by Jordan Fulghum, May 2026

My primary care doc recently went concierge, thus putting me on the market again. I realized that I don't want a new primary care doctor. I want less primary care.

My recent experience with primary care has been mostly fine in the way most legacy systems are mostly fine. I go once a year. Someone takes my blood pressure. I get a basic lab panel and a week later I am told whether my cholesterol is high, which I had already learned because I looked at the lab result several days before I remembered to check or figured out how to use the archaic messaging system.

If I am sick, they are there. If something is obviously wrong, they can route me. If I need an annual physical for some administrative reason, they can check the box. But that's not the same thing as optimizing my health, which is far more important.

The clinical default is usually necessity instead of upside. Their question is, “Do you need this to treat a condition?” not “Would this actually improve your odds of staying healthy, strong, and functional for the next thirty years?” Their default lens makes sense for insurance, liability, and acute care but is a poor fit for longevity.

The structure of primary care is built around scarcity. Scarce physician time. Scarce visits. Scarce lab work. Scarce interpretation. Scarce follow-up. The default cadence is annual.

This model fails because the more important job is to help me stay metabolically healthy, preserve muscle, reduce long-term risk, understand my biomarkers, evaluate new evidence, experiment based on rapidly developing new information, and make better decisions over time, personalized for me. For that, an annual office visit is a bad interface.

Concierge medicine is the obvious answer people point to, but I don't think it solves the right problem. Concierge solves the doctor's problem (fewer patients, more revenue per patient, more time per appointment, better economics, better upholstery). This probably makes sense for older and more at-risk patients, but what I want is actually much simpler.

I want a network of health nodes I can visit a few times a year. Something like Quest, but designed for this century. I want blood panels, vitals I can't easily get at home, body composition, blood pressure, ECG, DEXA, VO2 max, grip strength, metabolic markers, and other regular measurements that should not require a whole clinical relationship to obtain.

Everything synced to Apple Health, Google Health, and whatever EHR system still needs to exist in the background. I want the raw data, not a PDF buried in a portal or a brain scan image that I have to reverse-engineer via my browser dev tools to download locally.

Obviously, the interpretation layer has completely changed in the past couple of years. Frontier LLMs are already good enough to explain labs, compare them to prior results, identify what changed, summarize relevant/recent research, and analyze everything in the context of me. Given enough personal context and raw data, they are more useful than the average annual appointment. We're already there.

Prescriptions are already moving this direction.

For many common needs, I do not need to convince my primary care doctor to read three papers I found about tadalafil, GLP-1s, metformin, statins, creatine, blood pressure, sleep, or metabolic risk. I just use focused telehealth providers, get an immediate clinician review, and have medication shipped to my door through Cost Plus, GoodRx, Amazon, or any number of direct pharmacy options.

This hints to where medicine is headed: unbundled, specific, cash-transparent, and more convenient. The missing piece is still the physical layer.

So who is building the place where I can go 2-3x a year, get measured properly, sync everything, own the data, and use AI plus licensed clinicians where needed to decide what to do next? The winning version may look less like a clinic and more like a health data utility. A place to measure, verify, store, interpret, and route.

Primary care was built for a world where the doctor was the interface to medical knowledge, prescriptions, labs, and records but that world is quickly ending.

The next version should not just be a better doctor's office. I want a post-primary-care end-to-end UX: frequent measurement, portable AI-ready raw data, interpretation via my own agent, telehealth execution, and licensed clinicians where they actually matter. Make healthcare start with the data, not another appointment.

---

Follow me on Twitter for more.