Photo courtesy of MY DR NOW
Arizona is not an easy place to deliver healthcare. That is precisely why it has become the proving ground for a different model of primary care.
The structural realities are stark. Arizona faces a shortage of more than 4,000 physicians and 4,600 nurses, and today only about 35% of primary care needs are being met, according to Arizona Business Leadership. In some parts of the state, patients outnumber available physicians by the thousands or there are no physicians at all.
Layer on top of that a rapidly growing and aging population, significant rural geography and persistent disparities across Native American and Hispanic communities, and we begin to understand the scale of the access problem.
When nearly 29% of adults lack a regular primary care provider and more than 13% remain uninsured, the result is predictable: delayed care, higher costs and worse outcomes. Patients wait until conditions escalate, often ending up in emergency rooms for issues that should have been addressed earlier.
Arizona did not create these problems, but it concentrates them. And that makes it an ideal place to test whether a different approach can work.
Removing Friction by Maximizing Convenience for Patients
The traditional model of primary care was not designed for this reality. It assumes time, flexibility and proximity that many patients simply do not have. When access becomes constrained, everything downstream breaks.
What we have done differently at MY DR NOW is start with a simple premise: Access is the foundation. If patients can get care when and how they need it, engagement improves, outcomes improve and costs come down.
That philosophy has shaped a model that removes friction rather than adds to it. Care is available same day, across clinics, virtually and in the home. It operates on extended hours, seven days a week, embedded in the communities where people live.
At scale, this approach is delivering both clinical engagement and financial sustainability. The model has grown to hundreds of thousands of patient visits annually. New MY DR NOW sites reach breakeven quickly and achieve full payback within months, not years, while maintaining margins that are uncommon in primary care.
Those metrics matter because they demonstrate something critical: Improving access is not at odds with building a durable business.
Arizona has shown that when healthcare is designed around access, demand follows. Patients use the system as intended. Preventive care increases. Chronic conditions are managed earlier. Avoidable emergency utilization declines. What looks like a capacity problem is often an access problem in disguise.
Expanding Access beyond Arizona
The question is whether this model can work beyond Arizona.
The answer is yes, but with an important caveat. It is not about copying locations. It is about replicating discipline. The success of our approach is rooted in standardized operations, integrated care delivery and a relentless focus on removing barriers for patients. Without that consistency, scale does not translate.
Other states face similar pressures. Workforce shortages, aging populations and rising costs are not unique to Arizona. What differs is the urgency. Arizona forces the issue because the constraints are more visible and more acute.
That urgency created the conditions for innovation. It required rethinking long-standing assumptions about how care is delivered. It demanded a system that could function under pressure.
In that sense, Arizona is not an outlier. It is a preview.
If we are willing to acknowledge that access is the central problem in healthcare, then the path forward becomes clearer. Build systems that meet patients where they are. Eliminate unnecessary friction. Align care delivery with how people actually live.
Do that consistently, and the rest of the system begins to correct itself.
Payam Zamani, M.D., is the founder and CEO of MY DR NOW.
