A generation or two ago, when Americans had an important but nonemergency medical need, many of them would have called on their family doctor, somebody who had treated them for years. It was a little like going to a family restaurant: The purveyors knew you, knew your tastes and personal quirks, and they were part of the fabric of your community.

These days, patients aren’t visiting the family doctor nearly as frequently. They’re instead heading to what you might think of as drive-thru clinics — some physical, some entirely online — where they order off a menu, undergo a cursory and formulaic interaction with a healthcare provider they’ll never see again, and head off with the product they came to get. It’s like ordering a Big Mac at McDonald’s: When you pull up, you already know exactly what you want.

In some cases, this drive-thru healthcare approach is filling genuine holes in healthcare access for Americans who are in need, such as people in the United States who live in the states with restricted access to reproductive and abortion services, and who have had no choice but to seek help online from other providers out of state. Beyond that, we’re dealing with a doctor shortage. Wait times to see a physician for all types of care are getting longer and longer — and these new practices promise to put you in touch with one with a simple click of a button. They can also offer competitive prices compared to conventional medicine, even without taking insurance, because they have maximized their efficiency. They’ve eliminated a lot of overhead in terms of physical space or administrative workload. One provider can screen an enormous number of patients and rake in a lot of revenue, which allows the company to reduce their prices.

“The word of the day in health policy is affordability,” said Dr. Ateev Mehrotra, who chairs the Department of Health Services, Policy, and Practice at the Brown University School of Public Health and has studied these practices. “You can see how these can create a more affordable and accessible way” to get healthcare.

But replacing the traditional doctor-patient relationship with something brief and transactional presents real risks to patients and their long-term well-being. Some of the most common reasons for seeking these services — erectile dysfunction medications or hair loss treatments — could be signs of an underlying health condition that would benefit from a more serious conversation with a personal physician.

The trick is in knowing the difference — and that isn’t always easy to do. The US healthcare system in its current incarnation places an enormous burden on individuals to figure out the best way to get the care they need.

“A lot of quote-unquote empowered consumers are engaging in a lot of do-it-yourself medicine without necessarily understanding the limits of it,” Dr. Sachin Jain, who held several leadership roles in the Department of Health and Human Services during the Obama administration and is currently the CEO of the nonprofit Medicare Advantage insurance carrier SCAN Health Plan, told Vox. “I think even though there are more options for patients today than there were 30 years ago, the degree of fragmentation, in my view, is decreasing quality and truly eroding the patient experience.”

Drive-thru clinics don’t appear to be going anywhere — and that’s exactly why consumers need to be smart about how they use them.

In hundreds of communities, a doctor shortage is already here. Most of rural America, 80 percent of it, is considered by the federal government to be medically underserved. About 20 percent of the US population lives in rural communities, but only 10 percent of doctors practice there.

“This notion that there’s going to be this available person who’s covered through your insurance, like who schedules visits with you and really gets to know you and is able to provide you with a comprehensive assessment, is just unavailable to most people,” Jain said.

Faced with these barriers, Americans have gravitated toward the convenience offered by urgent care facilities and “minute clinics” in pharmacies or large retail stores. The number of urgent care visits among privately insured Americans doubled from 2008 to 2015. In 2024, more than 80 percent of Americans said they had visited an urgent care or other kind of walk-in clinic; about 7 percent said in 2022 that it was their regular source of care.

The success of those businesses revealed Americans were comfortable with one-time-only healthcare. The idea of visiting a provider for one specific purpose predetermined by the patient started to take hold. As medical marijuana proliferated in the 2000s and 2010s, clinics popped up that offered the kind of routinized service that is now commonplace: Simply answer a few questions, and you’ll get the prescription you desire.

Today, that kind of service is available for an array of medical products and services, including erectile dysfunction pills, testosterone, GLP-1s, birth control, performance anxiety drugs, and Botox. They are finding an audience as Americans desire agency over their own healthcare — driven by the lack of access to conventional healthcare, distrust in the medical establishment, and wellness trends that prioritize self-optimization.

According to one consumer survey, 80 percent of Americans said that they own at least one personal medical device, which could include a blood pressure monitor or smartwatch. Nearly half prefer at-home or virtual care to visiting a doctor’s office. They increasingly consult Google or ChatGPT to investigate their own health before seeing a provider.

“We glorified do-it-yourself medicine through the lens of this idea of consumerism,” Jain said. “What consumerism has really done is it’s created a high degree of fragmentation in a customer base, where they may not fully understand or know what they need.”

Amid those trends, the old-fashioned image of a family doctor you’d call for any range of medical needs looks increasingly out-of-date and out of reach.

“It’s turning medical care into a commodity,” said John McDonough, a public health professor at the Harvard T.H. Chan School of Public Health and author of the new book America’s Wrong Turn: US Health Care in the Neoliberal Era. “You can buy the package of services. You can buy the individual services, and you can go to the store and pull it off the shelf.”

Medical care looks more like Hims and Hers, perhaps the most high-profile examples of this kind of limited-category telehealth. Visit their websites and it looks a lot like ordering at a fast-casual chain restaurant: Have better sex, grow fuller hair, lose more weight, treat menopause, and would you like a side of testosterone with that? In 2025, the company generated $2.4 billion in revenue, an increase of 59 percent from 2024; it now claims more than 2.5 million subscribers.

Many consumers are getting the convenience they desire, but others may feel that the patient experience suffers. Patients on social media who’ve used Hims and Hers, for example, will sometimes complain about how impersonal the interactions feel or worry the service is increasing their dose too quickly.

In a statement to Vox, Dr. Pat Carroll, chief medical officer of Hims & Hers, said:

The premise of these services is that the patient knows what they want. But even a well-informed patient is not a physician — and, at the same time, these business models are based on doctors selling a specific product, not necessarily on whether they are providing the most clinically appropriate care during this one-time interaction.

“What happened is a number of entrepreneurs started picking off specific pain points, like things that are true pain points for patients, where there’s no clean place to go, and created access,” Jain said. For example, you may not be able to find a dermatologist covered by your insurance but visit a Hims and Hers-type service, and “there’s going to be someone there who’s willing to use their medical license to actually give you the thing you need.”

Patients should be cautious about using these “drive-thru” services, given those misaligned incentives, experts told me. Two of the most popular uses — for men who are seeking treatment for impotence or hair loss — are instructive.

On its face, erectile dysfunction checks all the boxes for this kind of service: It’s a narrow medical question and there is an obvious drug for physicians to prescribe. People who might be embarrassed to bring the problem up can get the treatment they want after answering a few questions from a provider that they will never have to see again, without anybody else needing to know.

But erectile dysfunction can be a more complex medical question than “can you get an erection when you want to have sex?” It absolutely could be something as innocuous as older age, and therefore an ED drug is the right treatment. But it could be a sign of serious underlying health problems such as hypertension, diabetes, depression and anxiety, sleep apnea, and more.

“Good clinical practice suggests that you have to rule out underlying causes while you’re simultaneously treating it,” Jain said. “I think that’s the kind of stuff that gets lost in clinically sloppy protocols. Oftentimes, these ‘lifestyle conditions’ are the window into broader systemic issues that go untreated or undertreated.”

Likewise, losing your hair can simply be a byproduct of aging and thus responsive to a hair-loss treatment. But it can be an outward symptom of a more serious issue like hypothyroidism or, again, stress and anxiety. Performance anxiety, which some of these services will prescribe a beta blocker for ahead of, say, a public speaking engagement, could be a signal you have deeper issues with anxiety or depression.

Or take GLP-1 drugs, which have become a popular offering for telehealth services. As Vox has reported, these powerful drugs can be effective in helping people lose weight — but they can also have serious side effects, including dramatic loss of muscle mass. They require careful management in terms of eating the right diet and getting on the right kind of exercise regimen. Developing a holistic weight-loss plan would be best done in ongoing consultation with a doctor who knows you and your medical history.

But this is where the economics of drive-thru healthcare fail patients. The doctors who practice in them don’t necessarily make money by offering you the best personalized advice or looking at your health from a whole-person perspective. They make money by prescribing you the medication you came to get; some of these services even ship the drug to you directly themselves.

“The business model is the provider has a drug they’re trying to sell,” Vivian Ho, a healthcare economist at Rice University, told me. Some pharmaceutical ads now even allow you to click through to connect with a provider who will prescribe you the advertised drug.

Secret-shopper research has revealed the limitations of these types of services. When Mehrotra’s team tried out contraception telehealth clinics using different patient profiles, they found these services were generally very good at screening for the specific product that they offer. But the companies did not take a broader look at the person’s sexual and reproductive health.

“They never address the fundamental questions. No one ever asked about STDs. No one ever asked, ‘Did you get your Pap smear?’” Mehrotra said. “There’s some holes here in this.”

Of course, it’s easy to say that everyone should seek out a primary care physician for some of these services — but, given the access issues faced by many people, it’s not that simple. For a person who needs birth control but can’t get an OB-GYN appointment (wait times were up 33 percent in 2025 compared to 2022), using that uncurious drive-thru clinic might be better than the alternative if the alternative is nothing.

“If a woman wants a freaking birth control, she should have every right to get birth control. … There’s all sorts of research out there about birth control deserts in the world,” Mehrotra said. “So if that’s what she wants, go for it. … You could see how the rationale for these in the context of birth control could be quite viable.”

Jain told me that, in his ideal world, insured patients would at least have a specific general practitioner who would hopefully become their first stop for some of these medical needs. The emergence of direct primary care — where patients pay a flat fee for on-demand access to the same doctor or a group of doctors — could also provide a counterweight to drive-thru clinics. The premise of these practices is that you pay for a subscription to have a doctor on call whenever you need them, and that doctor will already know you and your medical history. But those services tend to target people well-off enough to pay those fees on top of health insurance premiums (or who can afford to just pay for everything out of pocket).

And there may be times when a one-time-only provider is a good option. Going to urgent care or a minute clinic can be convenient for minor medical needs like a strep test or a flu shot. Prior case studies have found that these facilities tend to operate under rigorous clinical protocols that guide the care they offer to their patients. The value proposition is clear: It’s readily available, it’s clinically sound — and it’s cheaper than going to the emergency room.

“When there’s a degree of clinical discipline that is really rigorous and where there’s a high degree of protocolization that ensures people are getting really high-quality care, I have no problem with it,” Jain said. “But a lot of times the work is highly superficial.”

Then there is at least one truly special case, where drive-thru clinics are providing a service to patients when they have no other options available: mifepristone and other abortion drugs in a post-Dobbs America. Requests for telehealth abortion care have doubled since the decision, according to the Center for Reproductive Rights. They have offered a vital lifeline to patients with an urgent healthcare need when the alternative is having to travel out of state: A recent report from the Guttmacher Institute found that the number of American women who lived in a state with a total abortion ban and traveled out of state for an abortion dropped in 2025 while, at the same time, telehealth visits for women in those states were on the rise.

The Supreme Court is still weighing whether to permit doctors to continue virtually prescribing mifepristone. For this special type of drive-thru clinic, the stakes are high.

“Women in the United States already face real health consequences, including preventable deaths, due to abortion care being denied or delayed,” wrote two women’s rights advocate at Human Rights Watch in May. “Ending telehealth provision would greatly worsen this crisis, especially for women and girls with limited financial resources, or with disabilities, and those living in states with abortion bans or in rural areas.”

But those abortion providers are, in the broader context of DIY healthcare, an exception that proves the rule. Without those services, patients would lose access to lifesaving medical care.

For other healthcare needs, however, convenience does not always equal quality. Buyer — and patient — beware.