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. Shannon Scholl asked an endoscopy center what Medicare pays them per case, offered to pay exactly that, and now prices a colonoscopy at $1,500 all in, against a $2,500 to $4,000 local market. She left a 14 year private GI practice after her daughter spent three months in the hospital and the doctors dismissed what she told them.

A hospital board president told Dr. Jennifer Allen he would eat 40 kinds of crow if her Direct Primary Care practice worked. She now has three clinics, 14 employees, and around 2,000 patients across Hermann, Washington, and O'Fallon, Missouri. She was a nurse and nurse practitioner for 18 years first, and a patient paid her way through medical school.