KevinMD November 22, 2025
Even the most “affordable” DPC models struggle in lower-income markets because the behavioral economics of these populations create high churn and unstable revenue. Practices that succeed in underserved areas nearly always diversify into employer partnerships, institutional contracts, or expansion into higher-income neighborhoods. Without understanding these behavioral and economic realities, physicians risk building a model the community cannot sustain long-term.
I previously argued that physicians must answer five market questions before launching DPC, questions that could have saved the University of Houston’s $1 million DPC clinic from closing after 13 months.
Today I’m examining a harder truth: even “affordable” DPC at $50–75/month faces hidden economics in lower-income markets. And the practices that succeed in these communities do so because they fundamentally...
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