A health system vice president told Dr. Kirsten Lin that physicians cannot be trusted to manage their own schedules. She and Dr. Natalie Gentile met at a DPC Summit, spent six months of weekends vaccinating independent clinicians and homebound patients, then launched Direct Care Physicians of Pittsburgh in January 2022, the first managed services organization built for Direct Primary Care.

Dr. Erika Bliss was in the room when the term Direct Primary Care was written into Washington state law. She co-founded Qliance in 2007, ran it as CEO through seven clinics and a Medicaid contract, and watched it close in 2017. She rebuilt as a solo doctor in Seattle with one medical assistant and about 400 patients.

Dr. Niran Al-Agba still dictates into a tape recorder and files paper charts in the Silverdale, Washington practice her father opened in 1971. She carries roughly 3,000 patients, documents a visit in about one minute, and works around 20 hours a week. She also gave Medicaid 24 hours to reverse a rate cut, and it did.