Doctors Are Voting With Their Feet: What the Surge in Concierge Medicine Really Means

By Michael Tetreault, Editor-in-Chief, Concierge Medicine Today
January 2026

Concierge medicine and direct primary care didn’t just grow over the past five years — they surged. According to newly published national research, the number of concierge and direct primary care practice sites in the United States increased by more than 80 percent between 2018 and 2023, with clinician participation rising at nearly the same rate.¹

Hang on. Haven’t we heard this before in the headlines?

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For some observers, this data triggered immediate concern about access, equity, and workforce redistribution. Those concerns deserve serious discussion. But the more important story is not what these models are doing to healthcare — it’s what healthcare conditions are driving physicians to seek alternatives in the first place.

THE NORMALIZATION OF BURNOUT

“The real threat to medicine isn’t concierge care—or any other membership or subscription-based practice model. It’s the normalization of physician burnout, and the quiet acceptance of systems that expect physicians to endure it as a cost of doing business. Reversing that trajectory requires less finger-pointing and more leadership. And leadership, by definition, begins with reflection—and action—within the healthcare profession at-large.”

— Editor-in-Chief, Concierge Medicine Today

This growth is not a marketing phenomenon. It is a system response.

A Market Signal, Not a Trend

When a sector grows more than 80 percent in half a decade, it stops being a niche experiment and starts becoming a market signal. Physicians are not migrating into concierge and membership-based care because it is trendy. They are doing so because traditional primary care has become increasingly difficult to sustain clinically, financially, and personally.

Flat or declining inflation-adjusted reimbursement, rising overhead, escalating documentation demands, and persistent administrative burden have placed unprecedented pressure on front-line clinicians.²³ At the same time, physician burnout remains widespread, contributing to early retirement and workforce attrition.⁴⁵

In this context, concierge medicine and direct primary care are not departures from responsibility. They are redesigns of delivery models that allow physicians to practice medicine with manageable panel sizes, longer visit times, and fewer non-clinical distractions.

For many clinicians, this shift is not about working less. It is about practicing longer.

Workforce Movement and Career Longevity

Critics often frame membership-based care as “pulling doctors away” from traditional practices. The data tells a more nuanced story. Many physicians entering concierge or DPC models were already contemplating retirement, administrative roles, or leaving medicine altogether.⁵ Smaller patient panels and reduced administrative complexity may extend career longevity and reduce early exits from clinical practice.

In other words, this shift may be stabilizing the workforce rather than shrinking it.

Primary care shortages predate concierge medicine by decades.⁶ The emergence of alternative practice models did not create these shortages — it highlighted structural vulnerabilities that have existed for years.

Corporate Ownership: Opportunity and Caution

One of the most notable findings in the new research is the dramatic increase in corporate affiliation among concierge and DPC practices. Corporate-affiliated sites increased more than five-fold between 2018 and 2023, while independent ownership declined.¹

This shift reflects the growing capital requirements of modern healthcare operations, including technology infrastructure, compliance complexity, and staffing costs. It also reflects physician demand for management support that allows them to remain clinically focused.

At the same time, this trend warrants careful attention. The strength of concierge and membership-based models has historically been relationship-driven care, clinical autonomy, and patient experience. Scaling these models without eroding those foundations will be one of the most important challenges facing the sector.

Team-Based Care Is Expanding

The research also shows a growing role for nurse practitioners and physician assistants within these models, rising from roughly one-quarter to more than 40 percent of the workforce.¹ This mirrors national workforce trends and reflects the continued evolution of team-based primary care.⁷

When properly integrated, advanced practice clinicians can expand access, improve continuity, and support physician sustainability. This shift is not replacement — it is redistribution of clinical capacity.

Access, Equity, and Policy Reality

Concerns about affordability and access deserve serious attention. Membership-based models serve fewer publicly insured and lower-income patients.¹ But this is not simply a business choice. It is largely a function of reimbursement structures that make traditional primary care financially unstable for many practices.

If policymakers want to improve access to primary care, the solution is not restricting innovative care models. It is addressing payment reform, administrative burden, and regulatory complexity that make frontline primary care increasingly difficult to sustain.

The underlying issue is not who is leaving the system. It is why the system is struggling to retain them.

The Bigger Picture

Concierge medicine and direct primary care are not universal solutions. They will not replace traditional primary care, nor should they. But their rapid growth sends a clear message: physicians are actively seeking models that prioritize sustainability, access, and human-centered care.

Healthcare does not need fewer delivery options. It needs better alignment between incentives, outcomes, and professional sustainability.

When physicians consistently choose models that allow them to practice medicine with time, dignity, and focus, it is not a fad. It is a structural signal that healthcare delivery is changing.

The real question is not whether concierge medicine will continue to grow.

The question is whether the broader healthcare system is willing to learn from what that growth is telling us.

References

1. Song Z, Zhu J, Marsh T, Polsky D, Huntington A. Growth and Characteristics of Concierge and Direct Primary Care Practices, 2018–2023. Health Affairs. December 2024.

2. Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Medicare Payment Policy. March 2024.

3. American Medical Association. 2023 Prior Authorization Physician Survey.

4. American Medical Association. National Physician Burnout Survey Results. 2023–2024.

5. Shanafelt TD, et al. Changes in Burnout and Satisfaction With Work-Life Integration. Annals of Internal Medicine.

6. Association of American Medical Colleges. Physician Supply and Demand Projections. June 2024.

7. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook: Healthcare Occupations.