In my corporate strategy course with Professor Todd Zenger, we explored what makes for a good corporate theory—that is, the set of ideas that helps a company create and capture value over time. Zenger argued that any enduring corporate strategy must be grounded in three key features: insight, foresight, and cross-sight. While these principles are often applied to large corporations like Disney, Walmart, or Amazon, they are equally valuable for smaller, mission-driven practices—especially in the growing world of Direct Primary Care (DPC).
Even though our practices will never scale to Fortune 500 proportions, we can still think strategically like those companies do—identifying where value is being lost in the market, anticipating where the world is heading, and positioning ourselves to meet those needs before others do.
Foresight: Seeing What’s Coming Before Everyone Else
Foresight is the ability to anticipate shifts in the external landscape—economic, cultural, and technological—and act before the rest of the market catches up. For pediatric DPC physicians, foresight has been central to our movement from the start. We saw, long before the mainstream healthcare system did, that the insurance-based primary care model was becoming financially and emotionally unsustainable.
Declining reimbursement rates, ballooning administrative burdens, and the corporatization of medicine have pushed pediatricians to their limits. DPC is, at its core, a foresight-based response—an entrepreneurial recognition that the traditional system cannot sustain the kind of high-quality, relationship-based care families deserve. By stepping outside the insurance treadmill, DPC physicians are capturing the opportunity to restore time, trust, and continuity to pediatric care.
In this sense, every pediatric DPC practice is a living example of foresight in action: recognizing a structural problem in the system, envisioning a better model, and building it before the mainstream catches up.
Insight: Understanding What Your Community Truly Values
If foresight is about seeing the future, insight is about deeply understanding the present—particularly, what your specific patients and community value most.
Each pediatric DPC practice exists in a unique ecosystem. Some of us serve communities with high interest in integrative and holistic care; others see growing needs in behavioral health and mental wellness as childhood anxiety and depression rates rise. Still others may recognize opportunities to serve underserved populations, neurodiverse children, or families who seek more culturally responsive care.
Insight means asking: What is missing in my community that I am uniquely positioned to offer?
This is the part of strategy that’s deeply human and relational—understanding not just the clinical needs, but also the emotional, cultural, and logistical pain points families face. Insight allows us to craft offerings that resonate deeply—whether that’s extended visits, same-day texting access, integrative medicine consults, or wellness workshops for parents.
When combined with foresight, insight ensures we’re not just reacting to what’s broken in healthcare, but intentionally designing what’s next.
Cross-Sight: Building Value Through Collaboration
The third pillar, cross-sight, is about recognizing connections and complementarities across different domains—seeing how combining resources, skills, or partnerships can create more value than any one entity could alone.
For a DPC pediatrician, cross-sight might look like:
- Partnering with a local mental health counselor to offer integrated family wellness services.
- Collaborating with a nutritionist, lactation consultant, or sleep coach to expand support for new parents.
- Forming relationships with schools, small businesses, or nonprofits to bring preventive care and wellness education into the community.
- Building referral and collaboration networks with other DPC and integrative clinicians for seamless continuity of care.
Cross-sight allows a DPC practice to grow its reach and impact without “scaling” in the corporate sense. Instead of adding more patients or staff, we expand our value ecosystem—creating a web of trusted partnerships that enhances the patient experience and strengthens our local brand.
The Small Practice Advantage
Large corporations often struggle to act on insight, foresight, and cross-sight because of bureaucracy and inertia. Pediatric DPC practices, by contrast, are small, agile, and grounded in authentic relationships. This gives us a profound advantage: we can pivot quickly, experiment with new offerings, and co-create with our patients and communities.
When we bring strategic thinking into our DPC models, we elevate our work from “a different way to bill” to a movement that redefines the future of pediatric care. Each of our practices becomes a microcosm of what healthcare could look like when guided by wisdom rather than bureaucracy—built on foresight about where the world is heading, insight into what families truly need, and cross-sight into how we can create shared value through connection.
If you’d like more guidance launching or growing your own direct care practice, DPC Pediatrician offers a free startup guide, a Startup Foundations group coaching program, on-demand courses, and even one-on-one consulting.
