Urgent Care Companies are the next DINOs

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I just read this article called Direct primary care: Why Houston employers are rethinking the foundation of their health benefits and thought it was pretty good. Here are some highlights:

One model gaining renewed attention is direct primary care (DPC), a care-delivery approach that is quietly reshaping how employers think about health benefits.

Traditional employer-sponsored health plans are designed around coverage. Employees technically “have insurance,” but often face long wait times, high out-of-pocket costs, and confusing navigation when they actually need care. Direct primary care flips that equation. Instead of starting with insurance, DPC starts with access, giving employees direct, ongoing relationships with providers, typically for a predictable monthly fee. The focus shifts from claims management to care utilization, emphasizing preventive care, early intervention, and faster treatment.

Direct primary care models help address several pain points employers regularly cite:

  • Long delays to see a primary care provider
  • Overuse of emergency rooms for non-emergent issues
  • Missed workdays due to untreated or escalating conditions
  • Rising downstream medical claims

Then I saw that the company that sponsored/wrote this article is called Next Level. They do urgent care all around Texas. Why would they write this? Then it hit me. They are jumping on the DPC bandwagon by doing something called Next Level Prime. DPC is trending and they want in. They are charging employers anywhere from $30 – $60 per member, per month to get in on their version of Direct Primary Care. With this, they will include very basic labs, but they give no information on whether they discount extensive lab work as we do. They also throw in some wellness coaching (12/yr) and behavioral counseling (12/yr). Great, but I cannot find that you have one doctor to be your own. It does NOT look like it. Lastly, a deep search also shows that NPs and PAs make up a substantial share of the day-to-day providers. So, no MD or DO for the overwhelming majority of patients being signed up by their employer. And do you really think the employees who are signed up will truly understand Direct Primary Care? Hell, I had trouble educating small companies with less than 10 employees about us.

I don’t begrudge these companies trying to jump into the DPC space. By grabbing large employers, they can rake in guaranteed money. That being said, this is a DPC In Name Only (DINO), in my humble opinion. DPC was built on the premise of having your own doctor, who you choose and who knows you, in an office, whose staff knows you. It is that personal connection that makes DPC so special. An expanded urgent care is not the same thing. It is not even close.

Now, as time goes by, there will be blurred lines in DPC, and my old-fashioned take will probably marginalize me. Fine. But for an urgent care clinic company to sponsor an article about Direct Primary Care like they are experts at it, well, it makes my stomach churn.

Now I need to go take a proton pump inhibitor.

(If Next Level wants to contact me and correct me about their DPC aspirations, then I will take a look, but until then…..DINO).

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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 but continues to receive care there as a patient.