HCA Healthcare, the for-profit hospital chain, doubled its number of urgent care centers last year to about 100, according to Merchant Medicine. GoHealth Urgent Care has teamed up with major health systems like Northwell Health in New York and Dignity Health in San Francisco, to open up about 80 centers. “There is huge consolidation in the market right now,” said Dr. Jeffrey Le Benger, the chief executive of Summit Medical Group, a large independent physician group in New Jersey. “Everyone is fighting for the primary care patient.” He, too, has opened up urgent care centers, which he describes as a “loss leader,” unprofitable but critical to managing patients. Eva Palmer, 22, of Washington, D.C., sought out One Medical, a venture-backed practice that is one of the nation’s largest independent groups, when she couldn’t get in to see a primary care doctor, even when she became ill. After paying the annual fee of about $200, she was able to make an appointment to get treatment for strep throat and pneumonia. “In 15 minutes, I was able to get the prescriptions I needed — it was awesome,” Ms. Palmer said. Patients also have the option of getting a virtual consultation at any time. By using sophisticated computer systems, One Medical, which employs 400 doctors and health staff members in eight major cities, allows its physicians to spend a half-hour with every patient. Dr. Navya Mysore joined One Medical after working for a large New York health system, where “there was a lot of bureaucracy,” she said. She now has more freedom to practice medicine the way she wants and focus more on preventive health, she said.
As US medical care goes through several significant changes primary care doctors are becoming increasingly scarce. This has been driven by major shifts to urgent care centers and retail clinics as treatment centers. As a result, CVS Health and Walmart have both looked at deals for Aetna and Humana to choose their stores as care delivery centers. People have turned to clinics and care centers away from traditional hospital to avoid the prohibitive costs associated with the doctor’s office. At the same time, according to the Health Care Cost Institute, visits to primary care doctors have fallen 20 percent between 2012 and 2016, although specialist visits did rise. This has become representative of the changing relationship between doctors and patients, as patients seek instant care. Moves made by big companies towards merging various aspects of the health care industry, such as that by Walmart, are threatening the future of family and primary care doctors. As companies like Walmart dictate where people receive their care, they increasingly have the data to direct the rest of their health care experience. Traditional doctors face being squeezed out by these giants, and as this process develops, investors are looking at businesses that create new ways of providing primary care. Doctors are adamant that although people are shifting away from traditional health care avenues, it is not resulting in better or less expensive care. A lack of knowledge of a patient, may see result in unnecessary prescriptions or treatments although this is a contentious point among doctors and researchers. Big hospital groups are also having a detrimental impact on primary care practices. In 2016, 43 percent of primary care doctors were employed by these groups, a rise of 18 percent since 2010. This has been matched by a push to open urgent care centers to ensure a flow of patients among their facilities. All these changes represent a massive consolidation of the health care market as big companies compete for the primary care patient, and telehealth is also becoming central to this process. However, as this process continues doubt remains over the continuity of care that patients often require.