Increasingly, physicians have found work with corporations while losing their medical autonomy and often, so much more. Such a circumstance nearly 12 years ago nearly drove Harish Ponnuru out of the profession.

“We’re told we have to see more and more people every day, and no matter how many times I met the metrics or got a bonus or etc., just like being in an abusive relationship, it was never enough,” Ponnuru said.

Pushed to see more patients, he had to dip into his personal time, which meant he wasn’t sufficiently present for his family.

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“Whatever money I was making was not worth it because I’m miserable in my personal life,” he said. “The joy was gone.”

The corporation forbade him from seeing his own patients in the hospital. It wanted him to arrive an hour earlier to see more people in the office and to let somebody else take care of his patients in the hospital.

Luckily for Ponnuru and his future patients, he found a health care model called direct primary care, which likely will save some medical careers and offer affordable care to those now priced out of the system. Direct primary care customers pay an out-of-pocket membership fee for health care including immunizations, disease screenings, lab tests and more. These practices don’t accept insurance.

As Affordable Care Act enhanced subsidies expired Dec. 31, 2025, premiums for millions of individuals and families have exploded with many plans doubling or tripling in cost, further deepening and widening the health care crisis.

In some ways, insurance companies and corporate tyranny helped birth this innovation. Ponnuru said that we know for sure that some insurance companies use artificial intelligence to automatically deny claims. As a doctor working for a corporation, he needed to see 25 to 30 patients a day, spending as little as 12 minutes with patients face to face.

“That’s just not good care,” he said.

And he would know.

Ponnuru won the “Humanitarian of the Year” award during his residency in Milwaukee, where he served as chief resident, received patients’ choice awards from 2011 to 2013, compassionate doctor awards for that same period and a 2012 “Top Ten” doctor award. He also hails from a family 11 other doctors.

Now, Ponnuru sees 10 to 15 patients a day and spends 30 minutes to an hour with each.

“I’ve had many patients tell me that this is the longest a doctor has spent time with me in my whole life,” he said. “The satisfaction is when you think you’re doing a good job and you’re being thorough, and the patient feels heard and they feel like someone cares about them.”

Health care, he said, reminds him of the tax code — designed so that almost no one knows how to navigate it. Therein lies another innovation of his practice: negotiating lower prescription costs for his patients.

“All I did was ask,” he said.

He said wholesale companies trade with qualified medical practices, and when he looked at their catalogues, he said: “You’ve got to be kidding me. This is how much it costs?”

For example, he said, a common diabetes medication can cost $4 for a 30-day supply, but he has negotiated 90-day supplies for less than $3. That’s not for new, designer drugs, he cautioned. With generics, the price is cheaper.

The same goes for labs, he said.

“I was stunned. In many cases, it was 10 times cheaper. It was so much less than I thought it would be and so much more affordable if you knew how to access it, and access is always the key,” he said.

Some of the savings have everything to do with paying up front in cash.

“If you’re uninsured or have a high deductible, you’re told your chest x-rays are $400. But I have a company, and because it is an independent medical group, and I ask them, “If my patient pays upfront, is that worth any kind of discount?” They say, “Yes, if they pay cash, how about $50?”

Ponnuru isn’t anti-capitalism. “But it needs guardrails,” he said. “Every other first-world country does this. We should all have some basic right to health care.”

Without capitalism, he said, research and development dies and prevents people from going into health-related fields. Doctors also need a reasonable return on investment to manage soaring school debt.

“Suicide rates among physicians are at an all-time high,” he said. “Doctors and nurses are burning out.”

The drawback of this model for doctors stems from the business owner’s learning curve.

“I’m the IT guy, I’m the HR guy, I’m the payroll guy, I’m everything,” Ponnuru said. “After seeing patients and answering phone calls, then I’ve got to do administrative stuff.”

He now has 450 patients (some doctors have as many as 4,000).

He doesn’t have to work with insurance companies who are essentially practicing medicine. When he recommends a treatment for a patient and the insurance company refuses, it is practicing medicine.

Ponnuru left that world behind nearly 12 years ago, when he wrote in a letter to his patients:

“People need an advocate to help them navigate the complex health-care system and help them make personalized decisions. … As of August 1, 2014, I will be switching to a new kind of practice called Direct Primary Care. The purpose of this approach is to reduce overhead expenses and to strengthen our personal relationships. … I truly value the relationships I have with my patients, so I am excited to take this step to put some sanity back into our healthcare system.”

Mark McCormick is the former executive director of the Kansas African American Museum, a member of the Kansas African American Affairs Commission and former deputy executive director at the ACLU of Kansas.