DPC Grew 80% in Five Years. But Who's Driving That Growth?

Analysis by DPC Insider
#corporate consolidation#Health Affairs#DPC growth#independent practice#concierge medicine#physician autonomy
Sources: Growth In Number Of Practices And Clinicians Participating In Concierge And Direct Primary Care, 2018–23 · Corporations Are Moving Fast Into Direct Care and Concierge Medicine · What Is 'Concierge Medicine' and Why More Doctors Are Making the Switch · Snapshot: Reactions and Responses to the Growth in Concierge and Direct Primary Care · What the 80% Growth in Concierge Medicine Is Really Telling Us About Primary Care

The headline sounds like a win for the movement. From 2018 to 2023, the number of direct primary care and concierge medicine practice sites in the U.S. grew by 83%, from about 1,660 to over 3,000 locations. Clinician participation jumped 78%. Mainstream outlets like WPRI are running the story this week. DPC is having a moment.

But the data beneath that headline tells a more complicated story. And if you’re an independent DPC physician, or thinking about becoming one, the details matter.

The Growth Is Real, But the Ownership Is Shifting

The study, published in Health Affairs by researchers from Johns Hopkins, Oregon Health & Science University, and Harvard Medical School, tracked every concierge and DPC practice it could identify over a five-year period. The topline growth numbers are genuinely impressive. More practices, more clinicians, more patients gaining access to membership-based primary care.

Here’s the part that didn’t make the mainstream headlines: corporate-affiliated practice sites grew by 576% during the same period. Independent ownership dropped from roughly 84% of all practices in 2018 to about 60% by 2023.

To put that in plain terms, the share of DPC and concierge practices owned or affiliated with corporations more than tripled, going from about 9% to one-third of the market. The biggest operators now include Premise Health with 800 locations across 46 states and One Medical (owned by Amazon since 2023) with 240+ locations.

Independent DPC is still the majority. But the trendline is moving fast in the other direction.

The Workforce Is Changing Too

The study found another shift worth watching. The percentage of clinicians in these practices who were physicians (MDs and DOs) declined from about 67% to 60%, while nurse practitioners and physician assistants grew from roughly a third to over 40% of the workforce.

That tracks with national healthcare trends. But it also reflects how corporate-backed practices tend to scale. A physician-owned solo DPC practice might keep a tight panel of 400 to 600 patients. A corporate operator looking at unit economics might staff with APCs to cover more patients per location at lower labor costs.

Neither model is inherently wrong. But they represent different visions of what membership-based primary care is supposed to be.

Why This Matters for Independent DPC

Dr. Jane Zhu, one of the study’s lead researchers, raised the concern that “if large entities own these models, we may see similar trends towards profit maximization” that have played out in traditional healthcare. That’s not a prediction. It’s a pattern recognition.

DPC was built on a specific promise: a doctor who knows you, who has time for you, who answers to you instead of an insurance company. When corporate operators enter the space, they bring capital, marketing reach, and operational infrastructure. They also bring investor expectations, growth targets, and the kind of cost pressures that DPC was designed to escape.

The 80% growth stat is being used in boardrooms and investor decks. It signals a market worth entering at scale. That’s different from a movement worth joining because you’re burned out and want to practice medicine the way you imagined when you started.

The DPC Advantage Is Still There

None of this means independent DPC is in trouble. Sixty percent of practices are still independently owned. The model’s core economics still work. Practices maintaining panels of around 600 patients continue to report 66% fewer emergency department visits and 20% fewer specialist referrals compared to traditional models. Employer adoption is accelerating, with over 7,200 employers now offering DPC benefits.

And the physicians entering DPC aren’t doing it because a corporation recruited them. About 30% came from traditional health systems, according to the study. They’re choosing this path because traditional primary care has become, as Concierge Medicine Today put it, “increasingly difficult to sustain clinically, financially, and personally.”

The question isn’t whether DPC will keep growing. It will. The question is whether that growth will look like the movement physicians signed up for.

What This Means

If you’re running an independent DPC practice, this data isn’t a threat. It’s context. You’re competing in a space that now includes well-funded corporate operators, and patients will increasingly be comparing your practice to those. Your advantage is exactly what brought you to DPC: real relationships, genuine autonomy, and a practice built around your patients rather than investor returns.

If you’re considering the transition to DPC, understand what you’re stepping into. The model works. The economics are sound. But the landscape is more competitive than it was even two years ago. Going in with a clear vision of what kind of practice you want to build matters more now than ever.

The 80% growth is real. Make sure you’re part of the version of that growth that keeps DPC worth fighting for.