Welcome to the Swamp? Let’s Try This Again

Michelle Davey
5 min readApr 5, 2021

Disrupting healthcare has proven challenging for even the most successful companies and brightest minds. Bold promises have underwhelmed. Timelines have shifted. Expectations have lowered. Fundamentally changing our broken healthcare system is going to take a lot of blood, sweat, and tears with plenty of failures along the way.

At the same time, what makes our healthcare system so frustrating and challenging also presents an exceptional opportunity for change and evolution with the potential to drive immense impact on human lives.

That’s why I was surprised to hear Amwell CEO’s take when asked about Amazon’s decision to expand into virtual primary care: “I would just say welcome to the swamp. It’s much more complicated than you think.”

This rather brief statement spoke volumes about the state of mind for telemedicine incumbents. As the founder and CEO of a company that is focused on supporting companies of all sizes to expand access to virtual care services, here’s what I heard in his answer:

Fixing our broken system may be a lost cause. It’s too hard, it’s too challenging, and you’ll most likely fail if you try.

Of course, Amwell CEO’s reaction wasn’t simply about the anxiety around Amazon or any of the giant companies expanding into virtual care. It was also driven by the fatigue of a nearly 20-year uphill battle with regulatory red tape, skepticism from the medical community, and lack of interest from patients at large. It has been incredibly challenging to move an industry forward with these external forces at play.

Then the pandemic changed everything. Well, almost everything. Patient demand skyrocketed, policymakers enacted emergency waivers, and clinicians found comfort and confidence that telemedicine can uphold high standards of care.

What hasn’t changed is our industry’s knee-jerk reaction to bringing our broken system online. While many of us have been sprinting full speed ahead to meet the growing demand for telehealth and virtual care, it turns out the pandemic forced only some of us to think outside of the box.

To drive true change, we need to acknowledge the so-called swamp may be more man-made than we’d like to admit. Here’s what the virtual care industry has collectively failed to address over the years:

Replicating the 1:1 care model: Limiting clinicians to working within a single organization limits patient access, exacerbates our massive clinician shortage, and reinforces our existing healthcare deserts. Virtual care can offer clinicians the freedom and flexibility they deserve to work across multiple organizations, yet we’ve so far failed to take advantage of this opportunity to reimagine care delivery. Providing clinicians with the ability to treat patients from multiple organizations with ease, efficiency, and expediency is the only way we can meet the promise of expanding access and improving patient outcomes while decreasing costs.

Building next-generation technology: Telemedicine isn’t new, yet has been underutilized and underinvested in for the last 20 years. To date, we’ve largely taken the doctor visit online with a video call. These modalities have provided access to care for some but largely increased the digital divide. We can’t expect to deliver on the promise of expanding access to care if we make broadband internet a requirement to receive care. Technology should improve our relationship with patients, not exclude them. It’s our job to provide clinicians with all of the tools to communicate with their patients — whether it’s an asynchronous chat feature or a synchronous video call — and allow them to decide which method is best to meet the standard of care.

Lack of a clinician-centered experience: Historically the healthcare system has treated clinicians as commodities and the pandemic has only exacerbated burnout, resulting in anxiety, depression, PTSD, and suicide within the profession. We need to do a better job of taking care of those who take care of us — whether it’s offering flexible schedules, technology designed with the clinician experience in mind, or the training and resources needed to confidently deliver care. Clinicians shouldn’t have to work so hard to earn our support and protection.

Competing over patients: While many telehealth incumbents provide the technical support and infrastructure to help companies and hospital systems stand up virtual care services, their business is largely focused on their own direct-to-patient services. This not only creates an interesting dynamic where the client becomes the competitor but can also explain why the industry has been slow to innovate. When resources are spent on acquiring patients, that leaves less to invest on improving the clinician experience or investing in next-generation technology.

Tech is challenging and expensive to build, regulations are complicated and prohibitive, and clinicians are scarce and burned out. At the same time, there’s no good reason why it should take two decades worth of experience to reach millions of patients.

Wheel was founded on the belief that the virtual care industry needs a new and more efficient way to scale and reach more patients while ensuring clinicians are supported and protected. We’ve purposefully built our technology and clinician network to make it as easy as possible for companies to succeed if they have the drive to change and challenge our healthcare system

When we first came up with the idea for Wheel, we spotted the swamp from miles away. Instead of pulling out our water-proof gear, we decided to build a bridge. In other words, rather than continue along the path of encouraging companies to build in a silo with scarce resources, we set out to break down barriers to innovation and democratize the ability to deliver high-quality care.

We’re a fast-growing tech company with an ambitious agenda, and we built our business on the idea that it’s incredibly difficult to drive change in healthcare. But when we look at the future of our industry, we don’t see a swamp. We see a massive opportunity to meet the demand for virtual care and work together to put our big visions to the test. Most importantly, with an estimated 1 in 3 patient interactions going virtual in 2021, we don’t have any time to waste.



Michelle Davey

CEO & Co-Founder of Wheel on a mission to change the way healthcare works by putting clinicians first and delivering the highest quality virtual care at scale.