Why DPC is the Future of Primary Care?

During my family medicine training, I had a mentor who unintentionally taught me exactly how I did not want to practice medicine. I remember the moment distinctly as an intern. I was brought into his office and told that my patient volume was too low. That with my progression in training, I should be seeing a minimum of 15 patients per day. The words he used still ring in my ears: "You don’t make financial sense to me."

This was an overstatement, considering my salary was paid by ACGME Medicare funding. I was, for all intents and purposes, free labor—entrusted to be educated in the principles of family medicine. But instead of learning how to provide high-quality, patient-centered care, I was being pressured into a system that prioritized volume over value, efficiency over efficacy, and profit over people.

To blame any singular variable for the dysfunction in our healthcare system—whether it be overwhelmed physicians, declining insurance reimbursements, or the ever-growing administrative burdens—is to be disingenuous. The truth is, in that moment, I didn’t make financial sense. The truth is, the incentive to increase patient volume in order to make ends meet was an act of exploitation. My employer—my mentor—couldn’t see past the game he was forced to play, a game that had at some point made financial sense to him. But he never asked the most important question: Why am I allowing myself to be exploited, and why am I in turn exploiting others?

If he had asked the right questions, the answers would have been horrifying. The system we work in is designed for preventative measures to fail, for chronic disease to worsen, and for medical bankruptcy to be the ultimate endpoint of "care." We, as physicians, are treated as financial assets and liabilities, just as insurance companies treat us. And in turn, we are pressured to do the same to our patients—reducing their complex medical needs to seven-minute visits, addressing only one issue at a time, while their chronic diseases progress unchecked.

How does that make financial sense?

It doesn’t. And that is why the traditional insurance-based healthcare system is crumbling. Patients feel the lack of value. Physicians feel the burnout. The incentives are misaligned, and the game is rigged to prioritize profits over patient care. But there is another way.

Direct Primary Care (DPC) removes the misaligned incentives of insurance companies and restores the physician-patient relationship to its rightful place at the center of care. Without middlemen dictating how we practice, we can prioritize what actually matters: time with our patients, preventative care, and long-term health outcomes. Private insurance, when used without restrictive networks, combined with DPC as the preventative force reducing healthcare overutilization and unnecessary claims, is the future.

The delusion is over. Americans are waking up to the reality that the current system does not work. They want change just as much as physicians do. And together, we can make that change happen. We refuse to play the game anymore. We choose the physician-patient relationship over a system that sees both as financial instruments. We consider this relationship sacred. And we will not allow a middleman to dictate how we interact with those we are called to care for.

This is the power of free-market medicine. This is the future of healthcare. Let’s build it together.