“Physicians are many in title but very few in reality.” — Hippocrates
Corporate advertising that puts the customer first hardly begins with VillageMD and its Summit Health and CityMD subsidiaries. Of course, they “care” about their customers, otherwise known as patients. How else could they gain market share in the furiously competitive world of retail health services. Health plan advertising began in the mid-1970s and blossomed in the 80s, when the health industry became a buyer’s market in which consumers played a heightened role in the choice of hospitals, health plans, and even prescription medications.[1]
Boots Pharmaceuticals saw the handwriting on the wall. In 1983, it undertook the controversial step of airing a TV commercial touting the pain-reliever Rufun (prescription ibuprofen).[2] Healthcare plans were quick to follow. In the mid-80s, as managed care plans, especially HMOs, entered the market, UnitedHealthcare (now UnitedHealth Group), sought a competitive edge. An insurance company with a network-based health plan for seniors, it launched a nation-wide campaign of print advertising and 10- and 30-second TV spots. The corner had been turned.
In the mid-90s, a new player intent on market share was not content to insist that the customer always came first. It created an in-house culture of customer obsession. Indeed, the workplace mantra, “customer ecstasy,” was so omnipresent that company meetings included an empty chair to bring the customer’s voice into the conversation. Customer obsession, observed a senior executive of the time, “was our NorthStar.”
Was this a rival of UnitedHealthcare looking to bring customers into its fold? No indeed. It was Amazon, which opened the doors of its gigantic on-line bookstore in 1995. Jeff Bezos, brimming with idealism and expansionary zeal, recruited employees who joined him, he later reminisced, in “totally obsessing over the customer experience.”[3]
But Amazon began its odyssey by selling books. Its customers were book buyers pure and simple. Amazon did not profess a culture of caring to lull book buyers into the on-line store. It did not shower the internet with ads insisting that its mission was the intellectual and literary betterment of shoppers. It was enough to offer them a virtually limitless range of titles, discounted prices, and a hassle-free shopping experience. The only caring going on was the care of designers and programmers to ensure customers would be happy with the shopping experience and come back for more.
Now we have VillageMD and its affiliates, for whom “the customer comes first” becomes a pledge to provide care for life. For its customers, book buying gives way to issues of sickness and health – customers who arrive at an office or clinic with preexisting conditions, troublesome symptoms, and, often enough, anxiety at the prospect of diagnoses. Come to us, urges Summit Health, because our mission, above all else, is to care. Commerce is obscured by the radiant glow of beneficent intent. “Care at Every Connection” proclaims the firm’s 2021 advertising campaign. “Absolute customer satisfaction” is the promise. Go to summithealth.com and the light becomes blinding. A Lifetime of Care is the solemn promise given on the homepage in oversized bold font.[4]
Really? When Tim Barry co-founded VillageMD in 2013, he had a plan: to use technology, population data, and a network of health care professionals to provide quality primary care. The results would be better patient outcomes and reduced costs.[5] VillageMD would assume financial risk for the healthcare outcomes of its patients and would, he believed, garner market share across the nation. Financial success was just around the corner.
But things didn’t go as planned. Low primary care reimbursement schedules and staffing shortages were part of the problem.[6] Barry stepped down as CEO in November 2024 after Walgreens, its majority stakeholder since 2021, had ploughed a staggering $12.4 billion into new VillageMD clinics adjacent to Walgreens pharmacies. The main problem? The primary care clinics simply weren’t drawing patients.
New leadership, in the person of CEO Tim Murray, was necessary to reposition Walgreens for growth and profit. To this end, Murray would help Walgreens reach an “endpoint” in its financially draining commitment to VillageMD. After an operating loss of $13 billion in the first three quarters of 2024, $12.4 billion attributable to VillageMD, Walgreens apparently had had enough. Its CEO, Tim Wentworth, was refreshingly blunt about the new plan: reduce Walgreens’ stake in VillageMD. Only by putting an end to astronomical losses could Walgreens unlock liquidity, focus on “value creation,” and resume its growth. [7]
When Walgreens became majority owner of VillageMD in 2021, it anticipated 500-700 such adjacent storefronts. The plan was financially disastrous, and Walgreens began closing VillageMD clinics in 2023.
But where was the call to care in all this? Caring for people, connecting with them throughout the lifecycle – was this not VillageMD/Summit Health’s own NorthStar in the war for customers and market share. It was nowhere. But, then, where could it have been? In the world of corporate healthcare, how can caring be assessed, much less leveraged to increase profits?
VillageMD, with Summit Health and CityMD by its side, aspired to be a corporate juggernaut swallowing private practices and clinics wholesale in pursuit of profit. The caring predisposition of its providers and support staffs could not be further from its mind. It could hardly be expected to screen prospective physicians and nurses for the personality traits and professional orientation that make for caring providers. Does Summit Health, for example, seek out primary care physicians whose residencies included training in the skill set associated with narrative medicine and clinical empathy?[8] Does it provide newly hired personnel with any preliminary training, seminar-style, on the type of caring medicine VillageMD/Summit Health/CityMD physicians and staffs are expected to provide? And further, have practices or clinics in regions of expansion ever been passed over because providers were judged deficient in the psychological and interpersonal prerequisites of the brand’s ethos of care?
Did it occur to VillageMD and its affiliates that the inability of its office practices and clinics to draw customers (read: patients) related to some deficiency in the caring ethos celebrated by its advertisers? No, of course not. Merely to pose the question underscores the ridiculousness of a corporate healthcare entity training its gaze on the quality of caregiving in assessing the performance, financially speaking, of its clinics and practices.
You want a healthcare company that subordinates profits to care? Look to Blue Cross/Blue Shield prior to 1994, when its state plans became for-profits with access to the stock market to raise urgently needed cash. Prior to then, it was a nonprofit that, in accord with the charitable mission set forth in its charter, accepted anyone who sought enrollment – and hemorrhaged money in the process.[9] Today, the ethos of care for all lives on, but only outside the healthcare industry. You’ll find it among nonprofits that make it their business, literally, to care for the underserved, the handicapped, the abused, the homeless and hungry. Don’t look to corporate giants like VillageMD.
Don’t get me wrong. There are plenty of caring providers among those employed by healthcare corporations. VillageMD/Summit Health may not take steps to staff its facilities with empathic caregiving, but neither does it chase them away. One finds very caring physicians in all venues of clinical practice, corporate and otherwise. But in corporate healthcare, the caring impulse is hardly facilitated by corporate handlers. For the latter, physician engagement of patient narratives, followed by explanations and interpretations of the stories patients tell, are time-consuming indulgences. They are the stuff of corporate advertising – and of psychiatry – not the fast-paced realities of frontline primary care under corporate aegis
Yes, many VillageMD and Summit Health physicians care about patients. Far be it for me to suggest otherwise. But now more than ever, their caring is hemmed in by protocols, regulations, and lay monitoring. Time-consuming caring is not part of the corporate gameplan. Physicians labor under the weight of lay oversight and “rate” expectations. The start and stop time of a patient visit is electronically monitored; it is right there in front of them on their computer screens. To make matters worse, they must yield to “patient relations” personnel who may intrude into the doctor-patient relationship to the point of advising physicians not to contact patients who have reached out to them. This, in any event, was my experience when I called the Summit Health endocrinology office three times this past September 18th, requesting, with some urgency, that my physician return my call that day. It was a patient relations staffer who advised my physician not to return my phone calls.
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Who cares? Many physicians care. During a period of ocular crisis when my eyesight rapidly deteriorated, my wonderfully caring retinologist returned almost daily phone calls for several weeks to explain newly arising symptoms and provide reassurance. When I left a message with my ophthalmologist’s phone service one Sunday evening, reporting symptoms suggestive of retinal detachment, she drove back from a weekend outing and opened her office in the evening to evaluate me. When she determined I indeed had a detached retina, she went to the phone and made all the arrangements for a retinal evaluation early the next morning, with surgery later in the day. Now, with limited vision and chronic eye discomfort, she has me come to the office whenever I wish to see her without making an appointment. My hematologist, who appreciates my work in medical history, gives me all the time I need and encourages me to contact him whenever a medical issue arises, inside or outside his specialty. He now provides excellent referrals to caring physicians in other specialties.
These physicians are Hippocratic caregivers in an age of corporate pseudo-care. For them, the patient does indeed come first, and the Hippocratic injunction to practice “the Art” with compassion accompanies them throughout their careers. None of these physicians, be it noted, practices within a healthcare corporation.
My father, William Stepansky, whose inspiring life story is related in The Last Family Doctor: Remembering My Father’s Medicine, had a copy of the Hippocratic Oath taped to his dresser, a daily reminder of his calling. A first-generation immigrant whose parents fled Ukraine during the anti-Jewish Pogrom of 1921, he served in World War II as a surgical tech in the 80th infantry of Patton’s Third Army. He attended the wounded and dying during the Battle of the Bulge and was part of the unit that liberated Buchenwald. After the war, He finished pharmacy training and attended Jefferson Medical College. Following internship, he began his career as a rural generalist in a small borough 30 miles west of Philadelphia.
I asked him in retirement if he had ever turned away anyone who came to him for help. Without hesitation, he quietly replied, “No.” His commitment to his patients and their families was total, and intensified during the last phase of terminal illnesses. When a long-time patient passed away, he closed the office and joined his staff at the family’s memorial gathering. The letter from the daughter of his patient read in part: “Doctor, your act of compassion crosses the boundary of professionalism into humanity, and into my heart. I value your gesture of respect for my family – and for our father.”[10]
Nearing retirement, he sold his house and adjacent office building to a group of multi-specialty internists expanding into local communities. The understanding was that he would continue to see his patients in his own way until retirement, that his practice would be an enclave within the group. Several months after the arrangement began, an office manager knocked on his door and confronted him with a printout attesting to his low productivity. He retired the next day.
If VillageMD wants its website tagline, A Lifetime of Care, to be more than advertising drivel, it should have its providers read The Last Family Doctor. Medicine has changed enormously since my father put out his shingle in Trappe, PA in 1952, but the physician’s commitment to a life of care is, or should be, a constant. Contemporary physicians laboring under the weight of corporate oversight should be reminded from time to time of what Hippocratic caregiving looks like. No, they needn’t tape the Hippocratic Oath to their dressers. But it wouldn’t hurt if they familiarized themselves with a physician whose care of people, not customers, embodied cura in its true Latin sense – a care suffused with compassion, generosity of spirit, and love. Such cura reduces the care glibly scripted by corporate advertisers to rubble.
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[1] Richard K. Thomas, Marketing Health Services, 2nd ed. Chicago: Health Administration Press, 2009, 11-14.
[2] Dylan Scott, “The Untold Story of TV’s First Prescription Drug Ad,” Stat, 11 December 2015 (https://www.statnews.com/2015/12/11/untold-story-tvs-first-prescription-drug-ad).
[3] All material on early Amazon culture, includes quotations, from “Amazon Empire: The Rise and Reign of Jeff Bezos,” Frontline, 18 February 2020 (https://www.youtube.com/watch?v=RVVfJVj5z8s&t=2800s).
[4] “Summit Health Launches First Brand Advertising Campaign” (https://www.prnewswire.com/news-releases/summit-health-launches-first-brand-advertising-campaign-301364781.html); “Summit Healthcare Solutions – Business Philosophy”; (https://www.summithcs.health/about-us/#:~:text=Summit%20Healthcare%20Solutions’%20business%20philosophy,compliance%2C%20dedication%2C%20and%20timeliness).
[5] Kathy Hovis, “VillageMD CEO Named Cornell Entrepreneur of the Year 2024,” Cornell Chronicle, 23 January 2024 (https://news.cornell.edu/stories/2024/01/villagemd-ceo-named-cornell-entrepreneur-year-2024).
[6] Rebecca Pifer, “VillageMD CEO Tim Barry Steps Down,” Healthcare Dive, 2 December 2024 (https://www.healthcaredive.com/news/villagemd-ceo-tim-barry-out-walgreens/734247).
[7] Bruce Japsen, “Tim Barry Is Out As CEO Of Walgreens Clinic Partner VillageMD,” Forbes, 27 November 2024 (https://www.forbes.com/sites/brucejapsen/2024/11/27/tim-barry-is-out-as-ceo-of–walgreens-clinic-partner-villagemd). For Walgreens, the imbroglio over VillageMD capped a decade of mounting losses and, as such, was prelude to financial collapse. On 6 March 2025, it announced its sale to Sycamore Partners, a private equity firm, for roughly $10 billion. This was one-tenth Walgreens’s market value a decade ago.
[8] On the training exercises during residencies intended to cultivate caring doctors, i.e., doctors with empathic receptiveness to patients and the stories they bring to them, see Paul E. Stepansky, In the Hands of Doctors: Touch and Trust in Medical Care (Santa Barbara: Praeger, 2017), ch. 5 (“Can We Teach Doctors to Care?”).
[9] Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You can Take it Back. NY: Penguin, 2017, 14-20.
[10] Paul E. Stepansky, The Last Family Doctor: Remembering My Father’s Medicine. Montclair, NJ: Keynote, 2011, 103.
Copyright © 2025 by Paul E. Stepansky. All rights reserved. The author kindly requests that educators using his blog essays in their courses and seminars let him know via info[at]keynote-books.com.
Medicine, Health, and History 