Episode 19: Direct Pay, Demoralized Doctors, and the Future of Healthcare - with Jessica Craig
Brothers, and Doctors Erik and Davin Ludnquist sit down with health reporter Jess Craig to unpack what "cash-based care" actually means — and why it's quietly tripled over the past several years. Drawing on her reporting at Straight Arrow News and her decade in infectious disease epidemiology, Jess maps the landscape: direct primary care (now 11% of family physicians, up from 3% in four years), cash-based specialty and surgical centers like the Surgery Center of Oklahoma, longevity-focused practices, and the rapidly growing world of direct-to-employer contracting (40% of large companies and 20% of small ones now negotiate directly with health providers).
The conversation moves through the structural forces driving the shift — flat insurance reimbursement against rising overhead, the stakeholder problem of insurers and PBMs sitting between patient and physician, and what Jess in her recent reporting calls the demoralization of America's doctors. They wrestle with the inherent scaling tension in cash-based care, how AI is more likely to be deployed to maximize insurance margins before it relieves physician burden, and what international models (Kenya, Canada, global health insurance) can teach Americans about price transparency and personal responsibility. Jess closes with a journalist's challenge: keep questioning, follow the evidence, and resist letting health policy collapse into political tribalism.
For physicians evaluating a model change, employers reconsidering benefits, and anyone trying to understand why so many doctors are walking away from the insurance-based system.
The conversation moves through the structural forces driving the shift — flat insurance reimbursement against rising overhead, the stakeholder problem of insurers and PBMs sitting between patient and physician, and what Jess in her recent reporting calls the demoralization of America's doctors. They wrestle with the inherent scaling tension in cash-based care, how AI is more likely to be deployed to maximize insurance margins before it relieves physician burden, and what international models (Kenya, Canada, global health insurance) can teach Americans about price transparency and personal responsibility. Jess closes with a journalist's challenge: keep questioning, follow the evidence, and resist letting health policy collapse into political tribalism.
For physicians evaluating a model change, employers reconsidering benefits, and anyone trying to understand why so many doctors are walking away from the insurance-based system.
Creators and Guests
Host
Dr. Davin Lundquist
Dr. Davin Lundquist is a board-certified family physician, innovator, and healthcare leader with over 25 years of experience integrating medicine, technology, and holistic wellness. A graduate of the Keck School of Medicine of USC, he has held senior leadership roles at CommonSpirit Health, Dignity Health, and Augmedix, where he advanced the use of technology to enhance patient care. Driven by a passion to move beyond symptom management, Dr. Lundquist founded the Quantum Advantage Method™, a science-based, holistic framework designed to help individuals restore vitality and reverse dysfunction. His approach blends functional medicine, advanced diagnostics, and principles of quantum science to empower patients to achieve optimal health and lasting transformation.
Host
Dr. Erik Lundquist
Dr. Erik Lundquist, MD, ABFM, ABoIM, IFMCP Dr. Erik Lundquist is the founder and medical director of the Temecula Center for Integrative Medicine, where he blends conventional, holistic, and functional approaches to help patients achieve lasting wellness. Board-certified in Family and Integrative Medicine, he specializes in endocrine disorders, chronic fatigue, migraine management, cardiometabolic health, and chronic pain. A graduate of St. Louis University School of Medicine, Dr. Lundquist completed his Family Medicine residency at Naval Hospital Camp Pendleton, where he served as chief resident. He spent eight years on active duty with the U.S. Navy, including service as a battalion surgeon in Iraq and at the Naval Hospital in Naples, Italy. Certified by the Institute for Functional Medicine, Dr. Lundquist is passionate about empowering patients to take charge of their health and teaching fellow clinicians integrative approaches to chronic disease. Outside of medicine, he enjoys the outdoors, singing, dancing, acting, and spending time with his wife and three children.
Guest
Jessica Craig
Jess Craig is the health reporter at Straight Arrow News, where she covers vaccine policy, infectious disease, pandemic preparedness, and healthcare costs. Before journalism, she spent years as an infectious disease epidemiologist and health security advisor with the CDC, USDA, and USAID. Her reporting has appeared in the Guardian, National Geographic, Vox, Wired, NPR, and others. She holds a B.S. in Microbiology and a B.A. in English Nonfiction Writing from the University of Pittsburgh and an M.P.H. from George Washington University. https://san.com/about/team/jess-craig/
