diff --git a/.env.sample b/.env.sample
index dd2fc867..41f9b317 100644
--- a/.env.sample
+++ b/.env.sample
@@ -4,19 +4,18 @@ PIXL_QUERY_TIMEOUT=10
 CLI_RETRY_SECONDS=300
 
 # PIXL PostgreSQL instance
-PIXL_DB_HOST=postgres-exposed
+PIXL_DB_HOST=postgres
 PIXL_DB_PORT=5432
 PIXL_DB_NAME=pixl
 PIXL_DB_USER=pixl
 PIXL_DB_PASSWORD=
 SKIP_ALEMBIC=false
-EXTERNAL_PIXL_DB=false
 
 # PIXL DB Postgres host
 CLI_PIXL_DB_HOST=localhost
 
 # Orthanc Raw PostgreSQL instance
-ORTHANC_RAW_DB_HOST=postgres-exposed  # change to correct host if PIXL DB is external postgres instance
+ORTHANC_RAW_DB_HOST=postgres
 ORTHANC_RAW_DB_PORT=5432
 ORTHANC_RAW_DB_NAME=pixl
 ORTHANC_RAW_DB_USER=pixl
diff --git a/cli/README.md b/cli/README.md
index de753ac1..f2002f13 100644
--- a/cli/README.md
+++ b/cli/README.md
@@ -29,34 +29,17 @@ See general pixl commands and subcommands with:
 pixl --help
 ```
 
-### Starting PIXL
-
 For convenience, we provide the `pixl dc` command, which acts as a wrapper for `docker compose`,
 but takes care of some of the configuration for you.
 
-**1) Default Start-up**
+For example,
 
 ```bash
 pixl dc up
 ```
 
-**2) Start-up with External PIXL DB**
-
-PIXL can be set up so that the PIXL DB uses a separate postgres instance to Orthanc Raw, e.g. for production environment configurations. 
-Edit the .env file to enable this:
-
-```bash
-EXTERNAL_PIXL_DB=true
-
-CLI_PIXL_DB_PORT=7001
-
-ORTHANC_RAW_DB_HOST=postgres
-```
-
-Start-up PIXL:
-```bash
-pixl dc up
-```
+will run `docker compose --project pixl_{pixl_env} up --wait --build --remove-orphans`, where `pixl_env`
+is determined by the `ENV` environment variable.
 
 ### Configuration
 
diff --git a/cli/src/pixl_cli/_docker_commands.py b/cli/src/pixl_cli/_docker_commands.py
index 592606b8..ba9406be 100644
--- a/cli/src/pixl_cli/_docker_commands.py
+++ b/cli/src/pixl_cli/_docker_commands.py
@@ -34,27 +34,13 @@ def dc(args: tuple[str]) -> None:
     docker_args = list(args)
 
     if "up" in args:
-        docker_args = _parse_up_args(args)
+        docker_args = [*args, "--wait", "--build", "--remove-orphans"]
     if "down" in args:
         docker_args = _check_down_args(args)
 
     run_docker_compose(docker_args, working_dir=PIXL_ROOT)
 
 
-def _parse_up_args(args: tuple[str, ...]) -> list:
-    """Check up args and set docker compose profile"""
-    args_list = list(args)
-
-    up_index = args.index("up")
-    external_pixl_db_env = config("EXTERNAL_PIXL_DB", cast=bool)
-    args_list[up_index:up_index] = (
-        ["--profile", "postgres"] if external_pixl_db_env else ["--profile", "postgres-exposed"]
-    )
-
-    args_list.extend(["--wait", "--build", "--remove-orphans"])
-    return args_list
-
-
 def _check_down_args(args: tuple[str, ...]) -> list:
     """Stop all the PIXL services"""
     if config("ENV") == "prod" and "--volumes" in args:
diff --git a/docker-compose.yml b/docker-compose.yml
index 78c18de4..df27cf19 100644
--- a/docker-compose.yml
+++ b/docker-compose.yml
@@ -165,9 +165,8 @@ services:
         extra_hosts:
             - "host.docker.internal:host-gateway"
         depends_on:
-            postgres-exposed:
+            postgres:
                 condition: service_healthy
-                required: false
         healthcheck:
             test:
                 [
@@ -224,10 +223,6 @@ services:
         depends_on:
             postgres:
                 condition: service_healthy
-                required: false
-            postgres-exposed:
-                condition: service_healthy
-                required: false
             orthanc-anon:
                 condition: service_started
         healthcheck:
@@ -295,10 +290,6 @@ services:
                 condition: service_healthy
             postgres:
                 condition: service_healthy
-                required: false
-            postgres-exposed:
-                condition: service_healthy
-                required: false
             hasher-api:
                 condition: service_healthy
         ports:
@@ -368,8 +359,7 @@ services:
 
     ################################################################################
     # Data Stores
-    postgres-exposed:
-        profiles: [postgres-exposed]
+    postgres:
         build:
             context: .
             dockerfile: ./docker/postgres/Dockerfile
@@ -397,30 +387,3 @@ services:
         restart: always
         networks:
             - pixl-net
-    postgres:
-        profiles: [postgres]
-        build:
-            context: .
-            dockerfile: ./docker/postgres/Dockerfile
-            args:
-                <<: *build-args-common
-        environment:
-            POSTGRES_USER: ${ORTHANC_RAW_DB_USER}
-            POSTGRES_PASSWORD: ${ORTHANC_RAW_DB_PASSWORD}
-            POSTGRES_DB: ${ORTHANC_RAW_DB_NAME}
-            PGTZ: ${TZ:-Europe/London}
-        env_file:
-            - ./docker/common.env
-        command: postgres -c 'config_file=/etc/postgresql/postgresql.conf'
-        volumes:
-            - type: volume
-              source: postgres-data
-              target: /var/lib/postgresql/data
-        healthcheck:
-            test: ["CMD", "pg_isready", "-U", "${ORTHANC_RAW_DB_USER}", "--dbname", "${ORTHANC_RAW_DB_NAME}"]
-            interval: 10s
-            timeout: 30s
-            retries: 5
-        restart: always
-        networks:
-            - pixl-net
diff --git a/test/.env b/test/.env
index ba159a70..a8565840 100644
--- a/test/.env
+++ b/test/.env
@@ -8,13 +8,12 @@ PIXL_MAX_MESSAGES_IN_FLIGHT=5
 TZ=Europe/London
 
 # PIXL PostgreSQL instance
-PIXL_DB_HOST=postgres-pixl-db
+PIXL_DB_HOST=postgres
 PIXL_DB_PORT=5432
 PIXL_DB_NAME=pixl
 PIXL_DB_USER=pixl_db_username
 PIXL_DB_PASSWORD=pixl_db_password
 SKIP_ALEMBIC=false
-EXTERNAL_PIXL_DB=true
 
 # PIXL DB Postgres host
 CLI_PIXL_DB_HOST=localhost
@@ -23,8 +22,8 @@ CLI_PIXL_DB_HOST=localhost
 ORTHANC_RAW_DB_HOST=postgres
 ORTHANC_RAW_DB_PORT=5432
 ORTHANC_RAW_DB_NAME=pixl
-ORTHANC_RAW_DB_USER=orthanc_raw_db_username
-ORTHANC_RAW_DB_PASSWORD=orthanc_raw_db_password
+ORTHANC_RAW_DB_USER=pixl_db_username
+ORTHANC_RAW_DB_PASSWORD=pixl_db_password
 
 # Exposed ports
 HASHER_API_PORT=7010
diff --git a/test/docker-compose.yml b/test/docker-compose.yml
index 33078f49..f123709f 100644
--- a/test/docker-compose.yml
+++ b/test/docker-compose.yml
@@ -13,7 +13,6 @@
 #  limitations under the License.
 volumes:
     vna-qr-data:
-    postgres-pixl-db-data:
 
 networks:
     pixl-net:
@@ -74,27 +73,3 @@ services:
             retries: 2
             interval: 3s
             timeout: 2s
-    postgres-pixl-db:
-        build:
-            context: ../
-            dockerfile: ./docker/postgres/Dockerfile
-        environment:
-            POSTGRES_USER: ${PIXL_DB_USER}
-            POSTGRES_PASSWORD: ${PIXL_DB_PASSWORD}
-            POSTGRES_DB: ${PIXL_DB_NAME}
-            PGTZ: ${TZ:-Europe/London}
-        command: postgres -c 'config_file=/etc/postgresql/postgresql.conf'
-        volumes:
-            - type: volume
-              source: postgres-pixl-db-data
-              target: /var/lib/postgresql/data
-        ports:
-            - "${CLI_PIXL_DB_PORT}:5432"
-        healthcheck:
-            test: ["CMD", "pg_isready", "-U", "${PIXL_DB_USER}", "--dbname", "${PIXL_DB_NAME}"]
-            interval: 10s
-            timeout: 30s
-            retries: 5
-        restart: always
-        networks:
-            - pixl-net
diff --git a/test/run-system-test.sh b/test/run-system-test.sh
index 4e3cccd7..da7c71fd 100755
--- a/test/run-system-test.sh
+++ b/test/run-system-test.sh
@@ -28,14 +28,14 @@ setup() {
     # Warning: Requires to be run from the project root
     (
     	cd "${PACKAGE_DIR}"
-    	docker compose --env-file test/.env --env-file test/.secrets.env --profile postgres -p system-test up --wait -d --build
+    	docker compose --env-file test/.env --env-file test/.secrets.env -p system-test up --wait -d --build
     )
 }
 
 teardown() {
     (
     	cd "${PACKAGE_DIR}"
-    	docker compose -f docker-compose.yml -f test/docker-compose.yml --profile postgres -p system-test down --volumes
+    	docker compose -f docker-compose.yml -f test/docker-compose.yml -p system-test down --volumes
     )
 }