The Better Front Door: Why Musculoskeletal Care Is the Next Evolution of Direct Primary Care

Direct Primary Care has earned its place in the healthcare landscape by doing something deceptively simple-restoring the physician-patient relationship. Longer visits, easier access, proactive care, and continuity have produced better experiences for patients while giving employers a compelling alternative to traditional fee-for-service medicine.

That value proposition has served the DPC movement well. But as employer healthcare costs continue to rise, the conversation is changing.

Today’s employers aren’t simply asking whether employees can get same-day appointments or whether they’re happier with their physicians. Increasingly, they want to know how a DPC practice will help them manage the healthcare expenses that have the greatest impact on their business. Just as importantly, they’re asking why they need so many separate healthcare benefit vendors in the first place. Seventy-five percent of employers are consolidating or considering consolidating their point-solution vendors.[RK1]  And, with the growth of GLP-1 Incretin adoption compounding at a forecasted 12% compounded annual growth rate (CAGR) with patients metabolic, cardio and both sarcopenia and osteopenia health worsening a year after treatment, the world of the health benefit leader is becoming incredibly complex. They are asking whether their primary care partner can simplify an increasingly fragmented benefits ecosystem or if they should look at the bigger players that combine multiple point solutions.

That question often leads to musculoskeletal care due it being the largest cost for 90% of employers and due to incredible growth of the digital remote functional/physical therapy focused offerings.

For many employers, back pain, knee injuries, shoulder problems, and other movement-related conditions drive specialist referrals, diagnostic imaging, physical therapy, surgery, lost productivity, and prolonged recovery. Yet while a growing number of large Advanced Primary Care organizations are beginning to add musculoskeletal capabilities, most DPC groups still have little choice but to refer these patients into a disconnected specialty system. This is actually one of the most controllable cost for DPC.

The irony is that almost every one of those patients begins in the same place-the primary care office.

The Referral Isn’t the Problem; Losing the Patient Journey Is

One of Direct Primary Care’s greatest strengths is its ability to keep physicians engaged throughout a patient’s healthcare journey. Whether managing diabetes, hypertension, obesity, or increasingly the use of GLP-1 and GIP (incretin) therapies, DPC practices excel because they provide ongoing guidance rather than episodic treatment.

Movement health has become an important extension of that mission.

As more patients achieve significant weight loss through incretin therapies, physicians are paying closer attention to preserving muscle mass, maintaining bone health, preventing falls, and improving functional movement. Long-term health isn’t measured simply by pounds lost; it’s measured by how well patients continue to move, work, and live.

Yet when movement becomes painful-or when an employee develops persistent back, knee, neck, or shoulder problems-the care model often changes.

The primary care physician evaluates the patient but frequently lacks the specialty resources needed to determine the most appropriate next step with confidence. Referral becomes the safest option. The patient moves into imaging, physical therapy, orthopedic consultation, pain management, or surgery, often involving several providers who may have little connection to one another.

At that point, the DPC physician is no longer directing the patient’s care. Instead, the practice is waiting for reports to come back from a healthcare system it no longer controls.

For organizations built around continuity and trust, that’s more than a clinical challenge. It’s a strategic one.

Why Employers Are Looking Beyond Traditional Primary Care

From an employer’s perspective, musculoskeletal care represents far more than another clinical service. It’s often the costliest category in the health plan.

It affects absenteeism, productivity, workers’ compensation, return-to-work timelines, and long-term disability. It is also one of the few healthcare categories where better decisions at the beginning of the journey can dramatically influence everything that follows.

That’s one reason employers have invested heavily in digital MSK programs over the past decade.

The problem is that every new solution tends to become another point solution. One vendor manages physical therapy. Another focuses on navigation. Another addresses surgery. Another manages imaging. Each promises savings, but each also adds another contract, another platform, another enrollment process, and another experience for employees to navigate.

The result is a benefits strategy that often becomes more fragmented rather than less.

For DPC organizations, that creates both a challenge and an opportunity.

If the practice cannot help employers manage one of their largest healthcare spending categories, someone else will. But if primary care can remain meaningfully involved in the MSK journey, it becomes much more than the place where patients begin. It becomes the organization that helps guide the entire process.

Becoming the Better Front Door

This doesn’t require DPC practices to become orthopedic groups or build in-house physical therapy departments. Nor does it require replacing orthopedic surgeons or physical therapists, who are hardly replaceable.

What it does require is giving primary care clinicians better tools at the point where musculoskeletal care begins.

Imagine a different patient journey.

Instead of evaluating a patient with knee pain and immediately deciding whether to order imaging or refer to an orthopedist, the physician has access to AI-assisted, provider-guided Movement Intelligence that helps organize the assessment, supports clinical reasoning, and identifies the most appropriate next step.

Some patients may benefit from guided movement therapy and conservative treatment. Others may need physical therapy. Some will require imaging or specialist evaluation.  The important distinction is that the physician remains the clinical decision-maker and guide throughout the process.

Visor Health was designed around that philosophy.

Its role is not to replace physician judgment or create another virtual specialty clinic operating outside the primary care relationship. It is to give clinicians specialist-informed decision support that helps them evaluate movement problems earlier, coordinate care more effectively, and remain informed as patients progress through treatment.

Physical therapists remain essential. Orthopedic specialists remain essential. But now they become part of a coordinated pathway rather than isolated referral destinations.

And primary care stays connected to the journey instead of stepping away from it.

A Different Kind of Value Proposition

For DPC organizations, that shift has implications well beyond clinical care. It allows practices to expand their capabilities without hiring orthopedic specialists or building entirely new service lines. It gives employers a more compelling answer when they ask how the practice will influence one of their largest healthcare costs. And it helps address another growing concern among benefits leaders-vendor fatigue.

Many employers are actively looking to simplify their benefit ecosystems by reducing the number of standalone healthcare solutions they manage, while also not just reducing, but more importantly optimizing their GLP-1 Incretin management and spend. Movement health is proven to be the key variable that makes the immediate and lasting change both Incretin and overall health spend. A DPC practice that can provide trusted primary care while helping improve movement health offers a simpler and more complete story than one that relies on multiple disconnected vendors competing for the same member and more per employee per month spend.

Perhaps most importantly, it allows the practice to maintain the relationship that has always been its greatest competitive advantage.

Patients don’t disappear after the referral.

The physician remains involved before, during, and after specialty care.

That continuity benefits patients. It also creates a stronger story for employers at renewal because the practice can demonstrate not only access and satisfaction, but also meaningful influence over referrals, engagement, recovery, and long-term outcomes.

The Next Chapter for Direct Primary Care

Direct Primary Care has never been successful because it offered more procedures than traditional medicine. It has succeeded because it offers better relationships, better access, and better guidance.

Movement health represents the next opportunity to extend those strengths.

The goal isn’t to transform primary care physicians into orthopedic specialists. It’s to ensure they have the clinician lead training, tools and clinical support needed to improve overall movement health to prevent injuries and improve overall health, while also being guide patients through one of the most common and costly healthcare journeys they’ll ever experience when that inevitably happens.

Practices that can do that won’t simply offer excellent primary care. They’ll offer employers something increasingly difficult to find in modern healthcare-one trusted partner that can coordinate care across the conditions that matter most.

In that sense, the future of Direct Primary Care isn’t about becoming something different; it’s about becoming more complete.

The practices that thrive over the next decade will be those that remain the trusted front door for care. And the trusted guide who stays with the patient long after the referral that traditionally marked the end of the relationship.

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Council of Insurance Agents & Brokers survey, reported via Leader's Edge (2026).