New primary care doctors are going cash only

Primary care’s woes have been well documented, especially on this blog.

Pressure on reimbursement, combined with rising bureaucratic impediments to the doctor-patient relationship, are both causing primary care physicians to retire early, or seek another career path.

But what about on the other side of the spectrum, namely, newly graduated primary care doctors?

Well, they’re no dummies, as it’s obvious to them how difficult it is to practice primary care in a traditional setting. More of them are opting for cash-only practices from the start.

Josh Umbehr, a prior contributor to, will soon complete his family practice residency, and is busy prepping his concierge practice once he finishes. A piece from The Wichita Eagle publicizes the upcoming practice:

. . . primary care physicians have 3,000 to 4,000 patients; he hopes to limit himself to 400 to 600. Most adults will pay $50 or $75 a month. He expects to turn a profit within a year.

He will see those who need in-person attention, at his office, in their homes or at their workplace. But he expects much of his patient contact to be by phone or e-mail. Most physicians won’t do that because they don’t get reimbursed for it, he said.

Medical students plainly see the low morale and deteriorating practice environment that plagues primary care. Going cash-only provides a path for those who want to pursue primary care, yet are wary of the bureaucratic hassles.

Good for Josh for taking matters into his own hands.