THE POWER OF CHOICE: Why Direct Care Matters Today
Why Direct Specialty Care Is a Choice for Both Patients and Doctors
As a direct care advocate on a mission to save independent private practice, I’ve seen firsthand how the current system often gets in the way of simple, patient-centered care. Making the switch from insurance-based medicine to direct specialty care wasn’t an easy decision, but it became clear there was a better way. Let me share two real stories that helped shape this shift—and show how direct care benefits both patients and doctors.
The Frustration of Insurance-Driven Care
The Diabetic Wound
Several years ago, I was treating a patient with diabetes who developed a concerning ulcer on his lower extremity. As any specialist would, I wanted to do a thorough work-up even though I knew that he would need a surgical debridement (a procedure to remove infected tissue). I just wanted to determine how much of the soft tissue and if the bone was affected. The next logical step after my initial work-up in the office was to order an outpatient MRI to delineate the extent of infection. But when I submitted the request for an outpatient MRI, the insurance company denied it.
Instead of quickly getting the imaging and moving forward with care, the insurance company wanted me to attempt local conservative (non-surgical) wound care; however, in my judgement and experience, waiting to debride could lead to further spread of the infection and potential loss of limb.
I had to send my patient to the emergency room. Only then, after hours of waiting and a costly hospital admission, did he get an MRI and I consulted to re-evaluate (even though I already knew the case) before being able to schedule and perform the procedure.
The wound was finally treated —but at what cost?
The patient lost precious time, endured unnecessary stress, and the system racked up a much higher bill for something that could have been handled more efficiently and compassionately in an outpatient setting.
This wasn’t just frustrating—it was a wake-up call. My patient was angry, and rightfully so. He was stuck dealing with delays, surprise bills, and no real say in his own care. It was clear his needs weren’t part of the equation. What’s wild is that the same patient who was so fed up with the system ended up becoming one of my biggest supporters when I made the switch to direct care. He got it—because he lived it!
The Direct Care Alternative
A Fractured Foot
Here’s another real example from my direct specialty care practice.
One morning, a patient texted me—she’d dropped something heavy from her freezer onto her foot and was worried it might be fractured. After talking to her, I told her to come in. She came in that same day. We did the exam, got the imaging, and handled everything right there. Complete price transparency with every step. No waiting, no referrals, no hassle.
If she’d gone the traditional route, she probably would’ve ended up in the ER or scrambling to get in with her primary care doctor—neither of which guarantees same-day care. And even if she was seen, there’s a good chance she’d be sent to a specialist anyway, adding more time, more costs, and more runaround.
In my practice, care is available when patients need it, accessible without all the red tape, and affordable with clear, upfront pricing. No surprise bills, no delays, no confusion—just timely care from someone who already knows them.
Why I Chose Direct Specialty Care
These are just two scenarios why I chose to practice outside the insurance system. (Honestly, it is the way, that I would want to be treated.)
In direct care, I can focus on what really matters: timely, transparent, and personalized care. I’m not forced to make decisions based on what an insurance company will approve, but on what my patient actually needs.
And here’s something important: more than 80% of my patients still have health insurance, and nearly 40% have Medicare. They choose to see me because they value the relationship, access, and clarity that direct care provides. Insurance still has a place-for hospitalizations, emergencies, and care outside my scope-but for specialty care and ongoing outpatient management, direct care is a powerful alternative.
Think of healthcare like education: we have public schools, private schools, and charter schools. Each serves a different purpose, and families choose what fits their needs. Direct care isn’t about replacing insurance-it’s about giving you another option. You can use insurance for major events and direct care for ongoing, personalized specialty care. This “both/and” approach puts you in control.
You Have Choices
Participating in health insurance is a choice. So is joining a direct care practice. Direct primary care (DPC) and direct specialty care (DSC) empowers both patients and doctors to cut through bureaucracy, reduce costs, and focus on what matters most-your health.
If you’re tired of waiting, frustrated by red tape, or just want a more personal relationship with your doctor, know that you have options. Direct care is here for you, and it’s changing the way healthcare works-one patient at a time.
The number of physicians who are now practicing in a direct care model has exponentially grown in the last 10 years. There are several organization that are available to the general public, accessible with resources, and affiliated with members who support direct care and are all willing to talk to anyone who is interested in exploring this model. These include the Direct Primary Care Alliance and the Direct Specialty Care Alliance. Additionally, other organizations such as the Free Market Medical Association, the Association of American Physicians & Surgeons, Docs4Patient Care, Rosetta Health and Hint Health, sponsor meetings that support direct care and the doctors and patients who work in this alternative healthcare ecosystem.