Primary care in the United States is undergoing a significant transformation driven by rising costs, physician burnout and changing patient expectations. Traditionally, primary care has operated under a fee-for-service (FFS) model, where providers are reimbursed through insurance for each visit or procedure. While this system has long been the backbone of health care delivery, it has increasingly revealed its limitations. Administrative burdens, short appointment times and fragmented care have led many clinicians (and their patients) to seek alternative approaches that prioritize quality over quantity.
As a physician’s assistant (PA), my perspective on this shift is shaped by both personal and professional experience. I have lived in the Coachella Valley for 41 years and have worked as a PA since 2009. My clinical background spans emergency medicine, urgent care, and primary care—settings that have given me a broad view of how patients interact with the health care system. Through my private primary care practice, I have seen both the shortcomings of the traditional model and the promise of newer approaches.
One of the leading factors driving change in health care is the growing burden of chronic disease, which requires consistent, relationship-based care. Unfortunately, the traditional model often limits providers to brief visits that make it difficult to address complex, ongoing health issues. At the same time, clinicians face increasing administrative responsibilities tied to insurance billing, coding and prior authorizations. These pressures not only reduce time spent with patients but also contribute significantly to provider burnout.
In response, innovative models such as direct primary care (DPC) have emerged as a compelling alternative. DPC is a membership-based model in which patients pay a flat monthly fee directly to their provider in exchange for a defined set of primary care services. By removing insurance from routine care, this model allows providers to focus on what matters most: the patient relationship. In my own practice, this has translated into longer visits, improved access, more meaningful interactions with patients, and more favorable patient experiences.
From a provider standpoint, DPC offers a more sustainable way to practice medicine. It reduces overhead, simplifies operations and allows for a smaller patient panel, which improves both quality of care and work-life balance. From the patient perspective, the benefits are equally clear: better access to care, often with same-day or next-day appointments, and greater transparency in pricing without the confusion of copays or deductibles.
Another important advantage of DPC is its emphasis on prevention and whole-person care. With more time available, providers can focus on lifestyle changes, early intervention and long-term health planning rather than simply treating acute issues. This approach not only improves individual outcomes but also has the potential to reduce overall health care costs.
Despite its many benefits, DPC is not a complete replacement for traditional insurance, which can still be used for labs, imaging and specialist care. Additionally, because providers typically care for fewer patients, questions about scalability and access remain. However, these challenges do not diminish the value of the model; they simply highlight the need for continued innovation.
Primary care is clearly evolving, and DPC represents a meaningful step forward. By aligning the interests of patients and providers, reducing administrative burden and restoring the focus on relationships, DPC offers a model that is both practical and patient-centered.
Based on my experience in the field and in our growing community, this approach holds significant promise for the future of health care.
Matthew Keane is a certified physician’s assistant and the owner and primary care provider of WellHealthe Primary Care serving the Coachella Valley. He can be reached at (760) 333.1155 or matthew@wellhealthe.com.
Sources: 1) https://www.aafp.org/family-physician/practice-and-career/delivery-payment-models/direct-primary-care.html; 2) https://www.healthinsurance.org/glossary/direct-primary-care/; 3) https://www.medicaleconomics.com/view/how-pay-first-and-direct-primary-care-models-are-reshaping-practice-finances-and-patient-experience; 4) https://pmc.ncbi.nlm.nih.gov/articles/PMC8352511/; 5) https://www.forbes.com/sites/saibala/2025/12/25/primary-care-providers-are-increasingly-moving-to-direct-and-concierge-care-models/
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