12/26/2025
I can't believe that the video has had over 500k views:
https://www.youtube.com/watch?v=pxmgcvAOfIw
My response addressing some questions gets lost in all comments so I am posting it here also:
If you're interested in learning more about Direct Primary Care in your area, I'd encourage you to visit the “DPC Mapper” https://mapper.dpcfrontier.com/ to find practices near you. For full disclosure, I wrote this with the help of AI to organize my thoughts and present it more clearly.
I want to be clear that I can only speak from my own experience and perspective as one DPC physician. As we often say in the DPC community, "When you've seen one DPC practice, you've seen one DPC practice" — each practice is unique in how it operates and serves its community, though we all share the core commitment to relationship-based, accessible primary care.
First, I want to clarify that this model is not just targeting the rich. When you break down the costs, it's quite affordable for many families. To put this in perspective, a typical doctor visit in 1950 cost around $10. Using the Consumer Price Index (~24.1 in 1950 vs. ~320 nationally in 2025), that would equal about $133 in today's dollars. A healthy person seeing their doctor 2-4 times per year would have paid the equivalent of $266-$532 annually, while someone with chronic conditions needing 4-6 visits would have paid $532-$798 per year.
The average DPC practice in the US charges about $75 per month ($900 annually), which falls right within this historical range. Here in South Jersey/Philadelphia, where our regional CPI is ~330, we're essentially returning to what Americans historically paid for direct physician relationships before the insurance-dominated system took over. Of course, we must acknowledge that practicing medicine today involves additional costs that didn't exist in 1950—electronic health records, various technologies, and regulatory compliance—but DPC pricing still remains comparable to historical norms.
As DPC physicians, we're trying to balance what's fair to charge while remaining sustainable. In my own business plan, while my goal is 400 members, I'm acknowledging that many memberships won't be at full price (decreased rates for families and group accounts from small business employers)—much like physicians of the past who would accept a dozen eggs or barter for services, because our primary goal is providing care and maintaining the health of patients we've built relationships with.
Regarding insurance coverage for specialists and hospitals—I absolutely don't argue that there's still a need for those things, because they are costly. However, primary care is affordable and predictable, and shouldn't be lumped into those high-cost services. Think of it like car insurance: you don't use your car insurance to change your wipers or oil changes. Insurance was always meant to be for high-cost, unpredictable events. Primary care is a predictable cost that most families can budget for directly.
For major medical expenses, patients still need coverage for specialists, surgeries, hospitalizations, and emergency care. Many DPC patients pair their membership with high-deductible health plans, health shares (which are growing in popularity), or hospital indemnity plans. These options often cost significantly less than traditional comprehensive insurance since they're not covering routine primary care visits.
The beauty of Direct Primary Care is the transparency. Let me share my actual numbers: I plan to provide benefits for my future staff because I believe in ethical hiring practices—a salary of about $80k+ for a nurse, $40k+ for a medical assistant, and $55k+ for an office manager. I was fortunate to secure a lease with a local podiatrist who's renting to me reasonably below market, keeping overhead costs around $36-40k annually. While the average physician salary is $260-285k (some reaching mid-$300k), I'm also planning for the ability to eventually provide charity care, accounting for 20% of my patients being those who need it most. This is the thoughtful process that DPC physicians go through—I'd argue that a business built within the framework of medical ethics is the antithesis of the majority of healthcare these days.
I think there's a growing mistrust of physicians, and I believe it's partly because primary care physicians are too busy to have good public relations (though it's getting easier with technology) and become the face of a broken system. Some may argue that I'm making the physician shortage worse by leaving traditional medicine, since I can no longer see 1,500+ patients. Here's the reality: I would have left clinical medicine entirely if I hadn't found DPC. Even when I tried to see that many patients in traditional practice, it came at enormous personal cost and led to burnout. I applaud colleagues who can make the current system work, but many of us simply cannot sustain it. Doctors are already leaving medicine in record numbers. DPC gives physicians like me a lifeline to continue practicing our calling.
The distaste some people have for primary care (and what direct primary care is trying to counter) is actually the result of systemic problems. In traditional practice, physicians often refer patients not because we lack expertise, but because 15-minute slots (which include documentation time—I mentioned 7 minutes of actual patient interaction in the interview) don't allow for thorough evaluation. We're unable to practice at the top of our license. In DPC, I can initiate proper evaluations, manage most conditions myself, and collaborate directly with specialists when needed—like the doctors of the past who would consult colleagues on tough cases and provide that care directly themselves or until the point it was best to turn it over to specialists, not just simply refer a patient to neurology because of a headache or an allergist because of hay fever. Because I assure you that those specialists themselves would rather be managing something else (that's why they're specialists and highly valued for their medical expertise). But the system relies on premature referrals for more copays/productivity, etc.
Quality primary care addresses 80-90% of health needs. When primary care physicians have the bandwidth to properly manage their patients, it actually reduces healthcare utilization and prevents unnecessary specialist visits (think ENT specialists seeing patients for simple ear wax removal). There's tremendous inefficiency and redundancy in our current system that drives up costs.
Burnout happens when someone's daily tasks don't align with what they trained for. I went into medicine to think and solve problems, but insurance constraints leave little time for this in traditional practice. For self-preservation, some physicians take on non-clinical tasks just to survive, reducing their patient-facing time.
It's important to understand that DPC is not concierge medicine, though both offer more personalized care than current mainstream practice. The key difference lies in the financial model:
Direct Primary Care:
* Does not bill insurance at all
* Revenue comes from membership fees
* No third-party interference in medical decisions
* Physicians often earn less than current mainstream practice due to no insurance reimbursements.
Concierge Medicine:
* Typically still bills insurance in addition to membership fees
* Higher revenue model allows for smaller patient panels
* Often provides luxury amenities and services beyond medical care
* Generally more expensive for patients
Both models offer alternatives to current mainstream medicine, but they serve different needs and price points. DPC focuses on making relationship-based primary care accessible and affordable, while concierge medicine emphasizes premium service and convenience. Each has its place in healthcare, but they represent distinctly different approaches to the doctor-patient relationship.
One of my goals, like other DPC practices, is to show the next wave of physicians that relationship-based care is possible and that the best part of family medicine—the connections—still can exist. It's this lack of connection that has led many to seek care outside healthcare systems and develop distaste for “western medicine." A patient once told me, "It would be a shame if you weren't a doctor anymore," and that comment drove me to seriously consider this path.
Real healthcare reform is needed, but until that happens, DPC serves as way for some physicians who were going to leave medicine to stick around longer and continue serving patients. DPC is simply another option for care—one that allows us to practice medicine as we trained to do while giving patients the time and attention they deserve.
What was a niche aspect of medical care just a few years ago has exploded to thousands of practices across the country. In direct primary care, medical provi...
