Direct Care: Medicine the Way It Should Be - Integrative Medicine Functional Medicine Membership San Antonio TX
- John Kim
- Apr 22, 2022
- 11 min read
Updated: Dec 31, 2025
By Yoon Hang Kim MD MPH
updated 12/31/2025
About Dr. Kim
Dr. Yoon Hang "John" Kim is a board-certified integrative medicine physician with over 20 years of clinical experience. He completed his integrative medicine fellowship at the University of Arizona under Dr. Andrew Weil and holds certifications in preventive medicine, medical acupuncture, and integrative/holistic medicine. Through his telemedicine practice, Dr. Kim specializes in utilizing LDN or Low Dose Naltrexone for treating autoimmune conditions, chronic pain, integrative oncology, and complex conditions including fibromyalgia, chronic fatigue, MCAS, and mold toxicity. He is the author of three books and more than 20 articles, and has helped establish integrative medicine programs at institutions nationwide.
Professional: www.yoonhangkim.com | Clinical: www.directintegrativecare.com
Direct Care: Medicine the Way It Should Be - Integrative Medicine Functional Medicine Membership San Antonio TX
Direct Care: Medicine the Way It Should Be
Why membership-based medicine is transforming healthcare for physicians and patients alike
Healthcare in America has reached an inflection point. With insurance premiums projected to surge 6-9% in 2026—the steepest increase in fifteen years—and many families facing the prospect of paying $27,000 annually for employer-sponsored coverage, patients and physicians alike are searching for alternatives. Enter Direct Care: a model that strips away the bureaucratic barriers and returns medicine to its fundamental purpose—the direct relationship between physician and patient.
What is Integrative Medicine in Direct Care?
Direct Care means exactly what the name implies: a physician providing care directly to patients without anyone else interfering. No insurance company dictating what tests can be ordered. No prior authorizations delaying necessary medications. No five-minute visits squeezed between mountains of paperwork. Just a physician and a patient, working together toward a common goal.
The most well-known form of Direct Care is Direct Primary Care (DPC). The DPC Coalition reports that as of 2025, more than 2,300 DPC practices across 48 states serve over 300,000 American patients. The model has gained such momentum that 34 states have now enacted laws defining DPC as a medical service rather than insurance—freeing it from insurance regulations while providing consumer protections. DPC Nation, with its active Facebook community, has become a vibrant hub for physicians and patients navigating this transformative approach to healthcare.
During your first appointment in a Direct Care practice, you can expect an in-depth initial consultation where you and your physician discuss your health history, current concerns, and goals. This first appointment often includes a thorough assessment and may involve lab work, setting the foundation for a personalized health plan tailored to your needs.
The Simple Idea Behind the Movement
The concept is elegantly simple. In exchange for a monthly membership fee, members receive enhanced access to their physician that traditional insurance-based practices simply cannot provide:
Seven-day availability — Your physician is accessible throughout the week, not just Monday through Friday
Expanded hours — Evening and weekend availability that fits your life, not just office hours
Multiple visit formats — Office visits, telemedicine, phone consultations, text messaging, and email communication
Unhurried appointments — Thirty to sixty minutes with your physician instead of the rushed five-to-ten-minute visits that have become standard
Smaller patient panels — The average DPC practice maintains only 413 patients, compared to traditional panels of 2,000-2,500
In essence, the traditional barriers to accessing your physician simply cease to exist.
Principles of Direct Care
At its heart, Direct Care is about putting the patient-physician relationship first. This isn't just a business model—it's a philosophy that prioritizes actually getting to know you as a person, not just a collection of symptoms to manage.
The functional medicine approach fits naturally here. Instead of prescribing a medication for every symptom and sending you on your way, we take time to ask why. Why is your blood pressure elevated? Why do you have chronic fatigue? What's happening in your life—your stress levels, your sleep, your nutrition, your relationships—that might be contributing? This kind of detective work takes time. Time that traditional insurance-based medicine simply doesn't allow.
When we understand the root causes, we can develop a care plan that actually addresses them. Not just a band-aid, but real solutions. This approach—looking at the whole person rather than isolated symptoms—has been validated by leading medical institutions and consistently produces better outcomes. Patients feel better, stay healthier longer, and often end up needing fewer medications and interventions down the road.
Why Barriers Exist in Traditional Medicine
To understand why Direct Care is so revolutionary, we must first understand why the current system creates such obstacles. The answer lies in billing.
In insurance-based practices, the primary reason for requiring an office visit is billing. Insurers pay for in-person encounters—that's the unit of transaction upon which the entire system is built. Telemedicine coverage has improved but still hasn't achieved true parity with office visits in many situations. Phone consultations? Not covered. Text messages to your doctor? Definitely not covered. A quick email question that might save you an unnecessary visit? Not a billable event.
This creates a perverse incentive structure. Every moment a physician spends answering your phone call or text message is time taken away from activities that generate revenue. The system forces physicians to pack their schedules with office visits—often seeing 22 to 35 patients per day—because that's the only way to keep the lights on and pay the staff.
A recent Colorado Politics article highlighted the absurdity: one Direct Primary Care physician recounted spending forty-five minutes arguing with an insurance representative over whether a patient could receive a twelve-dollar blood test. That's forty-five minutes of a highly trained physician's time consumed by bureaucratic friction instead of patient care.
The Healthcare Cost Crisis
The timing for alternative models couldn't be more critical. According to Mercer's National Survey of Employer-Sponsored Health Plans, American workers face the steepest health benefit cost increases in fifteen years. Employees can expect to pay 6-7% more in premiums in 2026, while those on Affordable Care Act marketplace plans may see even more dramatic increases as enhanced tax credits expire.
For families already stretching their budgets, these increases are more than inconvenient—they're destabilizing. Many face agonizing choices between maintaining coverage and affording other necessities. A family might pay $8,000 out of pocket before their insurance deductible is even met. In one case documented in Colorado, a patient paid approximately $6,000 for their child to receive a simple prescription and chest X-ray at an emergency room—care that could have been handled entirely at a Direct Primary Care office for a fraction of that cost.
The math becomes compelling: when your annual deductible exceeds what you'd spend on Direct Primary Care membership and the care you actually receive, the traditional insurance model fails basic arithmetic.
The Physician Burnout Epidemic
The system isn't just failing patients—it's destroying physicians. According to the 2025 Commonwealth Fund International Health Policy Survey, 43% of U.S. primary care physicians report experiencing burnout, the highest rate among ten developed countries surveyed. Among those experiencing burnout, 44% cite time-consuming administrative tasks as the primary driver, while 65% report that time spent on insurance-related tasks is a major problem.
Research published in the Journal of General Internal Medicine estimates that primary care physicians would need 26.7 hours per day to provide all recommended acute, chronic, and preventive care for a standard patient panel. This impossible math—more hours required than exist in a day—explains why the average family physician panel size has dropped 25% over the past decade. Physicians are recognizing they cannot sustainably care for as many patients as the system demands, and the growing demand for primary care clinicians only adds to the pressure.
The burnout epidemic creates a vicious cycle: burned-out physicians leave practice, worsening the primary care shortage, increasing the burden on remaining physicians, accelerating their burnout. The financial toll is staggering—turnover from burned-out primary care physicians costs the U.S. healthcare system $260 million annually in excess healthcare costs.
A Better Way: The Direct Care Difference
Direct Care breaks this destructive cycle. When physicians aren't chasing insurance reimbursements, something remarkable happens: they can actually practice medicine.
Consider this story from the Colorado article: A physician had a cancelled appointment that unexpectedly freed fifteen extra minutes with a patient struggling with diabetes, high cholesterol, high blood pressure, and obesity. The patient mentioned she wanted to start exercising but didn't know where to begin. With that extra time—time that would never exist in a standard insurance-driven visit—he advised simply walking in place, then around the block, gradually building from there. Before she left his care, she had lost 150 pounds, no longer needed any medication, and had run a half-marathon.
This story captures what integrative medicine and Direct Care can achieve when we have time to actually connect with patients. The physician and patient worked together, taking action after carefully understanding her situation. That's the healing process—and it requires partnership, not a seven-minute transaction.
"That is an example of what direct primary care can be for every patient," the physician observed.
The evidence supports these transformative outcomes. Research indicates that Direct Primary Care reduces hospitalizations by 20-40%, while physicians report 90% higher job satisfaction. The model creates what economists call "direct accountability" between physician and patient. As one DPC physician put it: "I have to have my patients trust me and be willing to pay me out of their own pocket, which means I better do a damn good job of taking care of them."
Integrative and Functional Medicine: A Natural Fit
Integrative Medicine and Functional Medicine practices are particularly well-suited to the Direct Care model, and for good reason. These approaches are inherently time-intensive, focusing on the unique physical, mental, and emotional needs of each patient. Finding root causes means sitting with someone, listening to their story, and piecing together a picture that might span years of health history. That kind of work can't be rushed.
Insurance reimbursement for integrative approaches has always been problematic. Extended consultation time, many integrative procedures, and advanced functional medicine testing receive spotty coverage at best. Supplements—often essential components of integrative treatment protocols—receive no insurance coverage whatsoever.
For patients who previously paid for each service every time a physician's time and licensure was utilized—a common model in integrative practices—the membership approach represents a fundamental shift. All of that time, expertise, and access becomes included in one transparent monthly fee. No surprise bills. No nickel-and-diming for every phone call or email. Just comprehensive care from practitioners trained in integrative approaches—many board-certified through organizations like ABOIM—who have the time to actually know you and your health goals.
In practice, this might mean developing a personalized nutrition plan together, incorporating mind-body therapies to manage stress, or coordinating your care for a chronic condition with ongoing adjustments as we learn what works for you. It's medicine as relationship, not transaction.
Patient and Physician Experience Transformed
The patient experience in Direct Care is fundamentally different from traditional medicine. Physicians in this model report that when patients come to them, they hear a "sigh of relief." The anxiety that accompanies typical medical visits—wondering about costs, worried about rushing through concerns, uncertain whether questions will be welcomed—dissolves.
For physicians, the transformation is equally profound. No longer spending hours fighting with insurance companies. No longer watching the clock during patient visits. No longer choosing between adequate documentation and adequate patient time. The simple ability to use every communication means possible to take care of patients—office visits, telemedicine, phone, text, email—without worrying about whether it's "billable" fundamentally changes what's possible.
Direct Primary Care physicians can provide approximately 85% of a patient's healthcare needs and often prevent the need for costly emergency room visits or hospital admissions. Services that would be rushed referrals in traditional practice—joint injections, mole removals, contraceptive care, mental health support, chronic disease management—become routine, unhurried components of comprehensive primary care.
What Your Direct Care Physician Actually Does
In Direct Care, your physician has the time to be thorough. That means looking beyond the obvious—considering how your genetics, lifestyle, environment, and daily habits all contribute to how you feel. We might run specialized functional medicine labs to understand what's really going on, rather than just checking boxes on a standard panel.
This approach works particularly well for complex conditions that don't fit neatly into conventional categories: autoimmune issues, chronic fatigue, fibromyalgia, digestive problems, or conditions where patients have been told "your labs are normal" despite clearly not feeling well. We have time to dig deeper.
Direct Care also embraces the best of both worlds—conventional medicine when it's needed, combined with complementary approaches like medical acupuncture, targeted nutrition, and lifestyle medicine. For conditions ranging from chronic pain and neuropathy to long COVID symptoms, having access to multiple therapeutic tools means we can find what actually works for you, not just what's covered by your insurance.
Most importantly, your physician becomes your partner and advocate. I guide patients through treatment decisions, help them understand their options, and coordinate care when specialists are needed. The goal isn't to create dependency—it's to empower you with knowledge and support so you can make informed choices about your own health.
Direct Care for Chronic Conditions and Wellness
Direct Care works especially well for people managing chronic conditions or those who want to optimize their health proactively. If you're dealing with an ongoing health challenge, you know that it affects everything—not just your body, but your energy, your mood, your ability to do the things you love. Quick visits and prescription refills don't address that reality.
In a Direct Care practice, we can develop a comprehensive approach that addresses the full picture. That might mean combining conventional treatments with nutritional changes, stress management techniques, and movement practices tailored to what your body can handle. We have time to check in regularly, adjust the plan as things change, and celebrate the wins along the way.
For those focused on prevention and optimization, Direct Care offers something rare in modern medicine: a physician who actually knows you. We can track trends over time, catch problems early, and work together on goals that matter to you—whether that's having more energy for your grandkids, training for a race, or simply feeling like yourself again.
The value here isn't complicated: better access, more time, genuine partnership. These aren't luxuries—they're what medicine should be.
A Critical Clarification: Direct Care Is Not Insurance
Direct Care physicians universally emphasize that their model does not replace health insurance—it complements it. Catastrophic coverage remains essential for major medical events: cancer diagnosis, serious accidents, surgical interventions, hospital admissions. Many members pair their Direct Care membership with high-deductible health plans, which typically cost less while providing essential protection for major medical expenses. This combination delivers high value by offering superior access and personalized care at a lower overall cost compared to traditional insurance alone.
It's worth noting that Medicare recipients currently cannot participate in most Direct Primary Care arrangements due to regulatory restrictions, though advocacy groups continue working toward policy changes that would expand access.
Starting in 2026, people with Health Savings Accounts (HSAs) will be able to use pre-tax funds for DPC memberships under $150 per month, thanks to legislation passed in 2025—a significant policy victory that acknowledges Direct Care's legitimate place in the healthcare landscape.
Looking Forward: A Partnership for Wellness
Direct Care represents more than an alternative payment model—it represents a philosophical return to medicine's core values. When the financial incentives align with patient outcomes rather than patient volume, everything changes. Physicians can focus on prevention rather than crisis management. Patients can seek care early rather than waiting until problems become emergencies. The adversarial dynamic between patients, physicians, and insurers transforms into a genuine partnership.
In my own practice, I've limited my patient panel to 99 patients specifically to ensure that every person receives the attention and time they deserve. This isn't about exclusivity—it's about sustainability and quality. It's about practicing medicine the way medicine should be practiced.
The Direct Care movement is growing because it works—for patients seeking accessible, affordable, personalized care, and for physicians seeking to practice meaningful medicine without burning out. Both patients and physicians value this model for its focus on individualized attention and improved outcomes. Our interests are aligned: we both want healthcare built on trust, transparency, and shared goals.
As healthcare costs continue their relentless climb and system dysfunction becomes increasingly apparent, the elegant simplicity of Direct Care becomes ever more compelling.
In the end, Direct Care allows physician and patient to partner toward a common goal: the betterment of our patients' wellness and health. That's what medicine was always meant to be.
At Direct Integrative Care, Dr. Kim is dedicated to guiding you on your path to wellness through a deeply personalized and supportive approach. We focus on integrative medicine, looking beyond symptoms to uncover the root causes of chronic conditions and develop a treatment plan tailored specifically to your unique health journey. By combining compassionate care with innovative therapies, our goal is to empower you with the knowledge and tools needed to achieve lasting health. We invite you to explore our website to learn more about how our patient-centered practice can help you find balance and vitality.
Yoon Hang Kim MD
Integrative & Functional Medicine Physician
Virtual Practice Serving IA, IL, MO, FL, GA, and TX
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Interested in learning more about Direct Care? The DPC Coalition and DPC Nation Facebook group offer excellent resources for patients and physicians alike.
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