The AAFP Surveyed Family Physicians on DPC. The Satisfaction Gap Was 37 Points.

In May 2026, Sermo published a pros-and-cons guide to direct primary care built around satisfaction figures from the American Academy of Family Physicians’ 2024 Direct Primary Care Study. The headline numbers: 94% of DPC physicians report satisfaction with their practice, compared to 57% in traditional settings. And 49% of DPC physicians report no burnout at all, versus 14% of non-DPC family physicians.

A 37-point satisfaction gap. A 35-point gap in physicians who are completely burnout-free.

Those numbers come from the AAFP’s own recurring DPC Study, which the academy has run in one form or another in 2018, 2019, 2022 and 2024. The 2024 round was emailed to two audiences: family physicians already practicing DPC or interested in transforming to it, and a random sample of AAFP members. A total of 374 surveys came back, and 177 of them (47%) were from physicians currently in a DPC practice.

That sampling frame shapes how much the gap can carry. A specialty academy that runs a recurring study of the model surveyed a pool it deliberately stocked with physicians already drawn to it. The 37 points are a real measurement of that group. They are not a read on how family medicine as a whole would answer.

What Drives the Gap

The one source that addresses causation names something other than panel size. Sermo’s article puts the numbers down to “the elimination of insurance billing and prior authorization from daily practice,” not the financial model itself. Panel size still describes how differently the two days are built. DPC practices average around 402 patients. Traditional primary care runs 1,800 to 2,500. That difference changes the entire shape of a practice day. At 2,000 patients, appointments average seven to fifteen minutes and the schedule has no room to breathe. At 400, visits run 30-60 minutes, and same-day access is routine rather than an exception that requires a supervisor’s sign-off.

Overhead tells the same story from the practice economics side. DPC practices run 30-40% overhead. Traditional practices land at 60-70%. The gap comes almost entirely from insurance billing: no claims staff, no prior authorization queue, no revenue cycle management cycling billing errors back through the system. That administrative layer costs both money and physician attention.

A general practitioner commenting on Sermo described the trade this way: “Direct primary care or subscription-based models empower us to practice patient-centered medicine without administrative burdens.” That is one physician’s comment on a peer platform rather than a survey response — the AAFP brief carries no quotations at all.

The Trade-Offs Are Real

Sermo’s article is direct about what DPC asks in return.

Building a panel takes time. Sermo puts the build phase at one to three years to reach a sustainable panel, and separately notes that the most common advice is to budget 12 to 24 months of personal expenses outside the practice — a savings runway, not a revenue timeline. Physicians coming from employed positions often underestimate the business ownership demands. Marketing, hiring, lease agreements, and payroll don’t appear in residency training.

The income calculation is more layered than the top-line salary. The average DPC physician salary sits around $217,000 per ZipRecruiter data from late 2025. That compares reasonably to employed family medicine in many markets. But DPC physicians pay their own malpractice coverage, health insurance, and retirement contributions rather than receiving them through an employer. The income ceiling is higher in DPC, and so is the downside risk during the build phase.

Physicians who struggled during the build phase or left DPC almost always point to the same issues: not enough financial runway before opening, underestimating how long patient acquisition takes, or discovering the business management side didn’t fit their actual working style. The model itself rarely comes up as the problem.

What This Means

For physicians considering the transition: the AAFP data is a starting point rather than a verdict. The academy has a stake in the model it studies, and the survey went out partly to physicians already practicing DPC or interested in transforming to it. A 37-point gap measured that way describes how physicians who chose the model feel about having chosen it, which is worth knowing and is a different question from whether the model would suit any given physician.

The physicians who land in the 94% tend to share something specific. They wanted what DPC actually offers: fewer patients, longer visits, no insurance billing, and clinical autonomy. If those things matter enough to take on the financial risk of starting a practice from scratch, the data suggests the model performs as described over time.

For residents earlier in training: this survey exists not to push you toward any particular decision but to give you an accurate starting point. Most physicians who consider DPC spend months trying to piece together how other DPC doctors actually feel about the trade. A 374-response survey run by a specialty academy is a different kind of evidence than individual practice testimonials: broader, and drawn from physicians who selected themselves into the question.

The burnout gap tells a specific story. One in seven non-DPC family physicians reports no burnout at all. For DPC physicians, it’s nearly one in two. That gap doesn’t measure how hard each group works. It measures what the work consists of, and how much of it goes to patients versus the system that surrounds patients.

As more physicians hit year two or three of employment and start running those numbers for themselves, surveys like this one give them a reference point — one worth reading alongside a note about who ran the survey and who answered it.