Why People Don’t Understand Direct Primary Care (Yet)

Direct Primary Care is one of the fastest-growing primary care models in the United States. The American Academy of Family Physicians recently highlighted Hint Health data showing that the number of physicians practicing in a DPC setting grew by 555% from 2017 to 2025. Yet despite this growth, many patients still struggle to understand how the model works—or why it may offer a better approach to primary care.

Direct Primary Care doesn’t have a care problem.

It has an education problem.

After 16 years inside the healthcare system, I have experienced healthcare from nearly every perspective, and I’ve become convinced of one thing: primary care funding is broken. Fee-for-service funding in primary care was fundamentally flawed—financially rewarding only high volume, not quality, healthcare. Then came value-based care payments; while this improved incentives, it never fully aligned them. Current subscription models (whether insurance-funded PMPM payments or direct DPC memberships) finally align physician incentives with keeping patients healthy.  But, Direct Primary Care (DPC) has one critical advantage: the patient is the customer, not the insurance company. It’s the future of primary care.

There’s just one problem:

Patients don’t understand it.

This has been the biggest hurdle starting my DPC practice. Before transitioning to DPC, I spent years exploring alternative payment models for primary care – ACOs, MSSP, CPC+, and partnerships with self-funded employers. We, as physicians, were navigating new quality metrics, coding strategies, and payer negotiations while trying to improve clinical outcomes, lower costs and improve patient satisfaction scores. Behind the scenes, healthcare was changing rapidly, but patients rarely noticed.

Working inside healthcare – I noticed. My turning point came at the end of 2024. Through a value-based contract with an insurance company, I had firsthand evidence that our organization was improving patient outcomes and reducing healthcare costs. I was proud of what we had accomplished.

Then our company’s own employee health insurance renewal arrived. The same insurance system that had recognized our practice for lowering healthcare costs increased our insurance premiums dramatically. The irony was impossible to ignore. We had proof that we were delivering better, more efficient care, yet the broader system remained disconnected from those results. That moment reinforced what I had already begun to suspect: the incentives in healthcare are fundamentally misaligned.

As a physician, business owner, and patient, I was so frustrated that I even considered walking away from medicine. Instead, I called a local Direct Primary Care provider and discovered a model that made healthcare make sense again.

In July 2025, I became a DPC physician-owner, and I’ve never looked back. I love practicing Direct Primary Care. The relationship between physician and patient is once again direct. The patient—not the insurance company—is the customer. That simple shift aligns incentives, creates price transparency, and gives patients a greater voice in their own healthcare decisions.

But this shift represents a completely different way of thinking about healthcare—and that is where DPC’s next challenge begins: helping patients understand it.

The Problem: Lack of Understanding

As a physician, the benefits of Direct Primary Care are clear.  The model itself isn’t the biggest barrier to DPC growth.  The barrier is that most patients have never been taught how to think about healthcare.

After answering the question “What is Direct Primary Care?” countless times, I’ve found that three misconceptions come up again and again:

1. The “Double Payment” Problem

“Why should I pay a monthly health insurance premium and a monthly DPC membership?”

It’s a fair question. The challenge is that healthcare has conditioned us to think about routine healthcare (i.e. “primary care”) differently than we think about almost every other routine service in our lives.

In nearly every other industry, we understand the role of insurance. We don’t ask, “Why should I pay for auto insurance and for oil changes?” Nor do we ask, “Why should I pay for home owner’s insurance and the plumber to fix the leak?” We understand how, why, and who we pay for routine maintenance and small repairs. Furthermore, we expect transparency in pricing and will often pay more for quality. We get to chose what we value and how much we can afford. Insurance fits in as a safety net to protect us financially from the large and unexpected events like car accidents and destructive weather. It’s not a payment vehicle for the day-to-day expenses.

Healthcare has evolved differently. We have been taught to expect health insurance to function as both a payment system and a safety net, covering everything from routine primary care visits to catastrophic illnesses. Now the connection between cost, value, and decision-making becomes less visible. Ultimately, patients lose control over many of their healthcare decisions without understanding why.

Over time, this has contributed to a system where patients often do not know the true cost of care, providers and payers negotiate prices behind the scenes, and healthcare premiums continue to rise. Shifting our mindset toward using insurance for what it was designed to do—protect us from large, unpredictable expenses—can help create a more sustainable, and understandable, system going forward.

2. The Retainer Stigma

Many people hear “membership doctor” and assume it’s a luxury for the wealthy.

It shouldn’t be. This is the distinction between concierge medicine and direct primary care.

Direct access to your physician shouldn’t be viewed as a luxury. It should be considered a cornerstone of good primary care and good healthcare in general. DPC challenges the idea that exceptional access to your doctor must be exclusive.  Instead, DPC makes a trusted physician relationship available to everyday patients and families.

3. The Value Disconnect

Perhaps the biggest challenge is helping people recognize the value of a relationship with a physician before they need medical care.

After all, most people already pay monthly fees for subscription services they value – gyms, entertainment, even shaving supplies have memberships now.  The concept of a membership isn’t difficult to teach, but attaching the value to the concept of a primary care membership is the challenge.

DPC isn’t just about unlimited office visits and texting. It’s about having a trusted physician in your corner when questions arise, symptoms begin, medications need adjusting, or life changes. That ongoing relationship has value—even when you’re healthy.

To succeed, DPC practices must clearly demonstrate how they’re different—not only from traditional primary care and urgent care, but also from telehealth services like Amazon and Teladoc. The value isn’t just convenience. It’s continuity, trust, and partnership.

This is a tremendous amount of patient education.

But I also believe it’s one of the greatest opportunities in healthcare today.

The Solution: Patient Education in the DPC Culture

So where does DPC begin solving this problem?

Educate. Educate. Educate.

Some would call this marketing, but I believe it is something deeper. DPC is not simply a product to sell—it is a new healthcare model that has to be taught. Our job is not just to convince people to join; it is to help them understand why this model exists, what problems it solves, and why it may be a better fit for their healthcare needs.

Education is the foundation of DPC growth.

The encouraging news is that primary care physicians are uniquely qualified for this work. We aren’t salespeople—we’re educators. Teaching patients is what we’ve always done.

We educate patients every day. We explain diagnoses, discuss treatment options, interpret lab results, and help people make informed decisions about their health. Teaching is already one of the most important parts of primary care.

Now we simply need to extend that same mindset to the healthcare system itself.

We need to help patients understand why primary care is different from emergency and specialty care. Why insurance is valuable, but not designed to pay for every healthcare need. Why an ongoing relationship with a physician improves outcomes. Why access matters. Why continuity matters. And why investing in primary care is one of the most valuable investments they can make in their health.

This education doesn’t begin and end in an exam room. It happens through conversations with friends, social media, websites, newsletters, meetings with employers, and every interaction a potential patient has with a DPC practice.

The goal is not to sell DPC.

The goal is to teach patients to think differently about healthcare.

If we do that well, the growth of DPC will take care of itself.

The Conclusion: a New Mindset

The future of Direct Primary Care will require more than providing excellent care. It will require educating patients about why that care matters.

Patients need to understand that the value of DPC is not simply the convenience of a same-day appointment or the ability to text their doctor. The true value is having a physician who knows you—not just your medical history, but your goals, your concerns, and what matters most to you. It is having someone in your corner who can walk with you through every stage of your health journey.

Coincidentally, that is what patients are searching for today. They are looking for more than another healthcare transaction. They want to be heard. They want a trusted relationship. They want a healthcare experience that feels personal again.

So let us explain that DPC is not just a different way to pay for primary care. It is a different relationship between patients and physicians—one built on access, trust, and partnership. And, let us teach patients why it matters.

Changing healthcare requires more than a new payment model. It requires physicians, patients, and even employers to rethink what healthcare is supposed to be.

If you are curious about Direct Primary Care, I encourage you to learn more, ask questions, and explore whether this model aligns with what you want from your healthcare relationship. The conversation is just beginning— education is where change starts.