Direct primary care is one of several new models for independent practice being explored by physicians in 2025, but for many physicians, the exact definition of DPC still remains unclear.
Here are 12 notes on what DPC is and how it is shaping primary care and independent practice:
1. Patients at DPC practices typically pay a set monthly fee for comprehensive preventive care and direct access to their physicians. Some practices operate outside of insurance networks entirely, while others may still charge certain labs or imaging services through insurance,
2. According to a 2020 report by Wolters Kluwer, this fee typically ranges between $55 and $150. However, some practices may be more specialized or tailored to certain patient populations and may charge fees in the range of thousands of dollars per month. These practices are often referred to as concierge practices, which are often marketed towards more wealthy individuals.
3. In 2014, the average concierge medicine service charged $1,500 to $1,700 per year. By 2025, the median service rose to cost between $2,000 and $5,000 per year, according to concierge practice PartnerMD. Another estimate said annual fees range between $1,000 and $20,000.
4. DPC patients typically receive unlimited scheduled appointments, both in-person and virtually. Visits are longer, allowing for more comprehensive care management. Basic preventive services such as vaccines are usually covered by the membership fee, as are many simple lab services.
5. DPC practices commonly focus only on primary care, so patients may need additional insurance for emergency or specialty care.
6. Some physicians are drawn to the DPC model as the patient structure allows for greater flexibility in determining which treatments or procedures are best for a patient, compared with the more rigid fee-for-service model.
7. The One Big Beautiful Bill Act, signed into law in July, will allow people with high-deductible health plans and direct primary care arrangements to pay for concierge medicine through their health savings accounts.
8. Current tax code disqualifies patients with these arrangements to contribute to a health savings account. Effective Jan. 1, an individual with a direct primary care concierge model that costs less than $150 per month can contribute.
9. Critiques of DPC include questions about its incentive structure, which is “built on accepting healthier patients with limited healthcare needs and a willingness to pay a retainer fee,” according to a 2018 commentary piece in JAMA.
10. Another critique of this model is that it further reduces access to primary care physicians who are already strained by healthcare workforce shortages and burnout. Another sticking point is the sticker price: Since concierge medicine is often out-of-pocket, these services can exclude lower-income patients.
11. However, some physicians say the DPC and similar models can reduce administrative burden on physicians and improve physician-patient relationships. “It’s a way to practice self-preservation in this field that is punishing patients and doctors alike,” internal medicine physician Shayne Taylor, MD, who recently opened a practice offering direct primary care in Northampton, Mass., told KFF Health News earlier this year. “It’s either we do something like this or we quit.”
12. One Tennessee physician, Rahul Iyengar, MD told News Channel 5 Nashville in March that when he first graduated medical school, he encountered primary care physicians seeing 30 to 40 mostly sick patients per day.
“You’re on that hamster wheel day to day. In the system, doctors don’t get to make their schedules. You’re an employee, and insurance is really what dictates your scheduling,” Dr. Iyengar told the publication.
His DPC model has given him a flexibility that he sees improving his practice moving forward.
“Insurance is great. It has a role, but it’s not designed to keep you healthy. It’s designed for when something breaks. So I compare it to car insurance, where even if you have the best car insurance, you still end up paying for gas, oil changes, car washes, tires and all the maintenance. That’s what I do for health,” Dr. Iyengar said.
