Dr. Andrew Hertz

Dr. Hertz’s Leap: Reinventing Pediatric Care Through Direct Models

"Healthcare should prioritize patients - not systems," says Dr. Drew Hertz, pediatrician and founder of the Zest Pediatric Network. His journey from a corporate health executive to a direct care pioneer is a compelling example of how bold leadership can reshape the future of children’s health.

Dr.Hertz’s path into healthcare innovation is rooted in decades of experience within the very structure that many direct care advocates are seeking to transform. For nearly 30 years, Dr. Hertz worked in a large academic health system. He began as a general pediatrician managing a community-based practice and gradually climbed the administrative ranks. His career evolved to encompass leadership in population health and primary care, eventually serving as Vice President for Community Women and Children Services. In this role, he oversaw more than a hundred providers across pediatrics and women’s health, becoming deeply embedded in the corporate side of healthcare.

A Pivotal Shift: Departing the System

Despite his senior position, Dr. Hertz felt a growing misalignment between his values and the direction of academic medical centers. Increasingly, these systems prioritized institutional goals over patient care. What had always brought him joy, supporting doctors in caring for patients, was no longer central to his work. This realization led him to leave his executive role and explore consulting.

Discovering the Direct Care Model

Shortly after his transition, Dr. Hertz began consulting with a pediatric practice that had recently shifted to a direct care model. This practice was among the earliest to adopt this approach in pediatrics and was the first of its kind in the Cleveland area. Through this experience, Dr. Hertz became deeply familiar with the mechanics and philosophy of direct care. He saw in it the potential to resolve some of the systemic challenges he had encountered throughout his career. The transparency, accessibility, and patient-first mindset of direct care struck a chord.

A Broader Vision Emerges

While he recognized that direct care couldn’t fix every flaw in healthcare, Dr. Hertz grew increasingly convinced that it could dramatically improve primary care for children. After working closely with the pioneering Cleveland practice, he envisioned something larger: a network of pediatric direct care practices. Unlike a single clinic, a network would require robust infrastructure and offer collective strength, enabling more pediatricians to join this care model.

Building the Zest Pediatric Network Vision

Inspired by the potential of direct care, Dr. Hertz set out to create something larger than a single practice: a sustainable ecosystem for pediatricians. This vision materialized as the Zest Pediatric Network, a platform designed to reduce the logistical and financial hurdles of launching a direct pediatric care practice.

Understanding that not every physician aspires to be a solo entrepreneur, Dr. Hertz structured Zest as a Management Services Organization (MSO). The MSO model supports clinicians by offloading business operations such as IT, marketing, legal, HR, accounting, inventory procurement, office setup, and lease negotiations.

More than just a support system, Zest acts as a launchpad for pediatricians to adopt the direct care model without starting from scratch. It bridges the gap between clinical aspiration and operational reality, giving physicians the tools, infrastructure, and community they need to thrive within a modern, patient-first healthcare framework.

Holistic Services for Comprehensive Pediatric Support

Zest goes beyond supporting physicians, it supports families with wraparound services. The network offers lactation consulting, dietitian access, sleep coaching, parent coaching, and psychologist consultations. Future plans include expanding into maternal mental health, physical therapy, and developmental play therapy. Zest also works to integrate its care with schools, childcare providers, and therapy centers, creating a seamless network of support for children and their families.

Serving All Families: The Medicaid Initiative

One of Zest’s most groundbreaking efforts is its Medicaid program. The network directly contracts with a Medicaid plan to offer services to families across the economic spectrum. This initiative has dual aims: providing equitable access to high-quality care and gathering data to demonstrate the model’s effectiveness.

Through the Medicaid partnership, Zest is working to empirically validate the model by measuring its impact on emergency room visits, urgent care use, well-child visits, and chronic disease management. While there is data showing the value of pediatricians in traditional fee-for-service environments, specific outcomes data for pediatric direct care is limited. Zest’s Medicaid initiative aims to close that gap.

Clarifying Identity: Direct Pediatric Care vs. Direct Primary Care

To distinguish its model, the network uses the term Direct Pediatric Care (DPC) instead of the more generic Direct Primary Care. Though both share core principles, Direct Pediatric Care has unique elements specific to children’s health. Key distinctions include:

Home Visits: A majority of pediatric DPC physicians conduct home visits, particularly for newborns, a rarity among family medicine DPC practices.
Vaccinations: Pediatric DPC practices prioritize vaccination access, even delivering vaccines to homes, whereas some family medicine DPCs do not offer comprehensive vaccine programs.
Wraparound Services: DPC focuses heavily on additional services that support parents and child development.
Visit Frequency: Pediatric DPC involves more frequent visits, especially during the first year after birth.
Specialized Training: Pediatricians bring targeted expertise that family medicine doctors may not possess.
Fee Structure: Higher fees reflect the frequency and breadth of services offered.
Value for Young Children: The model is especially beneficial for children ages 0–5, a critical window for development.

Patient Acquisition: A Unique Challenge

One significant challenge in the pediatric direct care space is patient acquisition, which is considerably more difficult than in adult DPC. In traditional fee-for-service pediatrics, parents can often obtain appointments relatively quickly, even if not always with their preferred doctor. This immediacy reduces the perceived urgency for parents to seek out a different model like direct care.

Furthermore, marketing differs significantly. While traditional advertising can be effective in the adult DPC world, leading people to choose a doctor based on an ad, parents typically select a pediatrician based on warm referrals and the ability to build rapport. Increasing overall awareness of DPC as a viable model for pediatrics is a significant challenge for the entire movement. The MSO provides tools and strategies to help doctors overcome this, including social media libraries and networking toolkits, which are seen as key ways to acquire initial patients

A Pure Pediatric Focus

While Dr. Hertz acknowledges that partnering with adult-focused direct care networks could simplify business contracting, Zest remains intentionally pediatric. This decision ensures that children’s care doesn’t become secondary to more lucrative adult services. Zest is built to keep pediatric needs front and center.

Where Zest Is Today

Currently, the Zest Pediatric Network includes six offices across Cleveland ,Pittsburgh, and Weston. Each physician in the network operates as an independent LLC, offering business and tax flexibility. However, they benefit from Zest’s central infrastructure and are also owners in the parent company, an approach that fosters shared investment and community.

Zest makes significant upfront investments in helping doctors launch, with resources aimed at reducing the risk and stress of building a practice from the ground up. This collaborative, physician-first approach is core to its growth strategy.

Redefining Pediatric Care

Dr.Hertz’s transformation from a corporate health executive to a champion of direct pediatric care reflects a deep commitment to children and families. Through Zest, he has created a scalable model that removes barriers for pediatricians, strengthens the doctor-patient relationship, and delivers holistic care for the youngest, most vulnerable members of our communities.

With a strong foundation and a growing footprint, Zest is well on its way to reshaping pediatric care in America.