83% Growth in Five Years, and DPC Is Just Getting Started

Analysis by DPC Insider
#DPC growth#primary care access#physician burnout#practice trends#health policy
Sources: Growth In Number Of Practices And Clinicians Participating In Concierge And Direct Primary Care, 2018–23 · Direct Primary Care's Gains May Be the Traditional Care Setting's Losses · Direct Primary Care in Wisconsin Sees Increased Demand as Health Insurance Prices Skyrocket · 2026: A Turning Point for Direct Primary Care · 2026 DPC Trends: What's Next in Direct Primary Care

One in six Americans doesn’t have a primary care physician. In some cities, patients wait eight months just to be seen as a new patient. Forty-five percent of primary care physicians report burnout. And within the next decade, researchers project a shortage of 70,000 primary care doctors.

Against that backdrop, a new study in Health Affairs just landed with a number worth sitting with: DPC and concierge practices grew 83% between 2018 and 2023. The physicians working in those practices? Up 79% over the same period.

That’s a movement. Not a trend. A movement.

But like most things in healthcare, the picture is more complicated, and more interesting, than the headline number suggests.

What the Study Actually Found

The Health Affairs analysis is one of the most comprehensive looks at DPC and concierge growth in recent memory. Researchers found that the number of DPC and concierge practice sites in the United States nearly doubled over five years, with clinician participation growing almost in lockstep.

As of 2023 (the last year of data in the study), more than 1,000 DPC offices were operating nationwide, serving an estimated 250,000 members. For context, that’s still a relatively small fraction of total primary care in America. The growth rate, though, tells a story about direction.

What’s driving it? The same forces that have been building for years, now hitting critical mass. Insurance administrative burden that consumes more of every clinical day. Declining reimbursement rates that require ever-larger patient panels just to keep the lights on. Physician employment by hospital systems reaching levels that many doctors never anticipated when they started medical school; the AMA reported physician ownership fell from 53.2% in 2012 to just 35.4% in 2024. And increasingly, patients who want something different: a doctor who actually knows them, answers the phone, and doesn’t rush them through an eight-minute appointment.

The Demand Surge Is Real and Regional

The academic data matches what’s happening on the ground in states across the country. Wisconsin Public Radio reported in January that DPC clinics are seeing sharply increased interest as health insurance prices continue to climb. Wisconsin now has more than 100 DPC practices, some with multiple clinic locations, a meaningful footprint for a state of roughly six million people.

The pairing model has become a practical alternative for many: a DPC membership ($45–$110 per month at many Wisconsin practices) combined with a catastrophic health plan that covers hospitalizations and major events. With 2026 catastrophic plan deductibles at $10,600 for individuals, that combination isn’t right for everyone, but for healthy adults who were previously spending $600 to $800 per month on traditional insurance and still struggling to get a same-week appointment, the math is starting to look very different.

Now that HSA funds can be used to pay DPC membership fees, a change that took effect this year under the Primary Care Enhancement Act, that calculation has gotten even more favorable. Employers can now pair DPC memberships with high-deductible health plans without the legal ambiguity that previously complicated adoption. Accresa’s recent market overview called 2026 a structural turning point, not just an incremental one.

The Paradox Worth Taking Seriously

Here’s where it gets complicated: the same study that celebrates DPC growth also surfaces a tension the movement has to reckon with honestly.

Every physician who leaves fee-for-service for a DPC practice takes a smaller patient panel with them. A typical DPC practice serves 400–600 patients. A typical insurance-based primary care practice serves 2,000–2,500. When a physician makes the switch, there are potentially 1,500 patients who need to find a new doctor, in a market where finding a new primary care doctor is already difficult.

Dr. Dan Polsky, one of the researchers quoted in coverage of the Health Affairs study, put it plainly: “It’s important everyone understands the potential impact these practices have on the health care system at large.”

Dr. Zirui Song, a Harvard health economist who has studied the DPC model, has noted that the industry “increasingly face[s] more patients needing new primary care doctors but fewer doctors to meet that need.”

This isn’t a reason to dismiss DPC or to suggest that physicians shouldn’t make the choice that’s right for them. Burned-out physicians who leave medicine entirely serve no patients. Physicians who stay in miserable, unsustainable practice settings often deliver degraded care. And DPC physicians, by definition, provide deeper, more continuous care to the patients they do serve, which has its own systemic value.

But it is a real tension, and the most thoughtful voices in the DPC community are engaging with it rather than waving it away.

What This Means for Physicians Considering the Transition

The 83% growth number is validating. It confirms that the DPC model isn’t a fringe experiment; it’s a durable, growing alternative that thousands of physicians and hundreds of thousands of patients have chosen deliberately.

What it also means is that the DPC movement is large enough now to attract serious scrutiny. Health Affairs studying it is different from a DPC advocacy group releasing a white paper. That scrutiny will come with questions about access, equity, and what happens to the patients who can’t afford a monthly membership even at $50 a month. These are fair questions that the movement will need substantive answers to.

For individual physicians weighing the transition, the data cuts in a useful direction: the market is growing, the regulatory environment is more favorable than it’s ever been, and employer adoption (now over 7,200 organizations, per Elation Health’s 2026 trends report) means the patient acquisition challenge is increasingly addressable through employer channels, not just direct-to-consumer marketing.

The 70,000-physician primary care shortfall being projected for the next decade is simultaneously a systemic problem and a market signal. Patients who cannot find a traditional primary care doctor are going to look for alternatives. Some will turn to urgent care chains and retail clinics. Others will turn to DPC.

The physicians who are already there will be in a very strong position.

What This Means

The Health Affairs study documenting 83% DPC growth isn’t just a validation of what DPC physicians already knew; it’s the beginning of mainstream scrutiny of a model that has grown beyond niche status. For physicians considering DPC, the market, regulatory, and employer tailwinds are as favorable as they’ve ever been. The access questions the model raises are real and worth engaging seriously; they don’t undermine the case for DPC, but they do shape the conversation the movement is going to need to have as it continues to scale. If you’ve been watching from the sidelines, 2026 might be the year the numbers finally make the decision obvious.