What Causes Attrition in Pediatric DPC?

In this episode of the DPC Pediatricians Podcast, Phil and Marina tackle a question every Direct Primary Care (DPC) pediatrician eventually faces: why do patients leave—and how often does it really happen?

Drawing on five years of real-world experience, they unpack the truth behind patient attrition in a membership-based model. While DPC is known for its accessibility, strong relationships, and high-quality care, no practice is immune to turnover. But the reasons patients leave may surprise you—and they’re not always what you’d expect.

From families relocating or experiencing financial changes, to shifts in expectations or misunderstandings about the DPC model, Phil and Marina break down the most common causes of attrition. They also explore a critical mindset shift: not all attrition is a failure. In many cases, it’s a natural and even healthy part of running a sustainable practice.

The conversation goes deeper into how pediatricians can:

* Set clear expectations from the start

* Build stronger, longer-lasting relationships with families

* Identify preventable vs. unavoidable attrition

* Use patient departures as opportunities for growth and refinement

If you’ve ever worried about losing patients—or wondered what attrition really looks like in a thriving DPC practice—this episode offers both reassurance and practical insight.

Whether you’re new to DPC or years into your journey, this discussion will challenge your assumptions and help you build a more resilient, patient-centered practice.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com