Belt Nicholas G, Lee Austin, Mistovich R Justin, Hertz Andrew
Medicine, Case Western Reserve University School of Medicine, Cleveland, USA.
Orthopedic Surgery, MetroHealth Medical Center, Cleveland, USA.
Cureus. 2025 May 27;17(5):e84903. doi: 10.7759/cureus.84903. eCollection 2025 May.
Introduction Direct primary care (DPC) is an emerging healthcare model emphasizing patient-centered care, reduced administrative burden, and enhanced physician satisfaction. While DPC has gained traction among pediatricians, limited data exist on the distribution, characteristics, and satisfaction of pediatric DPC practices. This study aims to provide a national overview of pediatric DPC practices, describe physician demographics and motivations, and evaluate satisfaction among DPC physicians. Methods We conducted a cross-sectional survey of US-based pediatricians practicing in the DPC model to assess physician demographics, practice characteristics, and satisfaction. A 19-section survey was developed in consultation with pediatric DPC leaders and piloted within the Zest Pediatric Network. It was distributed on July 11, 2023, via the "Pediatricians Who Do DPC" Facebook group, practice websites, and direct outreach. Physicians were eligible if ≥75% of their panel was pediatric and their practice was operational. Descriptive statistics were calculated, and satisfaction between current and prior roles was compared using a two-tailed t-test (p < 0.05). Analyses were performed using Microsoft Excel. Results The analysis included 73 pediatric DPC physicians across 26 states. Most practices were single-doctor models (85%), located in suburban settings (73%), and managed small patient panels (<200 patients: 79%). Physicians reported high satisfaction; 94% were happier in DPC than in prior roles, citing reduced moral injury (89%) and improved work-life balance. While 73% of physicians earned less in DPC initially, 65% with practices ≥3 years old reported incomes similar to or greater than prior positions. Physicians cited meaningful patient relationships, greater autonomy, and improved work-life balance as key benefits. Key challenges included financial uncertainty, marketing burdens, and isolation. Conclusions Pediatric DPC offers significant benefits, including high physician satisfaction and reduced administrative burden, despite initial financial challenges. As practices mature, financial viability improves, suggesting long-term sustainability. Future research should evaluate patient outcomes, financial accessibility, and strategies to support new practices.
引言 直接初级保健（DPC）是一种新兴的医疗模式，强调以患者为中心的护理、减轻行政负担并提高医生满意度。虽然DPC在儿科医生中越来越受欢迎，但关于儿科DPC实践的分布、特征和满意度的数据有限。本研究旨在提供全国范围内儿科DPC实践的概述，描述医生的人口统计学特征和动机，并评估DPC医生的满意度。方法 我们对采用DPC模式执业的美国儿科医生进行了一项横断面调查，以评估医生的人口统计学特征、实践特征和满意度。在与儿科DPC领导者协商后制定了一份包含19个部分的调查问卷，并在Zest儿科网络内进行了试点。该问卷于2023年7月11日通过“从事DPC的儿科医生”Facebook群组、实践网站和直接外联进行分发。如果医生的患者群体中≥75%为儿科患者且其诊所正在运营，则符合参与条件。计算描述性统计数据，并使用双尾t检验（p < 0.05）比较当前角色与先前角色的满意度。使用Microsoft Excel进行分析。结果 分析包括来自26个州的73名儿科DPC医生。大多数诊所采用单医生模式（85%），位于郊区（73%），管理的患者群体较小（<200名患者：79%）。医生报告了较高的满意度；94%的医生在DPC模式下比在先前角色中更快乐，原因是道德伤害减少（89%）和工作与生活平衡得到改善。虽然73%的医生最初在DPC模式下收入较低，但65%运营3年及以上的诊所报告收入与先前职位相当或更高。医生认为有意义的患者关系、更大的自主权和改善的工作与生活平衡是主要益处。主要挑战包括财务不确定性、营销负担和孤立感。结论 尽管最初存在财务挑战，但儿科DPC提供了显著的益处，包括医生满意度高和行政负担减轻。随着诊所的成熟，财务可行性提高，表明具有长期可持续性。未来的研究应评估患者结局、财务可及性以及支持新诊所的策略。
