The Invisible Doctor: Why Patients Struggle to Find Physicians Ready to Help
Picture an adult in Texas late at night, worried about a fever and worsening cough, scrolling through her phone. Is this service legitimate? What will it cost? Will she speak with a physician? Does she need an emergency room instead?
Somewhere else, a physician may be licensed, available and willing to help. They may never meet. Nothing about the medicine keeps them apart. What separates them is the work of being found.
I know the physician's side of that distance. I am a board-certified physician whose work includes family medicine and emergency care, and I operate an independent Texas-based practice. I have learned that being qualified and available does not mean patients can find me.
Telehealth has made appropriate care more convenient for many people. Yet between a patient searching for help and a physician prepared to provide it sits a growing infrastructure of search engines, marketplaces, payment systems, certification programs, forms and automated intake. Much of it provides value. The question is whether each layer makes appropriate care easier to reach.
Help should be part of access
Before a virtual visit, patients may need to choose a service, confirm state eligibility, understand pricing, register, verify an email, upload identification, list medications and resolve camera permissions. Identity checks, consent and accurate histories support safe care. Other steps reflect software choices.
For someone sick, anxious, visually impaired or unfamiliar with online forms, those distinctions may offer little comfort. Every step can become a reason to stop. Federal telehealth guidance recognizes the importance of preparation and technical assistance.1 An abandoned registration may look like a lost lead. It does not tell us whether the person still needed help.
In my practice, my staff and I are willing to work through the process personally, within the practice's availability: explaining how to connect, clarifying what information is needed and reviewing medical information with the patient. When circumstances warrant and applicable requirements permit, that may include occasional reduced-fee or no-charge assistance or care. This is discretionary help, not a blanket promise of free services.
My Christian faith shapes that commitment to compassion, dignity and service. I try to express it through patience, honesty and practical help. Patients of every faith and no faith are welcome; sharing my beliefs is never an expectation or condition of care. My clinical decisions remain grounded in scientific evidence, professional judgment and each patient's informed preferences.
Paperwork deserves the same patience. Patients may know they need a doctor's help without understanding what a form requires the physician to establish. We are willing to review their information, explain what can honestly be supported and identify what is missing. Some certifications require an examination, testing, records over time or a specialist's assessment. Reviewing a request cannot guarantee a signature or a particular conclusion.
Appropriate referral is also part of responsible telehealth. A visit may reveal the need for local testing, an examination, specialist care or emergency evaluation. Explaining why, how urgently and what information to bring helps patients move forward. That assistance should remain honest about limits: another clinic's availability and insurance coverage cannot be guaranteed.
Being visible is different from being qualified
These acts of assistance are difficult to communicate in a search result. A listing can show a price, rating or appointment. It cannot readily show whether a physician will patiently help someone who gets stuck.
Patients searching online face two problems. They must assess the reliability of medical information. Then, even after deciding to speak with a clinician, they must find an appropriate one. The systems organizing their choices influence who receives the opportunity to demonstrate clinical skill.
Paid advertising and organic search are separate systems; buying advertisements does not directly buy organic rankings. Both nevertheless require resources: understandable websites, useful content, technical upkeep and, for advertising, money. Attracting patients is necessary to sustain a practice. The concern is proportion. A physician's ability to compete for attention should not be mistaken for the quality of care that physician can provide.
What does the intermediary add?
Commercial platforms solve genuine problems. Scheduling, payments, technology and an established audience can be valuable to patients and clinicians. Their business models differ, so criticism must be specific.
Sesame's published provider terms distinguish the Provider Price from the Listed Price. They describe clinicians receiving their Provider Price minus processing and transfer costs, currently stated as a maximum of 3.49 percent, while permitting an additional flat platform fee in the Listed Price.2 That does not support a blanket claim that the platform takes a large percentage from every doctor's compensation.
The stronger question concerns the patient's total cost: what is the clinician charging, what does the patient pay, and what additional service does the difference purchase? Patients should understand follow-up arrangements as well as the initial price. The same standard applies to independent practices. Direct care may leave room for affordable pricing or personal assistance, but neither follows automatically from being small.
When verification becomes a cost of being found
Healthcare advertising warrants scrutiny. Fraudulent prescribing and misleading health claims can harm patients. Google requires certification for relevant U.S. telemedicine advertising that facilitates prescribing, including LegitScript accreditation and Google's own certification.3 These commercial advertising requirements are separate from medical licensure and do not replace verification of the treating clinician's qualifications.
LegitScript's standard healthcare certification currently lists a nonrefundable $975 application fee and a $2,150 annual certification fee per website: $3,125 in the first year if approved.4 At a $39 evaluation price, covering that charge requires approximately 81 visits' gross revenue before clinical time or any other expense.
That arithmetic illustrates a burden; it does not establish that certification lacks value. Larger organizations can distribute fixed expenses across more encounters. A small practice may have far fewer over which to spread them. Clear requirements, proportionate pricing, predictable review and reusable verification deserve consideration. Patient protection should remain rigorous while responsible small practices retain a workable route to participation.
AI could help close the gap
Here is the irony: I am using AI to build tools that may help patients discover my practice while questioning the digital systems between us. AI helps me organize ideas, develop my website and draft explanations that I review and correct. A small practice may lack dedicated communications and technical teams. Access to that assistance matters.
AI also helped develop this essay. Reviewing its suggestions and checking published terms exposed places where my early argument was too broad. Sesame's terms required a more careful distinction between provider compensation and patient-facing charges. That correction strengthened the critique. Human responsibility includes challenging an AI-generated claim, even when it supports an argument we want to make.
The risks are real. WHO has warned that language models can produce plausible but incorrect health information and raise privacy and bias concerns.5 Record summaries require checking, medical forms require responsible professional judgment, and patient information belongs only in systems with appropriate safeguards. A confident answer should never be confused with a completed clinical assessment.
AI could create another barrier: automated intake with no practical route to a person, unclear commercial recommendations or advice that delays needed care. It could also reduce repetitive work, improve explanations and preserve time for patients. The principle should be simple: automate the bureaucracy, preserve the humanity.
If technology saves an hour, some of that time could support a better explanation, a difficult paperwork review or a clearer follow-up plan. Efficiency should be assessed through the care it enables, alongside the work it removes.
An accountable person at the other end
Patients should be able to identify their clinician, understand the price, confirm location eligibility and know the limits of the service. Sponsored placement should be recognizable. Clinical advice should make clear whether a human reviewed it. People struggling with an automated process need a practical way to seek assistance.
Independent practices must meet those expectations too. Being small does not excuse unsafe prescribing, confusing charges, inaccessible systems or promises that cannot be kept. The argument is for meaningful choice and a fair opportunity to demonstrate the value of responsible care.
Return to the woman searching on her phone. Her first need is help deciding where to turn. A suitable telehealth service may be one option; local examination or emergency care may be another. Finding a clinician should make that decision clearer.
I am using AI to help patients find me. What I want them to find is a physician who listens, exercises judgment and helps them understand the next step. For an independent doctor, being found is the beginning of that responsibility. And when a patient finally gets through, there should still be a doctor there.
Sources
Policy descriptions and prices reflect sources checked on October 15, 2026, and may change. Personal commitments and opinions are the author's.
- HHS, Preparing patients for hybrid care
- Sesame, Provider Terms of Service — Fees
- Google Ads, Healthcare and medicines and Prescription drug services
- LegitScript, Healthcare Certification — Pricing
- WHO, WHO calls for safe and ethical AI for health
About the author: Nicholas O. Atudonyang, MD, is a board-certified physician whose work includes family medicine and emergency care. He leads Americare Telehealth, a Texas-based practice. AI tools assisted with drafting and editorial review; the author retains responsibility for final approval and publication.