Pediatricians in direct primary care report less burnout, greater satisfaction, despite early pay cuts

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A new national survey of pediatricians practicing in direct primary care (DPC) paints a picture of smaller panels, solo practices and long hours — but also of physicians who are happier, less burned out and more connected to their patients.

In the first large-scale look at pediatric DPC nationwide, researchers surveyed 73 doctors across 26 states and found that nearly all (94%) say they’re happier in their current role than they were in traditional practice. Most operate solo, see fewer than 200 patients and run clinics with little or no support staff. Despite financial uncertainty in the early years, many say they’re not looking back.

“Nearly all physicians reported being happier in their DPC practice than in their prior job,” the study authors wrote. “Physicians cited meaningful patient relationships, greater autonomy and improved work-life balance as key benefits.”

The findings, published May 27 in Cureus, offer a national snapshot of a growing care model that’s gaining attention as a possible antidote to physician burnout — particularly among pediatricians looking for more control over their practice and their time.

Small panels, big impact

The majority of practices surveyed were lean by design. Eighty-five percent were single-doctor offices and 47% had no support staff at all. Most were located in suburban or rural areas, and 79% cared for fewer than 200 patients. Panel size grew with practice age, but the average remained well below traditional models.
That low-volume approach — enabled by DPC’s membership-based structure — lets doctors spend more time with each family, skip insurance billing and keep overhead low.

Pay drops early, but rebounds later

Financially, DPC remains a mixed bag, especially in the early stages. Roughly 73% of respondents said they earned less in DPC than in their previous role. Among those whose practices had been open at least three years, 65% said their income was the same or higher.

Monthly fees ranged from $25 to $400, with most practices charging between $101 and $150. Seventy percent of surveyed physicians said they provide care for children insured by Medicaid. Many also offer home visits, on-demand services and in-house lab testing — benefits that aren’t always covered in traditional fee-for-service pediatric care.

Happiness and healing

Asked to compare their emotional well-being in DPC to previous roles, 94% of pediatricians said they were happier, and more than half (53%) described themselves as “far more happy.” Just one respondent said they were less happy.

Physicians also reported dramatic drops in moral injury. Eighty-nine percent said they felt less or far less of it than before. None said it had gotten worse.

Vacation time was another area of improvement. Among those whose practices had been open for longer than a year, 40% said they now take four weeks off annually, and 59% felt that amount was “about right.”

When asked if they’d ever consider going back to fee-for-service pediatrics, only two respondents said yes.

Still, pediatric DPC isn’t without its challenges. In open-ended responses, doctors cited financial uncertainty, marketing responsibilities and the loneliness of running a solo practice as common hurdles. Many said the first year is particularly hard, with unpredictable patient growth and startup costs.

Compared to adult-focused DPC practices, pediatric models tend to have smaller panels, higher monthly fees and more frequent home visits. Because of those differences, the authors suggest distinguishing pediatric DPC as its own category — “Direct Pediatric Care.”

They also call for additional research into the long-term outcomes of these practices and whether they’re truly accessible to lower-income families.

For now, the data points to a model that offers relief from many of the pressures facing today’s pediatricians. For many doctors, smaller panels, deeper relationships and more autonomy may be worth the trade-offs.