A Peer-Reviewed Pediatric DPC Study Found That 69 Percent of Families Avoided the ER by Texting Their Doctor

Analysis by DPC Insider
#pediatric DPC#telehealth#emergency room#patient outcomes#research#cost savings
Sources: Impact of Telehealth on Pediatric Direct Primary Care: Is Virtually Showing Up Valuable? (PMC) · Impact of Telehealth on Pediatric Direct Primary Care: Is Virtually Showing Up Valuable? (Cureus) · Current State of Pediatric Direct Primary Care: A National Cross-Sectional Survey of Pediatricians · DPC Summit 2026

The moment you might recognize: a child runs a fever at eleven o’clock on a Tuesday night. You check the temperature, you check it again, and then you face the decision every parent with a traditional insurance plan knows—wait until the office opens in the morning and hope it breaks, or drive to the emergency room.

In a standard insurance-based pediatric practice, after-hours options are limited. An automated nurse line, an on-call physician who doesn’t know your child, or a message that sits in a queue until morning. None of those channels are designed for an 11 PM decision.

In a pediatric DPC practice, the access structure is different. Members can text their doctor a photo of the rash, the throat, the ear, or the redness that is keeping them up. The doctor knows the child, knows the family’s history, and can look at that photo in real time and give a specific response—not a protocol.

A peer-reviewed study published in Cureus in June 2025 set out to measure what that access actually changes.

The Study

Researchers distributed a cross-sectional electronic survey to 155 families enrolled in a multi-physician pediatric DPC network in April 2023. Fifty-nine families responded—a 38 percent response rate. The survey asked how they used telehealth modalities to communicate with their doctor and whether those modalities helped them avoid in-person care.

What members reported using:

  • 100 percent texted questions to their doctor
  • 93 percent sent clinical photos
  • 88 percent placed direct phone calls
  • 22 percent used video chat

Those modalities changed where families went—or didn’t go—when something came up:

  • 98 percent avoided at least one doctor’s office visit
  • 92 percent avoided at least one urgent care visit
  • 69 percent avoided at least one emergency department visit

The researchers calculated the minimum mean healthcare expenditure avoided by using those modalities: $1,171.13 per family per year.

Patient satisfaction landed at a Net Promoter Score of 98 out of 100—meaning nearly every respondent would actively recommend the practice to others.

Why That ER Number Matters

Emergency department visits are expensive regardless of insurance status, and a significant share of them happen because patients can’t reach their primary care physician in time. The gap between “I need to ask a question” and “I need a medical answer” is what sends families to the ER at midnight—not because the condition requires emergency care, but because no other option is available.

In pediatric DPC, the gap is smaller. The 69 percent ER avoidance figure in this study reflects what happens when that gap closes: families make different decisions. A photo of a rash sent at 10 PM and a response that says “watch it, call me if the fever goes above 103” is a different outcome than driving forty minutes to an emergency department and sitting for three hours.

The $1,171 figure is a minimum—calculated using the low end of cost estimates for each type of avoided visit. In markets with higher healthcare costs, the actual savings per family would likely be higher.

Two Studies, Two Angles

This study is the companion piece to a separate national survey of pediatric DPC physicians published in Cureus one month earlier. That study—the first peer-reviewed national survey of pediatricians in DPC practices—found that 94 percent of physicians in pediatric DPC would not return to a traditional model. DPC Insider covered those findings when they were published.

The two studies address different questions. The physician survey asked: does this model work for the doctor? The patient survey asked: does this model change what the patient does? The directional answer from both sides is the same.

Together, they are among the first peer-reviewed analyses of the pediatric DPC experience from both sides of the exam room. The pediatric DPC field has historically relied on practitioner testimonials and individual practice data. These two studies are early anchors in a more formal evidence base.

Limitations Worth Noting

The authors of the telehealth study are transparent about the limitations. The sample is small—59 respondents—and self-selected. Families who respond to a voluntary survey from their own practice might skew more satisfied than the broader membership. The survey asked participants to self-report how often they used telehealth to avoid in-person visits, which depends on recall accuracy.

The study represents one multi-physician network in one geographic area, not a nationally representative sample. Readers should treat the findings as directional rather than definitive.

With those limitations stated: the directional finding holds. Members of a pediatric DPC practice report that having direct access to their doctor’s phone number changed what they did when their child got sick. That behavioral shift shows up in the ER and urgent care avoidance data, and it carries a dollar value.

What This Means

For pediatric DPC practitioners, the study offers concrete numbers for conversations that often stay qualitative. When an employer asks what DPC membership actually changes for families, “69 percent avoided an ER visit” is a specific, citable data point—not just a description of the model.

For families evaluating a DPC membership, the $1,171 annual minimum savings provides a useful frame. Pediatric DPC memberships typically run between $50 and $100 per month. If the direct access that comes with that membership prevents one urgent care visit and one ER trip per year, the membership cost may pay for itself in avoided copays and facility fees alone.

For the broader evidence base, both 2025 Cureus studies point in the same direction: the access model changes clinician experience and patient behavior simultaneously. The DPC field needs more studies, larger samples, and stronger research designs. These are a start.

The 11 PM fever question has an answer in pediatric DPC. The data suggests that families who have that answer are using it.