35% of American physicians have considered leaving medical practice since the start of 2025, with burnout as the top reason (MedCentral, 2025).

Patients wait months for primary care. Physicians see thirty patients a day. Insurance premiums climb faster than wages. Hospitals lose money on the very service that should prevent admissions in the first place.

A quiet but growing group of physicians, entrepreneurs, and community leaders are asking the obvious:

"Why do we keep doubling down on a model that rewards volume instead of value?" Enter Dr. Brandon Alleman

Fulbright Scholar. MD, PhD. Family Physician. Trailblazer in Direct Primary Care (DPC).

Instead of chasing prestige, Dr. Alleman chose family medicine to reinvent care. He launched Antioch Med in Wichita, Kansas, where patients pay a monthly membership—priced like a Costco subscription—for full physician access, deeply discounted labs and medications, and care not defined by billing codes.

"It's more Costco than concierge medicine," he explains.

Today, Antioch Med is thriving and influencing employers, business leaders, and policymakers desperate for a way out of healthcare's vicious cycle.

Why This Conversation Matters Now

• Fee-for-service punishes physicians who spend time with patients.
• Primary care is treated as a loss leader in most hospital systems.
• Pharmacy Benefit Managers (PBMs) pocket massive spreads on prescriptions.
• The Affordable Care Act's medical loss ratio means insurers profit more when costs rise.

The incentives are backward. Dr. Alleman argues we cannot fix healthcare until we confront this directly.

What You'll Learn in This Episode

• Why fee-for-service fails primary care
• How Direct Primary Care (DPC) restores trust & transparency
• PBMs and the truth about high drug costs
• How the ACA's rules backfire
• The real crisis of physician burnout and moral injury
• Why employers may be the fastest leverage point for reform
• The future of community health plans

Episode Timeline

• 00:00 – Intro: Why Healthcare Incentives Matter
• 02:00 – From Fulbright Scholar to Family Medicine
• 03:54 – Why Fee-for-Service Fails in Primary Care
• 10:14 – Healthcare Price Transparency & Physician Innovation
• 18:00 – Direct Primary Care Explained: The Costco Model
• 22:19 – Training Full-Scope Family Medicine in Wichita
• 36:06 – Concierge Medicine vs Direct Primary Care (DPC)
• 50:35 – PBMs Exposed: The Truth About High Drug Costs
• 52:45 – The ACA & America's Perverse Healthcare Incentives
• 1:01:59 – The Future of Family Medicine & Community Health Plans

Meet Our Guest

Brandon Alleman, MD, PhD

• Fulbright Scholar (Budapest, Hungary) in biophysics
• MD-PhD, University of Iowa, with Gates Foundation–funded research
• Family Medicine Residency, Via Christi, Wichita
• Co-founder, Antioch Med, a Direct Primary Care clinic in Wichita, Kansas
• Consultant to employers redesigning health plans around DPC principles
• Advocate for physician entrepreneurship, price transparency, and incentive reform

Dr. Alleman blends rigorous science, lived primary care experience, and entrepreneurial courage. He is part of a new wave of physicians refusing to accept irrational incentives and instead building parallel models that work for patients and communities.

Production

Healthcare Reframed — produced by Judson Howe, Micah Buller, Todd Carpenter, and Lindsay Swain Hunt.

Call to Action

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