Direct Primary Care replaces insurance billing for routine care with a flat monthly membership, usually $50 to $150. Panels run 400 to 800 patients instead of 2,000 or more, visits run 30 to 60 minutes, and many practices open for under $50,000. Dr. Maryal Concepcion walks through the math, the myths, and who the model actually fits.

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.