Direct Primary Care vs. Traditional Primary Care

Traditional primary care

Knowing the differences between direct primary care and traditional primary care can help you choose which option might be better for you and for your health. While selecting a care type may seem simple, this single healthcare decision can have far reaching implications, as primary care is one of the most essential and impactful medical functions provided by doctors.

What is “Traditional” Primary Care?

When most people imagine primary care, they will often think first of their family doctor, sometimes called a general practitioner. Essentially, this is the physician you will see for all of your general and every-day care concerns, such as immunizations, check-ups, and common illnesses such as strep throat or influenza.

It’s not uncommon for primary care teams to refer their patients to specialists for anything beyond these “everyday” concerns. While primary care physicians and clinics can manage more complex conditions, in a traditional primary care setting they usually don’t have enough time to manage them effectively.

For example, if that sore throat becomes chronic, your primary care physician may refer you to an ear-nose-and-throat doctor (ENT). This can dilute the overall positive influence of primary care.

What is Direct Primary Care?

A direct primary care model of medicine focuses on strengthening the control that doctors and patients have over healthcare decisions by removing insurers from the equation. Patients in a direct care model pay a monthly (or annual) membership fee, which then provides access to a comprehensive array of primary care procedures and services. Direct primary care practices don’t accept insurance.

Direct primary care clinics tend to have fewer patients overall, allowing doctors to spend more time with each individual. This proves beneficial to members, as good primary care can help prevent the development of more serious conditions down the road. Under a direct primary care model, most routine medical examinations, treatments, and services are covered by membership dues. However, any care that is received outside of the direct primary care clinic would still be billed to insurance, meaning patients are encouraged to have additional insurance coverage.

Benefits of DPC for Small Business

Health insurance and healthcare are perennial challenges for small business. That’s because, in many ways, the system is stacked against them. Small businesses by their nature have limited bargaining power, curtailing their ability to offer high quality health insurance to employees at an affordable rate. 

Direct primary care offers a solution for small businesses. With direct primary care, these smaller collectives or individual entities can access a wide variety of benefits, including the following:

  • Predictable costs: The rates involved with direct primary care are set and stable. You’ll know precisely how much every employee will cost you, whether you pay monthly, quarterly, or on an annual basis. This isn’t necessarily true with health insurance; when employees use insurance, premiums can often go up as a result, and costs can become quite unpredictable. This will never happen with direct primary care, which means you can count on your employees having access to high quality primary care.
  • Healthier employees: Healthy employees usually mean more productive employees. For a small business, this can provide a distinct advantage. And it will occur because primary care can help your employees access the health care system. Patients enrolled in DPC programs spend, on average, 30 days fewer in hospital settings and undergo surgery 80% less often. That’s because primary care encourages strong relationships with physicians, so doctors will see problems before they begin (or when they’re small and more treatable). 
  • Employee loyalty: Direct primary care presents employees with a tangible benefit. In some cases, your employees won’t have to pay for their own primary care; in others, they’ll receive that care at a reasonable cost. With the copays and deductibles present in most traditional insurance plans, employees are still on the hook for their own primary care–they just never know how much it’s going to cost. When your employees have access to a DPC clinic, costs are predictable–and employees are usually much happier with the overall arrangement.

In general, it’s recommended that employees still have health insurance even if they are DPC members. This will help cover any need for specialist or emergency care. But, often, this health insurance will be less expensive or won’t need to cover as much due to the DPC membership. To be clear, DPC is not health insurance and is not a substitute for health insurance.

In other words, a DPC membership can help small businesses recruit and retain strong talent–saving costs and keeping your employees healthier (and happier) in the long run!

Which is Better?

Most medical research agrees that primary care is an essential part of your overall well being. So, given the choice between direct primary care and a more traditional model, which one should you select? Ultimately, the decision can be quite personal, depending on your circumstances and preferences.

traditional primary care

What Are the Benefits of Direct Primary Care?

For most patients, the benefits of direct primary care revolve around the stronger relationship between you and your doctors that develops as a result of increased familiarity and constancy. With a direct primary care model, you get to keep your doctor even if you change jobs or employment status.

What’s more, your doctor has more time for you–appointments are not rushed or frantic. Instead, you and your doctor can take the time necessary to provide the healthcare you need. In a DPC model, insurance companies have no say over what’s covered or not covered–you’ll know from day one what’s included in your membership and be able to make informed, intelligent healthcare decisions as a result. In fact, any and all costs in a DPC setting are fully transparent, so patients never have to worry about surprise billings. In our practice we dispense prescription medications at a discount to our members. Discounts are usually lower than the co-pay at many pharmacies. Our patients like the convenience of skipping the trip to the pharmacy and the lower costs.

Many of these benefits are backed up by research. In 2020 The Society of Actuaries sponsored a study that compared people who were in a Direct Primary Care model to other people who used traditional primary care. Overall, people using DPC didn’t use as much healthcare services outside of their primary care visits. In other words, the care and attention they received from their DPC doctors helped them avoid having to see other doctors. That lowered the costs the patients had to pay, and it reduced the amount of time they spent with doctors. Specifically, the patients using DPC doctors:

  • Experienced approximately 40% fewer ER visits that those in traditional plans, and
  • Experienced 25.54% lower hospital admissions (unadjusted).

An Expanding Model

Direct primary care is still relatively new. That means it may not be available everywhere. But as patient demand fuels the expansion of DPC models across the country, it’s worth taking some time to consider the advantages of direct primary care.


If you haven’t had a routine physical in years and don’t have a relationship with a primary care physician, please call us to ask about how our annual physical and practice is different than in a standard medical practice, contact Progressive Health Primary Care to schedule an appointment.