As more patients avoid primary care while retail chains and virtual care players push into the space, panelists at ViVE 2023 discussed the future of preventive medicine and whether digital health could improve access. 

Ali Parsa, CEO and founder of digital health firm Babylon, said more primary care options are a positive for the healthcare system. The problems are "too vast" for one group to manage alone. 

"There'll be a really varied group of people, that each flower can blossom and provide choice to our members and patients. That is not the situation we're working towards. I think we're seeing a huge amount of consolidation happening in the sector," he said. 

Dr. Nworah Ayogu, general manager and chief medical officer of the newly launched Amazon Clinic, argued primary care entrants shouldn't focus on who owns the sector, but how they can improve the patient and provider experience.

"What can we bring to customers? What can we bring to doctors and providers to help them do their jobs better? Because God knows it is actually really hard to be a provider. And in a lot of ways, it hasn't gotten easier. In a lot of ways, it's gotten harder," he said. "So how do we start to make that easier for the customers, easier for the doctors, easier for the system?"

Vidya Raman-Tangella, chief medical officer at virtual care giant Teladoc Health, said it's important to place patients at the center and involve them more directly in their care. It's not care that's being done to the patient, but care done with them. 

"All of us are here as stakeholders in a very large and complex ecosystem to do our part: provide effective, equitable care," she said. "But at the end of the day, what you want to do is empower the patient to do their part. Because they are the only ones that can control those intricate lifestyle factors that really influence health and disease."

Though access to primary care is associated with better health outcomes, more people aren't utilizing it. According to a recent FAIR Health report, 29% of patients who received medical services between 2016 and 2022 didn't visit a primary care provider. However, that varied between states, from a high of 43% in Tennessee to a low of 16% in Massachusetts.

Karen Silgen, general manager and vice president of virtual care at insurer UnitedHealthcare, said some patients are engaged, but others don't really want to see a primary care provider. That's where adding more convenient places to find care could help.

"I think creating those options and access points within the healthcare system is important," she said. "A lot of the virtual care companies we've put in-network, so all of our commercial members have access to them. So it's not a buy up to an employer."

But it can't be all on the patient, Amazon's Ayogu said. Patients want to be healthy, and it's not necessarily a will problem that's keeping them from primary care. 

"We know that healthcare is not affordable, it's not accessible, it's not convenient. We know that people are busy and have a lot of other pressing concerns to handle," he said. "The onus and impetus is actually on us to make healthcare easy to access, affordable, convenient. And that's really where our focus should be."