Your Guide to Direct Primary Care in San Diego
Quick answer: Direct Primary Care (DPC) is a simple healthcare model where you pay your provider one flat monthly fee — at Pacora, $100 a month for adults — and get direct access to your care team for your everyday health needs. DPC is not insurance and does not replace it: it covers your primary care, while a health plan still handles hospital stays, surgeries, specialists, and emergencies. Many people in San Diego pair DPC with their existing health plan.
The simple definition of Direct Primary Care
The American Academy of Family Physicians (AAFP), the national body for family doctors, describes direct primary care as a model where patients pay their provider or practice directly through regular payments for a defined set of primary care services. In plain terms: you pay a predictable monthly fee, and that covers your everyday primary care.
The AAFP notes these practices often give patients enhanced access compared with a traditional office — things like longer visits and real-time communication with your own provider. A DPC practice is funded by your flat fee, not by billing insurance for each visit. Removing that per-visit billing reduces the administrative work that fills a traditional office's day and eases the pressure to pack the schedule — which is what makes longer appointments and same-day access realistic.
“Primary care” simply means the everyday, front-line medical care most of us need: annual check-ups, help when you're sick, managing ongoing conditions like high blood pressure, and preventive care that helps keep small issues from becoming big ones.
Why the traditional model can feel rushed
To understand why DPC exists, it helps to look at the math behind a typical primary care office. In the traditional model, a practice bills insurance for each visit, and to stay financially healthy, providers often care for very large numbers of patients.
Research on “panel size” — the number of patients one provider is responsible for — shows how heavy that load has become. Studies estimate the average traditional primary care provider manages roughly 2,000 to 2,500 patients or more, and one widely cited analysis calculated it would take about 21 to 27 hours in a single day to deliver all recommended care to a panel of 2,500 people (peer-reviewed research via NIH / PMC). That's not a criticism of anyone — it's simply an impossible amount of work, and a big reason visits can feel short and appointments hard to book.
Direct Primary Care changes that equation. Because the practice isn't billing insurance for each visit, providers can keep much smaller patient panels and spend real time with each person.
How DPC is different from a traditional practice
- Smaller patient panels. DPC providers typically care for a few hundred patients rather than a few thousand.
- Faster access. Same-day and next-day sick visits become realistic rather than rare.
- Direct communication. You can often reach your care team by phone, message, or video between visits.
- Predictable pricing. You know your monthly cost up front, with no surprise bills.
- Time to be thorough. Longer visits leave room to talk about the whole picture — not just today's single symptom.
How Direct Primary Care works, step by step
- You join. You enroll directly with the practice and meet your care team.
- You pay one flat monthly fee. It covers your primary care — office visits, sick visits, telehealth, and communication with your care team.
- You get care. You see your provider when you need to, with longer visits and easier scheduling.
- Insurance covers the big stuff. For anything beyond primary care — a hospital stay, surgery, or specialist — your insurance handles it.
What's included at Pacora
We're a general adult primary care practice in Mission Valley, San Diego, serving patients 18 and older. Your $100 monthly fee is designed to cover the everyday care most adults need, including same-day sick visits for acute concerns:
- Annual wellness visits, chronic disease management, preventive care, and cancer screening based on national (USPSTF) guidelines
- Same-day and next-day sick visits for colds, infections, and minor injuries
- Women's health and men's health, including well-woman services
- Weight-loss management, nutrition, and lifestyle medicine
- Mental and behavioral health
- Minor wound care, dressing changes, simple suturing, and suture removal
- Telehealth for California patients, plus direct communication with your care team between visits
A handful of more involved in-office procedures — for example complex wound care, incision and drainage, cryotherapy, and certain joint or trigger-point injections — carry a small additional charge because they require extra materials. When one applies, we tell you the price before we proceed, so there are no copays or surprise bills for your care.
What does Direct Primary Care cost?
At Pacora, adult care is one flat $100 per month. You're paying for access and time, not a fee for every single visit. Most healthy adults won't need to see their provider often — the value for many is the peace of mind of knowing they have a provider they can call, message, or see quickly the moment something comes up.
We also offer a college semester option at $75 per month, locked in for the semester. For parents, that can offer real peace of mind when a student is away at school.
Important: DPC is not insurance. Direct Primary Care is a flat monthly fee for primary care services. It is not health insurance and does not replace it. DPC covers your everyday care — not hospital stays, surgeries, specialists, or emergencies. A common approach is to pair DPC with a catastrophic or high-deductible health plan, so your routine care stays affordable and predictable while your plan protects you against major, expensive events.
Is DPC the same as concierge medicine?
Both charge a monthly fee, but they differ in how they handle insurance and cost.
| Feature | Direct Primary Care | Concierge medicine |
|---|---|---|
| Fees | Flat, lower monthly fee (often ~$100/month) | Higher retainer, commonly ~$2,000–$5,000 per year or more |
| Insurance billing for visits | Does not bill insurance for your visits | Often still bills insurance in addition to the retainer |
| Copays / deductibles on visits | None | May still apply |
| Typical positioning | Affordable neighborhood primary care | Premium or luxury service |
Table 1. How DPC and concierge medicine typically compare. Source: MDVIP; AAFP.
Concierge practices typically still bill your insurance for visits in addition to charging their retainer, so you remain inside the insurance system and may still owe copays and deductibles. Direct Primary Care keeps things simpler: one flat fee covers your primary care, and the practice doesn't bill insurance for your visits.
Who is DPC a good fit for?
- People who are self-employed, freelance, or run a small business
- Anyone without health insurance who wants affordable, predictable access to a provider
- Anyone paying cash or without a regular provider who wants a predictable monthly cost
- Small businesses that want to offer an affordable health benefit to their team
- Students who want quality care on a semester timeline — and parents who want them covered while away at school
- Anyone who simply wants more time with a provider who knows them
Where did Direct Primary Care come from?
DPC isn't a fad — it has been developing for two decades. The AAFP traces its roots to the early 2000s, when primary care providers began looking for a way to restore the direct doctor–patient relationship. One of the earliest well-known practices, Qliance, launched in Seattle in 2007, and by the early 2010s the term “direct primary care” had become widely used (AAFP Voices).
When to use home care, book a visit, or seek emergency help
DPC makes it easier to reach a provider, but knowing where to turn still matters. This is general guidance, not personal medical advice:
- Home care may be appropriate for mild, short-lived issues — a common cold, a minor scrape — that tend to improve on their own. A quick message to your care team can help you decide.
- Book a visit when symptoms last longer than expected, keep coming back, or interfere with daily life, or for routine needs like a check-up or a medication question. Same-day and next-day sick visits are often available.
- Seek urgent or emergency care for warning signs like chest pain, trouble breathing, signs of a stroke, severe bleeding, or a serious injury. In an emergency, call 911 or go to the nearest emergency department. DPC does not replace emergency care.
Frequently asked questions
Can I use my HSA or FSA to pay for DPC?
As of January 1, 2026, federal rules changed to allow many people to use HSA funds toward qualifying DPC fees. FSA eligibility depends on your specific plan, so check with your FSA administrator or tax professional.
Do I still need insurance if I have DPC?
Yes. DPC covers primary care; you still need insurance for hospital stays, specialists, and emergencies. Many members pair DPC with a catastrophic or high-deductible plan.
Is Direct Primary Care worth it?
For many people, yes. If you value same-day access, longer visits, and being able to reach your provider directly, the flat monthly fee often pays for itself in convenience and fewer urgent-care trips.
Can I cancel if my situation changes?
DPC is generally designed to be flexible rather than a long-term contract. At Pacora there are no cancellation penalties — we want you to stay because you're happy with your care.
Key takeaways
- Budget one flat monthly fee ($100/month for adults, $75/month for the college semester option) for your everyday primary care, with no copays or surprise bills.
- Keep a health plan alongside DPC — ideally a catastrophic or high-deductible plan — to cover hospital stays, surgeries, specialists, and emergencies.
- Use DPC for same-day sick visits, check-ups, and quick questions by phone, message, or video.
- Consider joining early, since smaller panels mean a practice can reach capacity and start a waitlist.
References
- American Academy of Family Physicians. Direct Primary Care (policy). aafp.org
- American Academy of Family Physicians (AAFP Voices). The History of Direct Primary Care. aafp.org
- NIH / PMC. Estimating a Reasonable Patient Panel Size for Primary Care. pmc.ncbi.nlm.nih.gov
- MDVIP. How Concierge Medicine Works With Insurance. mdvip.com
This article is for educational purposes and should not replace personalized medical advice. If you have concerns about your health, speak with a qualified healthcare professional.