Dr. Ashley Agan left academic medicine after patients waited six months and traveled across the country just to see her, proof she could build Scottie ENT, a direct-pay practice in Dallas, on Google reviews and transparent pricing instead of billboards.

Dr. Tami Singh's panel hit over 4,000 patients in seven years before a hospital bought her physician owned group and started undercoding her billing. She quit, spent six weeks in Bali, and came home to open Aspire Health in a furnished room inside a plastic surgery office. Five years later her panel is closed, her mother handles billing, and three virtual staff in the Philippines run the phones.

Dr. Aerie Chung opened a Direct Specialty Care infectious disease practice at the end of 2019, then the pandemic arrived and, as an ID doctor watching the abuse aimed at her specialty, her first instinct was to become invisible. She stopped marketing infectious disease, added integrative care and IV infusions, and now has more acupuncture visits than medical ones.