The Podcast by KevinMD Economic reality tests the limits of subscription medicine
Jan 12, 2026
Healthcare strategist Dana Lujan, an expert in primary care models, dives into the challenges facing direct primary care amidst economic downturns. She discusses the financial strain on middle-class families, contrasting retail models with employer-sponsored options. Lujan highlights the importance of aligning medical business strategies with community financial realities and suggests diversifying towards employer contracts for stability. Her insights on the risks and sustainability of retail DPCs offer valuable lessons for a changing healthcare landscape.
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Two Distinct DPC Economies
- Retail and employer-sponsored DPC use fundamentally different economic models driven by who pays.
- Treating them as interchangeable obscures affordability and sustainability issues.
Price To Local Household Capacity
- When planning a retail DPC, evaluate household discretionary income and local cost pressures.
- Design pricing and offerings around the community's actual ability to pay, not ideology.
Common Retail DPC Structure
- Typical retail DPC subscriptions range widely, often including unlimited visits and no insurance billing.
- Practices often cap panels (e.g., ~600 patients) to preserve access and same/next-day availability.