The Physicians Who Built the Movement
Meet the Founders of the Direct Specialty Care Alliance
Diana Girnita MD, PhD
Diana Girnita, MD, PhD Co-Founder, Direct Specialty Care Alliance · Founder & CEO, Rheumatologist OnCall Board-Certified Rheumatologist & Internist
Dr. Diana Girnita, MD, PhD earned her medical degree and PhD Summa Cum Laude in Romania before moving to the United States to pursue NIH-funded research at Harvard and the University of Pittsburgh — producing 17 peer-reviewed publications in transplant immunology. She completed her rheumatology fellowship at the University of Cincinnati and built a successful conventional practice, where she was named Top Doctor in Cincinnati four consecutive years.
But the system's failures were impossible to ignore. Overbooked schedules. Prior authorizations consuming hours. Short appointments that could not do justice to complex autoimmune disease. The moment that crystallised it was a patient who spent over a year being told his pain was psychological — until she finally had the time to sit with him. The diagnosis was clear. He had been suffering unnecessarily because the system was designed to bill, not to heal.
"At some point I asked myself: who do I want to work for? The insurance company or the patient?"
In 2020 she launched Rheumatologist OnCall — one of the first Direct Specialty Care practices in the United States. Now operating across 20 states, the practice has documented what happens when a specialist finally has time to listen: patients finding care after 9-month insurance wait times, diagnoses after years of dismissal, and physicians practicing medicine with purpose again.
That same year she co-founded the DSC Alliance — the community she wished had existed when she made the leap.
National speaking engagements to advocate for DSC movement
Year | Conference | Topic |
2025 | ACR Convergence | Reimagine Your Practice: The Direct Patient Care Model |
2025 | ACR Convergence | Stand Out in the Crowd: Branding Your Practice for Success |
2025 | 27th Annual IWAA Scientific Session | How I Operate a Remote Specialty Practice |
2024 | RPPA Summit, Houston | Invited Panelist: Direct Care Models in Rheumatology |
2023 | RPPA Summit | Starting Direct Care Rheumatology: Things I Should Have Done Differently |
2023 | California Rheumatology Association | Direct Care Rheumatology |
2022 | ACR Convergence | From Concierge Medicine to Consulting |
2021 | ACR Convergence | Alternative Models of Care in Rheumatology |
2021 | United in Care Conference | The Emergence of Direct Specialty Care |
Media features & published articles on Direct Specialty Care
Publication | Title | URL |
New York Times | The Moral Crisis of America's Doctors | |
Medscape | Direct Specialty Care — Concierge Service Without the Price Tag | |
Medscape | Alternative Rheumatology Practices Aim to Improve Patient Experience | |
KevinMD | The Emergence of Direct Specialty Care (2021) | kevinmd.com/2021/09/the-emergence-of-direct-specialty-care.html |
KevinMD | 10 Steps to Create Your Direct Specialty Care Clinic (2022) | kevinmd.com/2022/06/10-steps-to-create-your-direct-specialty-care-clinic.html |
Lara Briseno Kenney, MD
Co-Founder & Board Member, Direct Specialty Care Alliance Triple Board-Certified Hematologist, Oncologist & Palliative Care Physician Founder, Leeton Medical (DPC) · DSC Practice in Hematology, Oncology & Palliative Care, Clinton, Missouri US Army — Active Duty 7 years · Multiple deployments
Dr. Lara Briseno Kenney did not take a conventional path to medicine — and she never has since. After graduating from the University of Missouri Kansas City School of Medicine, she entered active duty in the United States Army, completing her Internal Medicine residency at Fort Sam Houston and deploying multiple times in support of the Military Police Corps. Seven years of service built something no fellowship can teach: discipline, clarity under pressure, and the ability to make high-stakes decisions with no room for error.
After her Hematology Oncology fellowship, she settled in Clinton, Missouri — a small rural community where specialist access is not a matter of preference but of medical urgency. She became something rare: a board-certified specialist who knows her patients by name.
In 2019 she launched Leeton Medical, one of Missouri's earliest DPC practices. The insight that followed changed everything: if direct care could transform primary care, why not specialist medicine? In 2020 she launched one of the first DSC practices in the country — bringing Hematology, Oncology, and Palliative Care directly to rural patients who faced months of waiting and hours of travel for diagnoses that could not wait.
She pioneered peer-to-peer DSC consultation — offering primary care physicians across the country direct access to a board-certified specialist for their most complex patients. Rural doctors called it indispensable.
"Patients facing the most serious diagnoses deserve the most direct access to their specialist. An insurance company should never be the entity deciding what care a cancer patient receives."
Why They Built It Together
Two physicians. Two stories. One conclusion: the insurance system was incompatible with the medicine they had trained to practice.
One brought the research background, telemedicine architecture, and national media presence. The other brought military discipline, rural community roots, and a peer consultation model that proved DSC works even in the most demanding corners of medicine.
Every resource in the DSC Alliance — every curriculum module, legal template, mentorship connection, and directory listing — is something one of its founders had to build alone when they made the transition. The Alliance exists so no specialist ever has to do that again.