A KevinMD Essay Catalogs Every Broken Step in Patient Care Coordination. DPC Handles All of Them.
A developmental-behavioral pediatrician needed routine cataract surgery on his only functional eye. The surgery was simple. Coordinating the records and clearances around it was not. He wrote about the experience on KevinMD this week.
What It Takes to Schedule Your Own Surgery
Dr. Ronald Lindsay catalogs every administrative step he completed to prepare for the procedure. He reset expired portal passwords at multiple offices and downloaded medical records from one EHR only to upload them manually to another because the two systems couldn’t communicate. A preoperative cardiac clearance required yet another appointment. When the surgical center never received his lab results electronically, he drove them over himself.
Lindsay’s summary is blunt: “The system works only because patients do the work the system no longer does for itself.”
He reflects on the families he treated across his career. Parents managing developmental and behavioral needs for their children while working full time used to rely on their physician’s office to handle referral calls and record transfers. Today, those tasks sit in the patient’s lap.
The Numbers Behind the Frustration
Lindsay’s experience maps onto a pattern that PartnerMD’s March 2026 survey documented nationally. Only 14% of primary care patients reported complete care coordination across their providers. Eighty percent said they worry critical health issues could be overlooked between appointments.
The access numbers explain why coordination breaks down. Fifty-three percent of patients wait at least a week for a primary care appointment. Sixty-two percent can’t reach their doctor after hours. Sixty-eight percent describe their appointments as rushed. When your doctor carries a panel of 2,500 patients and sees you for seven minutes, nobody in that office is calling the surgical center to confirm your labs arrived.
Where DPC Fits
Every coordination failure Lindsay describes has a structural cause: too many patients per doctor, too little time per visit, disconnected electronic records and no staff member whose job is closing the referral loop.
DPC practices run on different math. A typical panel is 400 to 800 patients, and visits last 30 to 60 minutes. Patients reach their doctor by text, phone or email, often the same day. Because the practice runs on membership revenue instead of insurance billing codes, staff spend their time on coordination instead of claims processing. Many DPC practices also maintain direct relationships with local specialists and can make a referral with a phone call rather than a form submitted into a portal queue.
With the HSA rule now allowing patients to pay DPC memberships with pre-tax dollars, more patients are entering DPC practices for the first time. Many discover the coordination piece alongside the longer visits and same-day access: a practice that handles referrals, records transfers and follow-ups as part of the membership.
When a DPC patient needs cataract surgery, the practice calls the surgeon’s office, confirms the referral, checks that lab results arrived and follows up after the procedure. That coordination work belongs to the practice. A generation ago, this was standard primary care. It still is, in practices with panels under 800.
What This Means
Lindsay’s essay matters because he wrote it as a patient and never once mentions DPC. He’s documenting a system that requires a physician to hand-deliver his own lab results because the electronic infrastructure can’t do it.
If you’re a resident exploring practice models, his list shows what patients in the conventional system deal with every day. For physicians considering DPC, it’s a preview of the friction your future patients won’t face. And for those already running a practice, the essay is a useful reminder of why care coordination sells the membership.
The system Lindsay describes won’t fix itself, and someone has to do that coordination work. In DPC, that someone is the practice.