Direct primary care has been gaining momentum as a practice model that can cut through the extensive wait times, short appointment windows and excessive costs that both physicians and patients have come to associate with primary care.
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.
Susan Baumgaertel, MD, a Seattle-based internist, practice owner and patient advocate at myMDadvocate, told Becker’s that while she has seen this model of practice grow significantly over the last several years, many people still hold certain misconceptions about DPC.
“When I think about access to care, I always think of direct primary care, or direct care, [if you include] specialties as well, and I think there’s so much of a misunderstanding still,” she said. “Even someone who’s pretty savvy about healthcare and how to access it — they all think, ‘Oh, well, that’s not for me. I’m not rich.’ This is not a wealthy scheme. This is not a high-end concierge. No, this is bread-and-butter medicine.”
Dr. Baumgaertel started her own telemedicine practice called myMDadvocate after leaving her previous position at a large physician practice that had been acquired by a major consolidator. She bills for her time, and her patients benefit from having direct access to someone who can help them navigate their own insurance and healthcare options.
Dr. Baumgaertel said that when she broaches the subject of DPC with patients, their first response is often concern about costs and they’re already covered by an insurance plan.
“We talk about what it means. It’s not obscene amounts of money — it’s a monthly fee, and then you get access. What does that mean?” she said. “Well, when you need care, you get it. You don’t have to wait six to eight weeks. And when you go in for a visitor, you do a telemedicine [appointment] there’s no charge for. It’s not like your insurance is being billed and you have a copay.”
According to the American Academy of Family Physicians, individual monthly DPC fees typically do not exceed $150 per month, or $300 for a family, which can include a range of services in addition to unlimited appointments. This differs significantly from concierge practices, in which monthly or annual fees can climb into the thousands. Concierge practices frequently offer more in-depth screenings and specialized services, generally catering to higher-income populations.
The average DPC practice patient panel size is 413 patients, with 99% of practices providing same day appointments.
“Many practices do it differently. It could be that they provide immunizations if they have a brick-and-mortar office, or maybe discounted drugs,” Dr. Baumgaertel added. “[DPC] is not a red carpet kind of thing. It’s a valuable way to get care, be healthy and have access when you’re ill.”
A scenario she frequently uses as an example with patients is urgent care visits — she starts by asking them about the last time they were sick.
“Their eyes are opening at this point. They think, ‘Oh, you’re right. Because I got sick, I went to urgent care or the hospital [emergency department], whatever it was, and suddenly got this facility fee, my deductible was $10,000, I’m paying all of these bills.'”
She has often found that when patients calculate the added costs of copays, labs and other unexpected charges, it frequently exceeds that of a DPC plan that may have been able to provide the same services. She also underscores to patients that weighing the costs of a DPC plan isn’t the same as other day-to-day investments and purchases.
“It’s not just affordable — it’s your health,” she said. “It’s not like a car wash or something. It’s really, really so vital to access somebody in that way.”
Dr. Baumgaertel acknowledged that despite this, DPC is not a silver bullet for healthcare access and won’t necessarily work for everyone. But for those who are already paying monthly insurance premiums, and especially those who utilize their healthcare services more frequently, it can make a significant difference in their healthcare experience.
“People are just plagued with trying to get in [with their physician] and can’t get in. And then, of course, maybe you get in, and it’s not even your doctor — it’s someone you’ve never met because yours is unavailable,” she said. “That whole rat race is so frustrating when you’re well, and beyond frustrating when you’re ill. And imagine that you have a critical illness or cancer or something going on — it just compounds.”
She also noted that as these practices scale up, it could take some burden off of health systems who are managing high patient volumes and provider shortages that contribute to strain that led to DPC’s creation to begin with.
For example, Rahul Iyengar, MD, a primary care physician in Nashville, Tenn., told WTVF NewsChannel 5 in March 2025 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 outlet.
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.
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