Day: June 28, 2016

Episode 8: The History & Future of Direct Primary Care –with Qliance Founder Dr Garrison Bliss

“Once patients see [direct primary care] and doctors see [direct primary care], great stuff happens.”
–Dr Garrison Bliss


  1. Qliance
  2. BlissMD –Dr Bliss’ current practice
  3. NPR Article on Qliance Closure
  4. Times Article on Dr Bliss

What initially started as a frustration with health insurance eventually spawned a national movement to restore primary care. In 1997 Dr Garrison Bliss said good-bye to health insurance, starting a direct pay practice in the Seattle, WA area. While this initial clinic was out of the price range for many families, his experience forming deeper relationships and quality care led him to expand his practice model to be well within the price range of every-day people. This new model became known as direct primary care. It involved a low-cost monthly fee for comprehensive primary care. While regarded with skepticism by many, the model has grown rapidly over the years since its beginning and has been responsible for a grassroots movement to restore primary care from the ground up.

In the interview, Dr Roussel interviews Dr Bliss about the origins of his motivation to pioneer the direct primary care model, including a frustration with insurance-based care that made it difficult for him to provide the quality of care he felt he could provide. While a couple of his colleagues formed a concierge practice charging $1000 a month per patient, he wanted his practice to be accessible to every-day people. As a result, he founded Qliance in 2007. Since then, the direct primary care movement has exploded from a few doctors in the late 1990s to thousands of doctors. The reason for the growth of the movement is clear, says Dr Bliss, doctors and patients are tired of caregiving arrangements dictated to them by insurance companies. As a result, they are flocking to the DPC model in droves, improving the relationship between doctors and patients. This improved doctor patient relationship is what drives the DPC movement and what will ultimately be responsible for its success, says Dr Bliss, but it will ultimately depend on the motivation of grass roots activists (both doctors and patients) who have seen the model succeed to keep the movement going and push it into the mainstream.

Time Stamped
[3:54] Why Dr Bliss decided to start an insurance-free primary care practice.

[4:55] Dr Bliss discussion of trying to do ‘concierge’ affordably

[7:15] How and why Dr Bliss converted Seattle Medical Associates to a direct primary care practice, Qliance

[14:20] How has Dr Bliss viewed the evolution of the direct primary care movement

[18:33] Where does Dr Bliss see the tipping point where direct primary care becomes mainstream

[25:31] How can the direct primary care movement keep up its momentum?

[29:30] What happened to Dr Bliss when the insurance commissioner threatened to shut his practice down

Dr Garrison Bliss


Dr Garrison Bliss is an internist in Seattle, WA. In 1997, he started Seattle Medical Associates, a membership-based insurance-free practice. His positive experience providing primary care outside of health insurance led him to found Qliance, the nation’s first low-cost direct primary care practice. He is regarded by many as the founder of the direct primary care model and continues to speak around the country to doctors, lawmakers, companies, and patients about the beauty of direct primary care.


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