Primary care is the most underfunded and undervalued part of our health care system.¹ To provide truly comprehensive primary care, physicians would require a 27-hour workday.² With the ideal team-based approach, the number shrinks to about nine hours per day,² but unfortunately current billing mechanisms are inadequate to support the required dietitians, counselors, nurses, and care managers.

Over the last few years, 71,000 physicians have left the workforce, with primary care and mental health hit hardest.^3,4 The result is that more than 100 million Americans now lack access to primary care⁵ — meanwhile, health care costs and the prevalence of chronic disease continue to rise.

Despite these headwinds, we will describe in this article a model that can stabilize primary care within our current health care system. By co-locating primary care and “immediate” care — essentially urgent care without urgent care certification — under the same operational umbrella, we improved fiscal solvency, patient access, and clinician satisfaction. While our specific model is no longer in effect due to changing institutional priorities, we still believe it holds promise.