Direct primary care makes complete sense as a concept. In the real world, of course, it's a bit more messy and complicated, especially within the confines of an employer's health plan, and finding the right pathway to achieve the desired results is sometimes tricky. Replacing the traditional entry point to a health care journey with a higher-performing primary care partner sounds ideal, up until the point when personal preferences and emotional bonds prove larger barriers than originally expected.

Related: Direct primary care: The key to cost savings and improved health?

The main arguments against the traditional primary care pathway include:

• Providers get paid on a fee-for-service basis, so they are rewarded for managing chronic conditions and have no financial incentive for simply curing a condition.
• Primary care providers have to see too many patients in a day to meet the needs of a huge patient "panel." Appointments are rushed, and rather than root-cause health care, only symptom-management is typically discussed.
• Primary care doctors often refer to specialists to protect from liability or malpractice claims.
• Upstream medical practices (i.e., more expensive providers such as hospitals) have purchased primary care providers to control the pathway to their services, and thus silently influence volume and referral patterns away from primary care treatment to their affiliated and more expensive providers and facilities.

The main value-propositions heralded by the DPC provider often include:

• Smaller patient "panels" equals more time spent with the patient (member).
• Money is spent to achieve wellness.
• Direct primary care is free from financial pressures and upstream interests.
• The DPC model focuses on a broader scope of services and refers to specialists less often.

So, yes, it's easy to see how the employer or consumer starts to recognize the advantages of this strategy. If the employer shifts their money from paying for services and instead moves that investment into a direct primary care relationship, their employees should get better care through a relationship with a provider who is compensated to focus more time on their employees and have fewer upstream referrals for testing and specialist interventions.