KevinMD December 23, 2025
I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with her on one essential point: No care model works equally well for everyone.
Where I part company with her argument is not in the experiences she describes (which are real and important) but in the conclusion she draws from them. In critiquing DPC, she implicitly treats it as equivalent to private-pay...
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