A Pediatrician Started With 8 DPC Members. Eighteen Months Later, He Had 200.

The first time Dr. Trey Williams walked into a patient’s home for a sick visit, he saw mold on the bedroom wall.

The child had been treated four times for “recurrent respiratory infections.” No clinic visit had found the cause, because no one had been inside the apartment before. Williams found it in the first five minutes.

That’s what house calls make possible. Information a waiting room can’t give you.

Williams is a board-certified pediatrician in Charlotte, North Carolina and the founder of Peds MD, a pediatric direct primary care practice built around house calls and monthly memberships. He described the practice this week on KevinMD. He launched 18 months ago with eight members. He now has 200.

How Peds MD Works

Members pay a monthly fee and get direct access to Williams by text, 24 hours a day. Not a triage nurse. Not an answering service. Williams. Unlimited virtual visits and house calls come with the membership, without insurance authorization before anything happens.

The standard pediatric model runs on volume: 15-minute appointment slots, 20 to 30 kids a day. Time spent understanding a family’s home situation or daily routine doesn’t generate a billing code. The system isn’t built around that kind of attention.

Williams built his practice around exactly that.

What 18 Months Produced

Peds MD has an 85% retention rate from its original eight members. DPC practices tend to hold patients better than fee-for-service, but 85% from the founding cohort after a year and a half is a strong signal. Those families are staying because the care works for them.

The more interesting number: 36% of Peds MD’s pediatric households have converted to adult memberships.

Parents who joined for their children are now using direct primary care themselves. That’s growth from inside the existing member base, with no marketing budget required. When a pediatric patient leads the adults in their household into the model, the practice economics shift in ways most DPC projections don’t account for.

Williams’s framing explains part of why: “The front door was always where the relationship lived. We just forgot that for a while.”

House calls make that concrete. When a physician comes to the home, they see what a clinic visit doesn’t show: the mold, the sleep setup, the pantry, the family dynamics around a chronic condition. Those observations change diagnoses. They also change the relationship between physician and family in ways that make 85% retention easier to understand.

Why Pediatric DPC Is Still Uncommon

Pediatric DPC makes up a small share of direct primary care practices overall. Most DPC physicians serve adults, and the economics of pediatric membership medicine are different. Young children go to the doctor frequently. Healthy teenagers almost never do. Panel size and membership revenue don’t behave the same way they do in adult medicine.

The concern for physicians considering pediatric DPC is usually that retention is harder and families drop memberships when kids age out of the high-visit years.

Williams’s data pushes back on that. Families aren’t dropping when kids get healthy. A third of them are adding themselves.

What This Means

For pediatricians thinking about DPC, the standard path runs through adult-model resources: family medicine practice guides, adult pricing data, conversations with physicians who see adults. Pediatric-specific resources are thin.

Williams’s 18-month numbers are self-reported from one practice in one city. That’s not a study. But it’s real retention data from a real practice, with a figure that rarely shows up in discussions about pediatric DPC viability: 36% of pediatric member households converting to adult memberships.

He also founded Evolve Care Partners, a management services organization designed to help other pediatric DPC practices launch on the same model. Whether that takes hold depends on whether other pediatricians find the economics work for them.

For residents in pediatrics weighing alternatives to employed medicine, DPC tends to enter the conversation late, after family medicine and internal medicine and adult urgent care. The assumption is that pediatrics and membership medicine don’t fit together cleanly.

Williams’s practice doesn’t prove it works everywhere. What it does is give pediatricians something concrete to look at: a house call practice in Charlotte with 200 members, 85% retention, and a third of its families signing up for more.