Nov. 22, 2025

Why bad math (not ideology) is killing DPC clinics

Health care strategist Dana Y. Lujan discusses her article "." Dana argues that the DPC community's obsession with "purity" is missing the point, stating that these models don't fail over ideology, they fail because of bad math. She uses the...

Health care strategist Dana Y. Lujan discusses her article "Why direct primary care (DPC) models fail." Dana argues that the DPC community's obsession with "purity" is missing the point, stating that these models don't fail over ideology, they fail because of bad math. She uses the University of Houston's $1 million clinic failure as a prime example of a "fundamental market mismatch," where a DPC model was placed in a low-income area that couldn't sustain its membership fees (a ~70 percent revenue deficit). Dana also debunks the myth that institutions can't run successful DPC programs, citing CHI Health and Johns Hopkins as proof that financial sustainability and market fit are the true keys. This episode explores the critical difference between what's legally permissible and what's operationally sustainable, and why the DPC conversation must shift from philosophy to execution. Learn why you cannot "subscription-model your way out of poverty."

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