I opened a primary care practice. Now I see why doctors are giving up.

Traditional health insurance pressures doctors to work at volume, or if they add layers of bureaucracy that independent physicians can't easily handle, writes Dimitri Coupet, who says it's time to consider formalizing a direct payment of care model.

By: Dimitri Coupet

Outlets: Maryland Matters

Published: October 11, 2026

Words: 733

Last Updated: 4 days, 22 hours ago

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When I opened an independent family medicine practice, I believed I was creating the kind of care patients say they want: A physician who knows them, listens and has enough time to think.

Instead, I learned why so many primary care doctors are leaving.

The problem is not that physicians have stopped caring. It is that the system asks us to accept enormous responsibility while paying mainly for brief, billable encounters.

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