Direct Primary Care as a Retention Strategy for Women in Medicine

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I’ve been thinking and speaking a lot lately about women in medicine—particularly women in primary care—and what it takes not just to recruit us into the profession, but to keep us there.

This week, Amy Walsh, MD, posted a chart showing the ongoing exit of women physicians from primary care relative to men over time. It underscored something many of us already know firsthand: talented women are entering medicine, contributing deeply, and too often leaving systems that no longer work for them.

This conversation matters because women are not a side note in primary care. In many communities, we are a major part of the workforce. If we care about access, continuity, and the future of frontline healthcare, retention matters.

Why Women Leave

Women physicians are not leaving because they lack grit or commitment.

Many are leaving because the structure asks too much while giving too little control in return.

Administrative burden. Endless inboxes. Productivity quotas. Documentation overload. Rigid schedules. Emotional labor. Caregiving responsibilities outside of work. The quiet exhaustion of trying to be fully present everywhere at once.

Primary care can be especially vulnerable to this because the very skills that make it meaningful—listening, counseling, pattern recognition, prevention, and relationship-building—take time.

And time is often the first thing the traditional model takes away.

A Small Moment That Said a Lot

Recently, I joked in a social media reel that for the first time in my career, my patients were rushing me.

Apparently, I take too much time.

Humor aside, that moment reflects something meaningful. In the traditional fee-for-service model, physicians are often pressured to rush patients. In Direct Primary Care, I’ve created a practice where there is finally enough time that patients occasionally want to move faster than I do.

That difference is not trivial—it is the difference between surviving medicine and sustaining it.

What Direct Primary Care Offers

Direct Primary Care is not the only answer, but it offers something increasingly rare in medicine: alignment.

It aligns the physician’s incentives with the patient’s needs.

It rewards relationships over volume.

It creates space for longer visits, smaller patient panels, less bureaucracy, more autonomy, and more meaningful care.

For many physicians—and especially many women physicians—that matters deeply.

Because sustainability is not just about income. It is about whether a career can fit inside a life.

A Life That Fits

Today, I blocked the end of my schedule so I could leave work a little early and take my son to an extra soccer practice.

In previous practice settings, that simple decision would have felt nearly impossible. The day would have already been overbooked, behind schedule, and shaped by demands I did not control.

But today, I had the autonomy to make a different choice.

I still cared for my patients well. I still practiced meaningful medicine. And I also got to be present for my family.

Because many women physicians are not only doctors. We are mothers, daughters, spouses, caregivers, leaders, and community members. A model that asks us to sacrifice every other part of ourselves is not sustainable.

A Better Question

If we want to retain women in medicine, especially in primary care, perhaps we should stop asking why women are leaving and start asking what kinds of systems are pushing them out.

Direct Primary Care is not simply an alternative payment model.

It may be one of the most practical retention strategies available.

Because when doctors have time, autonomy, and the ability to be whole people, more of them stay.

And that is good for physicians, good for families, and good for patients.

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About Angela Andrews, MD

Dr. Angela Andrews is a board-certified Internal Medicine and Pediatrics physician, health coach, wife, mom, and lifelong athlete. When not spending time with her family or caring for her patients, she is training for her next competition. Dr. Andrews graduated from the University of Michigan with a Bachelor of Science in Engineering in Biomedical Engineering and worked at General Electric Healthcare Wisconsin for nearly five years before returning to her dream of becoming a doctor. She received her medical degree from Michigan State University College of Human Medicine. She completed her Med-Peds residency at the Detroit Medical Center & Children's Hospital of Michigan in Detroit, MI. After 8 years in the system, Dr. Andrews opened Seeds of Health Direct Primary Care in Grand Rapids, MI in February 2014. Her personal journey with fitness, nutrition, and lifestyle medicine training was a key factor in her decision. She spent years trying to figure out how to incorporate this experience into a “standard” clinical practice, before finding a natural fit within Direct Primary Care. Dr. Andrews is passionate about helping patients address the root cause of their mental and physical conditions and guiding them to cultivate healthy habits around exercise, good nutrition, and mental well-being. Dr. Andrews lives in Byron Center, Michigan, with her husband and exercise companion, Joseph VanEss, their son, Myles, and her two bonus children, Griffen and Quinne. She engages in various fitness activities (CrossFit, running, swimming, yoga, and bodybuilding) and enjoys gardening, tackling projects around the house, and building things out of wood.