Guide
Direct Primary Care vs. Concierge Pediatrics: What's the Difference?
The short version
Direct Primary Care (DPC) pediatricians charge families a flat monthly membership and do not bill insurance for the care they provide. The membership is the payment for the pediatrician's all of the pediatrician's time, communication, and visits.
Concierge pediatricians also charge a membership , but they still bill your insurance for visits on top of that fee. The membership pays for the access to the doctor, with the medical care running through insurance as usual.
| Direct Primary Care | Concierge | |
|---|---|---|
| Monthly membership | Yes | Yes |
| Bills insurance | NO | Yes, typically |
| Visit copays / coinsurance | NO | Yes- varies by insurance |
| Panel size (patients per doctor) | Small (less than a few hundred) | Small to moderate |
| Direct access to your pediatrician | Yes | Yes |
| Best for | Families who want access to a great pediatrician, continuity of care, and transparent pricing. | Families who want to keep insurance-billed care but with more access |
Why DPC pediatricians opt out of insurance
Insurances reward volume. To be able to be a profitable practice, doctors typically need to see many patients a day for a short amount of time, and spend significant time on documentation aimed at billing codes. This is not in alignment with what is important to me as a pediatrician or my patients. We both want more time with each other. More time talking and getting to know what is really going on home, at work, or at school. With DPC, I am able to have a much smaller panel, typically up to around 200 patients compared to 1500-2000 patients in an insurance model. This allows me to get to know my patients and understand their needs for a healthier family and home.
Common questions
Do I still need health insurance with a Poppy Pediatrics membership?
Yes. The membership covers the care provided by Dr. Landsman (visits, texting, emails, well child visits), while insurance is important for specialty care, labs, imaging, ER and hospital care if needed. This membership pairs well with a higher deductible plan used for those situations.
Can I switch to a DPC pediatrician if my child sees specialists?
Yes. Dr. Landsman would be a great resource to have to help coordinate specialist recommendations. The specialists bill your insurance as they normally would.