Exclusive Interview with the Researcher: Jane Zhu on Primary Care

Exclusive Interview

A new study, published in Health Affairs, analyzes the rapid growth in concierge and direct primary care (DPC) practices in the United States. The work was conducted by researchers at Oregon Health & Science University, Harvard Medical School, and Johns Hopkins University. Learn more in this exclusive interview with author Jane Zhu, MD: 

Q: What surprised you the most about your study findings?

A: Two findings were particularly notable. First, while this wasn’t a census and likely underestimates concierge and DPC practices nationally, we observed an impressive speed of growth over a 5 year period. This growth mirrors what we’ve been seeing on the ground, with significant interest from clinicians and patients alike on these models. Second, I was surprised to see growth in corporate ownership of these practices. In theory concierge and DPC models are direct responses to rising corporatization and reduced clinical autonomy - a way for clinicians to go back to the foundations of clinical care and to take medicine back. So in some ways this ownership shift may run counter to those principles and is worth monitoring over time. 

Q: What does the growth of concierge and direct primary care models mean for primary care workforce shortages and patient access to care?

A: In many ways, the rise of concierge and direct primary care models reflect dissatisfaction with traditional primary care, which faces persistent workforce shortages and access constraints. They also address a simple and real demand in the market - people are willing to pay for more personalized care and better access. These models offer clear benefits to clinicians: smaller patient panels, reduced administrative burden, greater autonomy, and may also improve access and satisfaction for enrolled patients. These are positive things! At the same time, their implications for system-wide access remain uncertain and likely vary by model and market. And the potential for unintended spillover effects may widen if these models scale, particularly if we can’t expand the primary care workforce simultaneously as clinician participation increases. As these approaches expand, a key question is whether they ultimately increase overall primary care capacity or simply reallocate care toward patients who are able to access these models.