The First National Survey of Pediatric DPC Physicians Found 94 Percent Are Happier. Seventy Percent Still See Medicaid Children, and the Survey Cannot Explain How.

Analysis by DPC Insider — Research Desk
#pediatrics#burnout#physician satisfaction#Medicaid#research#survey
Sources: Current State of Pediatric Direct Primary Care: A National Cross-Sectional Survey of Pediatricians (Cureus, May 2025) · Current State of Pediatric Direct Primary Care: A National Cross-Sectional Survey of Pediatricians (PubMed)

Ninety-four percent. That’s the share of pediatric DPC physicians who told researchers they were happier in direct primary care than in their prior jobs. More than half described themselves as “far more happy.”

The number sounds too clean. It probably reflects some self-selection. But the study behind it is the first national survey of pediatric physicians in the DPC model, and the data it captures covers more than mood.

What the Survey Measured

Published in Cureus in May 2025, the study was developed in consultation with pediatric DPC leaders and piloted through the Zest Pediatric Network. It reached physicians through the “Pediatricians Who Do DPC” Facebook group, direct outreach, and practice websites.

The study’s final cohort covered 73 pediatricians across 26 states. That’s a small sample and likely a meaningful share of the pediatric DPC physicians practicing in the country at the time, given how concentrated the DPC model remains in adult primary care. Eighty-five percent were solo practitioners. Most practiced in suburban settings. Most carried fewer than 200 patients.

The solo-practice pattern fits what the study’s authors describe as typical of the DPC model overall. The panel sizes sit below adult-model DPC: the study’s own comparison puts pediatric panels at 100 to 300 patients, versus 300 to 600 for adult-model practices.

Eighty-nine percent of respondents reported less moral injury than in their prior work. The autonomy, the patient relationships, the exit from insurance coding: these are what physicians say they leave fee-for-service to find, and the survey suggests most of them found it.

The Income Picture

That’s half the picture.

Seventy-three percent of pediatric DPC physicians in the survey currently earn less than at their prior job. The study’s authors note the figure is likely skewed by the large share of young practices in the cohort. Many respondents were still in the startup years when the survey ran. An income gap during that period can derail a practice before the panel has time to fill, and physicians with student debt, mortgages, or family obligations have limited room to absorb a slow start.

The follow-on data is more encouraging. Among physicians with practices three years or older, 65% reported income at or above their previous level. That income path appears to be real. It also describes only the physicians who made it to three years. The survey has no account of the ones who tried and stopped.

Membership pricing in the survey ranged from $25 to $400 per month, with most practices landing between $101 and $150. Those figures sit well above what the study reports for adult-model DPC: its own comparison table puts adult DPC membership at $20 to $75 per month. Whether that premium reflects the different care patterns in pediatrics, or just how pediatric DPC physicians have priced while figuring out what the model supports, the survey can’t say.

The Medicaid Finding

Here’s the data point that got the least attention: seventy percent of the pediatric DPC physicians in this survey provide care for children covered by Medicaid.

The persistent critique of DPC in pediatrics is that a model built on monthly membership fees serves families who can afford to pay, and leaves behind the ones who can’t. Most Medicaid-insured children come from households that qualified for coverage on the basis of income. A monthly fee of $101 to $150 is not a trivial cost for those families.

So what does “provide care for Medicaid-insured children” mean here? The survey doesn’t say. A pediatric DPC physician might offer scaled or waived fees for Medicaid families. They might see Medicaid patients episodically without requiring full membership, or participate in local or county programs. They might absorb a share of uncompensated visits within a panel that can cover the cost. The number tells you the care is happening. It doesn’t tell you how, what it costs, or who covers the gap.

That’s where the model’s actual access question lives, and it’s the thing this survey can’t resolve.

The Open Question

The 73 respondents self-selected in a way that matters. The survey reached physicians via a Facebook community for pediatric DPC practitioners, through DPC networks, and by direct outreach to practices already operating the model. Physicians who complete a 19-section questionnaire reached through DPC community channels are, by definition, still in the model. That’s a different group from the ones who tried it and went back.

The satisfaction findings sit on that problem. The researchers built the survey carefully, but they couldn’t fix who shows up in a DPC Facebook group and responds to a 19-section questionnaire.

None of that makes the data useless. Seventy-three accounts of what pediatric DPC looks like: panel sizes, pricing, earnings levels, burnout. They add something the field has been missing: actual numbers, not anecdotes. The model’s critics don’t have a counter-survey. Neither do its advocates.

What comes next would need to follow new practices through those first three years rather than look back at the ones that survived them. And it would need to ask a sharper question about the Medicaid finding: not just whether the care is happening, but what it costs, who absorbs the difference, and whether any of those arrangements could hold at a larger scale.

When it was published in May 2025, this survey was the first national data on pediatric DPC. That’s both its contribution and its ceiling.