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RED HOT Contributors


Episode 17: Doctoring From The Good ‘Ol Days


When you can’t beat ‘em – LEAVE ‘EM. That’s the rallying cry taken by a frustrated, growing group of primary care physicians. They tried the traditional route of doctoring, only to find too much stress, administrative demands, and patients being left short on time and engagement.

They decided to make a clean break from the system – and that brings us into the growing world of Direct Primary Care or DPC.

NO…this is not concierge care. Rather, it’s physicians who said ‘no more’ to billing insurance payers – including Medicare. It’s strictly a two-party service relationship between doctor and patient.

DPC practices average between 400-800 total patients (vs. the national 2,300 patient base average for traditional primary care provider patient panels). Such practices offer affordable and high-touch care, with affordability and greater levels of patient engagement, stemming from a closer doctor relationship.

direct primary care

In this episode we welcome Dr. Samir Qamar, CEO of MedLion, a chain of DPC practices in 22 states; and Michael Tetreault, Editor for the DPC Journal. They’re talking about the emerging movement and benefits of Direct Primary Care.

A Short Snippet from the Interview on Direct Primary Care:

STEVE: “I want to focus our talk today on Direct Primary Care. For the uninitiated, it’s an emerging model of healthcare where primary care physicians willingly choose to break away and no longer work for health systems and hospitals – and take their own path into a two-party model with patients.

Michael, I’d like to start with you – and ask you a bit more about this model.”

MICHAEL: “Direct Primary Care is in its purest form, a direct relational and direct financial relationship between a doctor’s office and a patient. It creates a relationship between the doctor and patient that is affordable, accessible, convenient, and relational.

It really goes back to old-fashioned healthcare; you know, if we think about Andy Griffith, you don’t think of that doctor going into Aunt Bea’s home and asking:

“Are you Medicare eligible?” and “What kind of insurance does Opie have?”


“Doctors say that they are tired of having a better relationship with their keyboard than their patients…and getting paid $4 for filling out pages and pages of paperwork.

So there’s a traditional primary care setting out there that is very unattractive, ugly, and [for many doctors]not working. Direct primary care fosters a better relationship between doctor and patient – but without a lot of paperwork and administrative overhead. A lot of these offices carry only 1 or 2 employees.”

STEVE: “Dr. Qamar, you took an interesting approach with MedLion in that you took DPC – not just from a single clinic growing in a locality. Rather, you decided to take an approach to grow wide. Please explain what made you come to this decision.”

DR. QAMAR: “Back in 2008, in the town of Monterey, many of our patients could no longer afford care – as a number had lost their jobs to the economy. My wife had a primary care practice that was being tremendously affected – and we had to make a change.

Separately, I had an existing concierge care practice that carried perhaps the highest charges in all of the country. Despite the effects of the economy on my wife’s practice, my practice continued to flourish.

It dawned on me that concierge care found a way to charge subscriptions for primary care…with a few bells and whistles. So why not scale down those fees, to something affordable for everyone, and get into a different market altogether?

That became the impetus to start MedLion.



 I have had the privilege and pleasure of working with Steve Ambrose on a podcast that covered a range of topics in healthcare information technology. The podcast logistics – communications, interview questions, scheduling and production – were every well managed.
A great experience that I would do again in an instance.

Dr. John Glaser
SVP, Population Health at CERNER

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