Before Direct Primary Care had a name, Dr. Clint Flanagan was selling monthly membership medicine in Longmont, Colorado for $99 a month. He opened his own clinic 15.1 miles from a former employer to clear a non-compete, met Dr. Garrison Bliss over a long dinner in Denver, and grew Nextera Healthcare into more than 100 affiliated clinics.

Dr. Aleem Kanji finished his Baylor endocrinology fellowship with no student loan debt, then used the savings to open Ethos Endocrinology instead of taking a job. He tried a membership, found specialty patients did not want the commitment, and switched to per visit pricing. His landlord covered two thirds of the build out.

Dr. Stephanie Phillips charges $75 a month, flat, for every patient in Royston, Georgia, a town of 2,700 people. She also signed her own alma mater, Emmanuel University, to pay $47 per student per semester for 750 students, which brings her three to five extra visits a day. Public Service Loan Forgiveness is what finally let her leave the VA after nine years.