Direct Primary Care (DPC)
What Happens When a Doctor Fires the Insurance Companies
Dr. Ryan Neuhofel in Lawrence, Kansas charges $75 per month. For that, his patients get unlimited visits, same-day appointments, his personal cell phone number, basic labs, and common medications at wholesale cost. He has 600 patients. He doesn’t bill insurance. He doesn’t have a billing department. He doesn’t need one.
What It Is
About 1,800 DPC practices charge a flat monthly membership ($50–$150) for unlimited primary care. No insurance billing. No coding. No prior authorizations. Typically 400–800 patients per physician versus 2,000+ in traditional practice.
Why It Exists
Insurance-based primary care has become unsustainable for many physicians. Twenty-minute visit slots. 2,000+ patient panels. Hours of documentation for every hour of patient care. DPC strips all of that away and rebuilds the physician-patient relationship from scratch.
The Tradeoffs
The upside: Zero admin burden. Small panels. Longer visits. Transparent pricing. Physician autonomy. Evidence suggests DPC reduces total cost of care by keeping patients out of ERs and specialist offices.
The downside: Inaccessible to low-income patients. Doesn’t cover hospitals, specialists, or emergencies (patients need separate catastrophic coverage). Exists entirely outside the insurance system — no population health reporting, no quality measurement infrastructure. Inherently small-scale.
The Bottom Line
DPC is the purest expression of primary care idealism in American medicine. It proves that when you remove insurance overhead, primary care can work beautifully. The question is whether a model that serves 600 patients per doctor can address a country with 330 million people who need primary care.