Direct Care: What is it?
Before it became an industry shaped by billing codes and profit margins, medicine centered on the bond between physician and patient. Direct care is a simple idea with a big impact: it removes the insurance company from the exam room and puts that central relationship back where it belongs.
There are two related models under the direct care umbrella —
Direct Primary Care (DPC) and Direct Specialty Care (DSC).
Here's what each one means, how they differ, and why a growing number of New York physicians are choosing to practice this way.
Direct care is a return to something medicine used to be, and should be: a relationship.
Direct Primary Care (DPC)
Direct Primary Care is a model where patients pay their primary care physician directly — usually through a flat monthly or annual membership — instead of billing insurance for each visit. In exchange, most DPC practices offer:
Prompt, short wait times for appointments, instead of weeks on a scheduling calendar
Extended, comprehensive visits that give your physician room to actually listen, examine, and think
Quick access to your physician by phone, text, or email — not a call center or portal queue
Transparent, predictable pricing, often including labs, basic procedures, and wholesale-cost medications
A much smaller patient panel — so your doctor actually has time to know you
DPC is still primary care in every clinical sense: your annual physicals, chronic disease management, urgent concerns, and preventive screenings all happen here. What's different is how it's paid for and how much room your doctor has to actually practice medicine with you, the way physicians once did, before the relationship was squeezed to fit an insurance clock.
Direct Specialty Care (DSC)
Direct Specialty Care applies that same membership-based, insurance-free structure to specialty medicine — neurology, cardiology, dermatology, endocrinology, and beyond. A DSC practice is run by a board-certified specialist who has stepped outside insurance networks so that visits can look like:
Extended, comprehensive visits, with follow-up that's more responsive and care that's more proactive than reactive
Timely access to a specialist — not waiting weeks, months, or even years, as patients too often do
The ability to address complex, multifaceted problems in a single visit, instead of insurance rules that push patients back for separate appointments to address one issue at a time
Room for the advanced testing and workup that preventive care in specialties like cognitive longevity or cardiac health requires, even when it isn't considered "routine" by industry standards
"Practicing this way has truly brough the joy back to the practice of medicine!"
Dr. S Koehn. DO
How DPC and DSC work together?
DPC and DSC aren't competing models,
they're complementary.
A patient might have a DPC physician for everyday primary care and see a DSC specialist for a specific area of focus, such as neurology or cardiology. Because both physicians are freed from insurance administrative burden, they have the time and freedom to actually talk to each other, coordinate care, and treat the patient as a whole person rather than a claim number split across two disconnected systems — the way medicine used to work, built on relationships between physicians as much as between physician and patient.
Impact Stories
Sharing how direct care changes lives daily.
Advocacy Efforts
Partnering with lawmakers and physicians to promote policies that support direct care models and improve patient access across New York State.
Educational Events
Hosting workshops and webinars designed to educate both doctors and patients about the benefits and logistics of direct care.
Contact
Questions or thoughts?
Reach out to the New York State Direct Care Physicians Alliance team.
Phone
NYSdirectcare@gmail.com
518-555-1234
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