A DPC Doctor Answered the Model's Ten Most Common Criticisms. He Had Data for Each One.

DPC gets the same ten arguments thrown at it on a loop: cherry-picking patients, abandoning the poor, shrinking the PCP supply, dodging quality metrics, pricing patients out.

Kenneth Qiu, a family medicine physician running EuDoc Direct Primary Care in Midlothian, Virginia, published a response to all ten on DPC News this week. The piece is structured as a series of “how dare you” reversals directed at the model’s critics. The citations do most of the work.

The Full List

Qiu addresses ten criticisms in total, running from cherry-picking patients and abandoning the poor to dodging quality metrics and worsening health equity. He also takes on the charges that DPC can’t handle catastrophic costs, that it prioritizes physician happiness over access, and that leaving the system is irresponsible.

None of these arguments are new. What separates this version is that Qiu went point by point and attached published research to each answer.

The Numbers That Carry the Weight

Three data points stand out.

The workload math comes first. Qiu cites a 2022 study estimating that a primary care physician would need 26.7 hours in a single day to deliver guideline-recommended care to a standard panel of 2,500 patients. With team-based care, that drops to 9.3 hours. DPC panels of 400 to 600 patients make the actual care feasible. The counter-argument is real: fewer doctors taking insurance means fewer options for everyone else. But the current model is already failing the math on its own.

Second is the quality-metric problem. A JAMA Health Forum study found that primary care physicians face 57 unique quality measures across their value-based contracts. Qiu’s point is that 57 metrics per physician turned measurement into the product and patient care into the overhead. DPC practices are making an argument about what accountability should look like, not trying to avoid it.

Third, the chronic disease data. The Milbank Memorial Fund’s 2026 report found that adults with a usual source of primary care had 20% fewer hospitalizations and 11% fewer ED visits. That phrase, “usual source of primary care,” describes exactly what DPC is designed to provide: a named doctor who picks up the phone and sees you the same week.

Beyond the clinical data, Qiu points to a structural reality. HRSA data from March 2026 shows 101 million Americans living in primary care Health Professional Shortage Areas. The AAMC projects a shortage of 86,000 physicians by 2036. The system that DPC is accused of leaving behind is already short-staffed.

Where the Criticism Sticks

The equity argument is the hardest one for DPC to answer cleanly.

Every physician who moves to a membership model removes one PCP from the insurance-accepting supply. Qiu acknowledges this and points to employer adoption and Medicaid as potential fixes. Both are moving: 60% of DPC memberships are now employer-funded, and the Medicaid Primary Care Improvement Act (H.R. 1162) has bipartisan support in both chambers.

But “moving” and “solved” are two separate categories. Medicaid DPC is still stuck in committee. The patients most affected by the PCP shortage are the ones least likely to have an employer offering DPC as a benefit. Qiu’s piece is strongest when it sticks to published numbers and weakest when it leans on what DPC could do if policy catches up.

What This Means

The criticisms of DPC haven’t changed much in five years. What has changed is the data available to respond to them. The HRSA shortage numbers, the Milbank chronic disease findings and the JAMA quality-measure analysis give DPC advocates specific citations where they used to have anecdotes.

For physicians considering DPC, Qiu’s piece is a useful field guide to the arguments you’ll hear from colleagues, hospital administrators and insurance groups. For practicing DPC doctors, the data points are worth bookmarking for the next time someone asks how you dare.

The critics aren’t going away. The numbers aren’t either.