Patients ask me this all the time. What's the difference between direct primary care (DPC) and concierge medicine, and which one fits me? Both react to the same problem (traditional primary care is rushed, fragmented, and hard to reach when you actually need it), but they solve it differently. The choice between them isn't a coin flip; it depends on what you actually need from a primary care physician.
TL;DR
- DPC = monthly fee ($50-$200/mo) paid directly to physician, panel typically 400-800 patients, no insurance billing for primary care, longer routine visits. Doesn't cover specialists, hospital, imaging, or most prescriptions.
- Concierge = annual membership ($1,500-$25,000+/yr), panel typically 300-600 (this practice: 50), longer visits, same-day access, after-hours direct contact, hospital and specialist coordination. Some practices still bill insurance; some (this one) are private-pay.
- DPC fits: generally healthy adults who want better routine primary care at a low price, paired with a high-deductible plan or health share for everything else
- Concierge fits: complex chronic conditions, aging-parent care, demanding schedules, snowbirds with cross-state needs, anyone who wants a physician embedded in their care
- To reach the practice: call 561-468-6981
What direct primary care is
DPC practices charge a monthly fee, usually $50 to $200, paid directly to the physician. No insurance billing for primary care services. The doctor keeps a smaller panel than traditional practice (commonly 400 to 800 patients), which allows longer visits and same- or next-day appointments.
What the membership typically covers: routine primary care visits, basic preventive care, often some in-office labs, simple procedures, and (in some DPC practices) wholesale-priced prescription dispensing. What it doesn't cover: specialists, hospital care, advanced imaging, ER visits, or most pharmacy-acquired prescriptions.
The DPC origin story is worth knowing. The model emerged in the early 2000s as a deliberate decoupling from insurance reimbursement. The physician's fee is direct; insurance has no say in what gets covered or how long a visit lasts. Many DPC practices contract with employers to provide primary care to employees as a benefit, which has driven much of the model's growth.
DPC fits generally healthy people who want more time with their doctor and are willing to pair it with a high-deductible plan or a health share for everything else.
What concierge medicine is
Concierge practices charge an annual membership. The range is wide, roughly $1,500 to $25,000 a year, depending on what's included. The fee pays for access and the physician's time. Most concierge doctors still bill insurance for services insurance covers. I don't. My practice is private-pay, which keeps the relationship simple and keeps me accountable to you rather than to an insurance company. (Full breakdown of how concierge tiers work and what each costs.)
What that buys in my practice: I cap at 50 patients. That's much smaller than a typical concierge panel and a fraction of DPC. Appointments run 30 to 60 minutes, sometimes longer. You get my cell phone. Text or call, any hour, and you reach me. Same-day visits are the norm, including house calls across Palm Beach County. I handle specialist coordination, hospital follow-up, and imaging or lab logistics so you don't have to.
How the two models compare
The meaningful differences come down to panel size, access, and scope.
| Traditional | DPC | Concierge | |
|---|---|---|---|
| Panel size | 2,000 to 3,000 | 400 to 800 | 300 to 600 (this practice: 50) |
| Appointment length | 10 to 15 min | 20 to 30 min | 30 to 60+ min |
| Same-day visits | No | Often | Yes |
| After-hours direct contact | No | Varies | Yes (cell, 24/7) |
| House calls | No | Rare | Standard in this practice |
| Specialist coordination | No | Limited | Yes, handled by physician |
| Hospital involvement | No | No | Yes (this practice attends at Boca Regional) |
| Insurance billing | Yes | No | Varies (this practice: no, private-pay) |
| Cost (typical) | $0 to copays | $50 to $200/mo | $125 to $2,000+/mo |
DPC gets you more time and easier access for routine primary care at a low price. Concierge adds same-day access, direct physician contact around the clock, a much smaller panel, and care coordination that extends into hospital, specialist, and home. It costs more because there's more of the physician per patient.
Which one fits you
A few honest questions.
Do you mainly need a better primary care experience, or do you need a doctor who can actually navigate the system with you when things get complicated? If it's the first, DPC probably does the job. If it's the second, concierge is closer to what you're looking for. Think chronic conditions, aging parents, frequent specialist needs, a schedule where you can't spend half a day on hold.
Can you accept that your DPC doctor likely won't be rounding on you if you're admitted, won't be calling your cardiologist directly, and won't be at your house at 9 p.m. when your spouse spikes a fever? If that gap matters to you, it's a concierge question.
Do you split time between two states? DPC works less well for snowbirds because the model assumes the patient and doctor are in the same geography year-round. Concierge practices that handle snowbirds (like this one) build the cross-state coordination into the relationship. (How concierge medicine works for snowbirds specifically.)
Is your situation low-complexity now but might not stay that way? Mid-life is when chronic disease typically arrives. DPC handles routine care well; concierge handles complexity well. The right answer can shift over time.
When DPC stops being enough
Some patterns I've seen in patients who started in DPC and moved to concierge:
- A new diagnosis (cancer, heart failure, autoimmune disease) that suddenly requires multi-specialist coordination
- Aging parents who became the patient's responsibility, requiring weeknight and weekend access for clinical questions
- A career inflection (executive role, board seat, surgeon practice) where the consequences of being out for an avoidable acute issue became severe
- Snowbird transition (selling the home up north, splitting time more evenly between two states)
- Frequent travel for work where having a physician reachable from anywhere became important
DPC is a real improvement over traditional care; it's not always a permanent destination.
Questions worth asking either kind of practice
- How many patients does the physician actually carry today (not the cap, the current number)?
- Who answers calls after hours, and how fast?
- What's in the fee and what costs extra (labs, in-office procedures, after-hours visits)?
- If you get hospitalized, what does your doctor do?
- Does the practice still bill insurance for any services?
- How long has the practice operated this way?
A practice that's comfortable with how they operate will answer all six directly. (Full criteria for evaluating any concierge practice.)
Frequently Asked Questions
Is DPC always cheaper than concierge?
On a per-month basis, almost always. DPC typically runs $50 to $200/month while concierge runs $125 to $2,000+/month. The honest comparison isn't the membership fee in isolation, though; it's the total cost including what each model doesn't cover. DPC patients still need insurance for hospital, specialists, and imaging. Concierge patients also keep insurance for those. The right framing is "what does my actual healthcare cost per year, and how much avoided ER/specialist friction does the membership offset?"
Can I have both DPC and concierge?
You generally wouldn't, because they're solving the same primary-care problem. Some patients pair DPC for primary care with a separate concierge service (or executive physical) at a hospital system; that's two memberships solving overlapping needs. Most patients pick one model or the other and use insurance for everything outside it.
Does DPC accept Medicare?
Most DPC practices have opted out of Medicare entirely (the model requires it for the direct-pay structure). That doesn't mean Medicare patients can't use DPC; they can, by paying the membership and continuing to use Medicare for hospital, specialist, and imaging care. If you're on Medicare, ask any DPC practice specifically about their opt-out status before joining. (How concierge medicine works alongside Medicare specifically.)
Is concierge better than DPC?
Not universally. Concierge offers more (smaller panel, after-hours direct contact, hospital and specialist coordination), and it costs more for that reason. For patients with simple needs, DPC may deliver more value per dollar. For patients with complex needs or demanding schedules, concierge often pays for itself in avoided system friction.
What's the difference between concierge and "executive physical" programs?
Executive physical programs (often offered by hospital systems) are typically a single annual event: a one-day workup, lab panel, and report. Concierge medicine is an ongoing relationship; the executive-level physical is the baseline visit, but the value is in the year-round access and coordination. (What an executive-level physical actually includes when delivered through concierge primary care.)
What's the difference between concierge and MDVIP?
MDVIP is the largest national concierge network, structured around a per-patient annual fee. Independent concierge practices (like this one) operate on the same general model but with different panel sizes, fee structures, and clinical approaches. (Detailed breakdown of MDVIP vs independent concierge tradeoffs.)
Is there such a thing as a hybrid model?
Some practices combine concierge-style access with insurance billing for covered services (the membership covers access and time; insurance pays for the medical services). That's what most concierge practices do. Pure private-pay (membership-only, no insurance billing) is less common. Both models work; the choice usually comes down to whether you want insurance involved in your physician relationship at all.
Where I come out
DPC is a real improvement over traditional primary care for people whose needs are relatively straightforward. Concierge is a different category. It's built for people who want a physician embedded in their health and available when it matters, not just when the schedule allows. Neither is universally better. The right answer depends on how complex your life is, how much the access actually changes the way you'd use medicine, and what you can afford.
About the Author
Dr. Ben Soffer, DO is a board-certified physician practicing concierge primary care in Boca Raton, Florida. He caps his practice at 50 patients, which puts his practice on the smaller-panel end of the concierge tier and well below typical DPC panels.
If you want to talk through which model fits you
A no-obligation conversation about your specific situation, including the honest answer about whether DPC or a conventional plan would serve you better than concierge.
- Call: 561-468-6981
- Email: info@drbensoffer.com
- Or reach out through the contact form
