The First Peer-Reviewed Survey of Pediatric DPC Is In. Ninety-Four Percent of Physicians Would Not Go Back.

A parent notices a rash on their child’s arm at 8 p.m. In most practices, the choices are the emergency room, an urgent care visit in the morning, or waiting three days for an appointment. In a pediatric DPC practice, the parent sends a photo by text. The physician responds within minutes. The urgent care visit doesn’t happen.

That interaction — multiplied across a panel of a few hundred families — is now the subject of peer-reviewed research. Two studies published in the journal Cureus in the summer of 2025 provide the first systematic, quantitative look at pediatric direct primary care in the medical literature: one surveying the physicians who run these practices, the other measuring what their member families experience.

What the Physician Survey Found

The first study is a national cross-sectional survey of 73 pediatric DPC physicians across 26 states — the closest thing to a census of the field that currently exists. The researchers, led by pediatricians at a multi-physician pediatric DPC network, developed a 19-section instrument in consultation with pediatric DPC leaders and distributed it through the “Pediatricians Who Do DPC” Facebook group and direct outreach to known practices.

The picture that emerged is one of small, physician-owned practices carrying patient panels that most conventional pediatricians would find strikingly modest. Eighty-five percent of the practices surveyed were single-doctor models. Seventy-nine percent had panels of fewer than 200 patients. Most operated in suburban settings.

Monthly membership fees ranged from $25 to $400. The most common price point was $101 to $150 per month, charged by 58% of practices. Eleven percent priced below $100.

The satisfaction numbers are the headline. Ninety-four percent of physicians reported being happier in DPC than in their prior roles. Eighty-nine percent cited reduced moral injury — the sense of being required to practice medicine in ways that conflict with their clinical values. The benefits named most often were meaningful patient relationships, greater clinical autonomy, and improved work-life balance.

The Income Curve Is Real

The survey did not smooth over the transition costs. Seventy-three percent of physicians reported earning less after moving to DPC — at least in the early years. Financial uncertainty was the most commonly cited challenge, followed by the demands of marketing and operating a small business and the professional isolation of solo practice.

The longer-term picture looks more stable. Among physicians with practices at least three years old, 65% reported incomes at or above what they earned before. That trajectory is consistent with what practice economics research on DPC has documented more broadly: a lean first few years while the panel fills, followed by revenue that stabilizes around membership base.

For pediatricians, the financial context is worth naming. Pediatrics already sits at the lower end of the physician compensation spectrum. A pediatric DPC physician’s annual income depends directly on panel size and fee structure. A practice of 150 families at $130 per month generates roughly $234,000 in annual membership revenue before expenses — and before any income from employer contracts, optional procedures, or ancillary services. That’s a workable floor for a solo practice; it’s not a ceiling.

What Families Actually Do

The companion telehealth study, by the same research group, surveyed 59 member families at a multi-physician pediatric DPC network and measured something harder to capture: whether DPC access actually changes patient behavior.

The results are unambiguous. Every respondent — all 59 parents — reported texting questions to their physician. Ninety-three percent sent photos of their child’s symptoms. Eighty-eight percent called the physician directly by phone. Twenty-two percent had used video chat.

That access, according to family accounts, consistently diverted care away from higher-cost settings. Families reported avoiding urgent care visits, emergency department visits, and unnecessary in-person appointments by reaching the physician through those channels instead. The study calculated the financial value of those avoided encounters: the minimum mean annual healthcare expenditure avoided per family was $1,171.

The Net Promoter Score — a standard measure of whether people would recommend a product or service — came back at 98 out of 100.

What This Means

Pediatric DPC has been growing alongside the broader DPC movement, but until now it has operated largely on practitioner experience and firsthand accounts. Pediatric DPC conferences sell out. Physicians post about their practices on forums. Parents in online communities describe what it’s like to text a photo at 9 p.m. and get a clinical response within minutes.

What has been missing is peer-reviewed documentation. These two studies, while modest in scale — 73 physicians, 59 families — provide the first quantified picture of how pediatric DPC actually works and what it costs and saves.

For physicians considering the model, the research provides both encouragement and an honest benchmark. High satisfaction is documented. So is the income dip in year one and two. The median physician in this sample is running a solo suburban practice with fewer than 200 patients at $101 to $150 per month. That’s a realistic picture of what the model looks like in practice, not a promotional version.

For families weighing the membership, the $1,171 in avoided costs offers a counterweight to the monthly fee. A membership at $130 per month costs $1,560 per year. If the research holds directionally — and the response pattern suggests it will for families who engage with the access — the net cost looks different from the sticker price.

The evidence base for pediatric DPC is no longer entirely anecdotal. That matters for physicians explaining the model to prospective families, for researchers who want to study pediatric DPC health outcomes at scale, and for anyone who has wondered whether the 8 p.m. photo text actually changes what happens next.

According to the families who were asked: it does.