hybrid” practice.

The direct primary care community has created a false binary: either you’re “all in” on DPC (no insurance, pure membership fees, complete independence) or you’re still trapped in the traditional system.

Again, the author has no clue what she is talking about. I love how she decries the “direct primary care community.” I guess we are so stupid and she has all the answers because, well, she has been in this space for all of six months.

She really loves the concierge model and uses it as her beachhead for her entire argument. The problem is that DPC does NOT bill insurance or charge ridiculously high prices. More differences are explained here.

She continues:

One family medicine physician I advised transitioned to a hybrid concierge model, adding 150 members at $95 per month while continuing to bill insurance for clinical services. 

Yeah, double dipping means you are not DPC!

I couldn’t disagree with this author any more. As someone who actually started a DPC practice when the whole concept was in its infancy, written three books on the subject, have done three keynote talks, help start the DPC Alliance, and writes about DPC in DPC News daily, I feel confident this person is wrong about her entire premise. But what do I know?

Could it be that the author is pining for consulting work?

As the founder of Wellthlinks, I lead our work with physicians transitioning to concierge, direct primary care (DPC), and hybrid models. Together, we provide strategic and operational support to build sustainable, compliant practices.

No conflict of interest there. This is pathetic for Kevin Pho to put this up on his website without saying it is really a subtle ad.

Listen, if you want to do concierge medicine for the rich, go ahead. If you want to offer affordable care in a membership model where you don’t double-dip by billing insurance then do Direct Primary Care. But if you want to do both fee-for-service and DPC (hybrid model) then the chances of you succeeding are VERY, VERY low. It can happen, and I know a few who succeeded, but I would bet against it. That bridge you are creating, as the author discussed, will probably collapse before you get to the other side. Since I am the ONLY one who spent time investigating why some DPC practices fail, I feel very confident in saying that. Oh, and I have never charged a fee to any of my fellow doctors to help them.

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