What most physicians get wrong about direct primary care, with Josh Umbehr, M.D.
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A direct primary care pioneer breaks down what the model actually costs, why the practices charging the least tend to earn the most and why he believes insurance-based primary care is closer to collapse than most physicians think.
Direct primary care has been around long enough that most physicians know the pitch: drop the billing, charge a monthly membership, keep a smaller panel and spend real time with patients. What takes longer to answer is whether the economics hold up once you're in it.
Josh Umbehr, M.D., co-founder of Atlas MD in Wichita, Kansas, moved into DPC straight out of residency in 2010 and has spent the years since helping other physicians make the same jump. He joins the show to walk through the real math of a DPC practice, what happens when a patient needs a specialist and why he thinks the window for insurance-based primary care is closing fast.
Music Credits:
Distant Memories by Buurd - stock.adobe.com
A Textbook Example by Skip Peck - stock.adobe.com
Editor's note: Episode timestamps and transcript produced using AI tools.
0:00 Cold open: putting the hospitality back in health care
0:22 Introduction
1:44 How Umbehr found direct primary care
3:40 The basic math of a DPC practice
6:38 Panel size, and why bigger isn't the goal
8:11 Setting prices and the good-better-best tradeoff
11:18 What low overhead actually looks like
13:50 Specialists, imaging and hospitalizations
17:38 P2 Management Minute with Keith Reynolds
18:47 The honest timeline and runway to convert
22:31 What AI changes about primary care
26:38 The biggest misconceptions physicians have
29:42 How patient relationships change in DPC
32:34 Where DPC is headed, and 'peak insurance'
34:18 Closing thoughts