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I greatly appreciate this article by Dr. Stange. I toiled in the system for many years as an educator and clinician convinced that in my practice lifetime family medicine would become consequential to more than just our patients. I nearly left medicine in despair but found a second wind and my moral compass again by opening up a DPC office in a small Michigan town 7 months ago. With small patient panel sizes DPC is not the immediate solution to health system access issues. However, by removing ourselves from insurance, demanding better in our conversations with patients, employers, and health systems and refusing to participate in the systems that eat us alive we can at least pursue a path that can better serve patients and give us opportunities to really develop the patient-centered relationships and care we hold dear as a discipline. What we have now is not only dysfunctional, but absurd.