DPC Started as a Rebellion. Now Some of Its Founders Are Asking What It's Becoming.

Dr. Angela Andrews opened her DPC practice in Michigan in 2014. She’s not a newcomer raising questions from the outside. She’s part of the founding generation of physicians who built this movement when DPC was small enough that most practitioners knew each other.

So when she recently attended a healthcare event billed as representative of the DPC community — and noticed that practices like hers weren’t in the room — she asked why.

The answer from organizers, according to her essay published today on DPC News: “We didn’t know you existed.”

Twelve years of DPC practice. Didn’t exist.

Two Versions of DPC, One Name

The Direct Primary Care model was built by physicians who wanted out of insurance-driven medicine. Small panels. Long visits. Monthly fees paid directly by patients. A doctor who knew your name and answered when you called.

The numbers have changed. Hint Health’s 2026 DPC Trends Report, released last month at Hint Summit 2026, showed DPC membership growing 837% since 2017. For the first time in the model’s history, employers fund the majority of active memberships — 60%. The movement now spans all 50 states with more than 2,800 practices and 1.4 million members.

That’s not a fringe experiment. That’s a healthcare infrastructure layer.

The tooling is following. In April, Hint launched a marketplace — an app-store-like platform connecting practices with software tools and partner integrations within the Hint ecosystem. CEO Zak Holdsworth described it as a response to a fragmented ecosystem: the marketplace consolidates it. The bet implicit in that move is clear: DPC is going to keep scaling, and it needs scalable infrastructure.

None of that is wrong. Growth helps more patients.

What Gets Counted as Authentic

But Dr. Andrews noticed a pattern in who gets the room, the keynote, the case study slot.

The practices being held up as exemplary at events look like one thing. Employer-facing. Team-based. 24/7 availability. Growing toward larger patient rosters. Multi-provider, potentially multi-site. One panelist she heard went further, asserting that “authentic DPC” means 24/7 access to your doctor — implying that a solo physician who keeps reasonable after-hours boundaries isn’t doing real DPC.

Andrews runs Seeds of Health DPC in Michigan with intentional limits. Not because she can’t handle more patients, but because the depth of relationship she’s building requires it. She’s been doing this for twelve years in a model the conference circuit didn’t know existed.

She’s not the only one. The physicians who built DPC before there were trend reports weren’t all planning to go employer-facing. Many of them wanted to practice medicine the way medicine is supposed to be practiced — with time, with presence, and with a panel small enough that they actually knew who was calling when the phone rang.

What the Data Measures

The Hint Trends Report is comprehensive. It documents employer adoption, geographic expansion, pricing stability, burnout reduction. It draws on data from more than 2,700 clinicians.

But a report built on data from a billing and membership platform naturally reflects the practices that look like what the platform is built for. That’s not a criticism — it’s a byproduct of how data gets collected. The growing employer-facing clinic with a dedicated billing coordinator and multiple providers generates more data than the solo physician who takes direct patient payments and uses a simple system.

When the narrative follows the data, the smaller practice starts to disappear from the room.

And when the conference programming, the vendor infrastructure, and the press coverage all orient toward one version of the model, the physicians building the other version start hearing things like: “We didn’t know you existed.”

What This Means

For physicians considering DPC who don’t see themselves in the employer-facing growth story, this is worth understanding: the model you’re imagining might be closer to reality than the conference coverage suggests.

Solo DPC practices are still opening. Panel sizes of 400 to 600 patients — the range that characterizes most DPC practices — are still financially viable. The direct-pay, patient-only model still works. It’s quieter than the employer-funded version. It doesn’t have a keynote slot at Hint Summit.

For existing DPC physicians building the smaller model: you’re not an incomplete version of something else. The intentionally-limited solo practice is a legitimate form of DPC. It was the original form of DPC.

Dr. Andrews isn’t arguing that the scaled, employer-facing version is wrong. She’s arguing that when one model becomes the default definition — when the word “authentic” gets attached to a specific size and structure — the physicians building something different stop appearing in the conversation. And eventually, they stop being recognized as doing the same thing at all.

The DPC movement started because a handful of physicians decided to do something different from the system that was crushing them. Some of those physicians want to grow that rebellion into something big. Others want to practice medicine the way it should be practiced, quietly, for a few hundred patients who know their doctor by name.

Both are still building. You just have to know where to look for the second kind.