Direct primary care memberships surge as doctors seek less rushed practice

Patients often endure long waits and rushed exams because insurance reimbursement favors brief, service-specific visits, leaving doctors to manage panels of over 2,000 individuals with average appointments of about 18 minutes. To restore a more personal pace, a growing number of physicians are offering direct primary care, where patients pay a monthly or annual membership—usually between $50 and $100—to cover routine services and gain direct access to their doctors.

Smaller patient rosters, averaging around 400 per practice, allow for extended visits, with some clinics advertising two-hour appointments for $200 a month. Research indicates that clinicians in these arrangements report far less burnout, and enrollment in direct or concierge practices jumped 78.4 percent from 2018 to 2023. Federal rules now permit health-savings-account funds to cover these fees, making the model more affordable for some.

Nonetheless, patients must still maintain insurance for prescriptions, hospital care, and specialist referrals, creating a dual-payment scenario. Opponents argue that such models could exacerbate the projected shortage of 20,200 to 40,400 primary-care doctors by the mid-2030s, limiting care for lower-income patients.