Your next primary care doctor could be online only with an AI partner – WBUR
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When her doctor died suddenly in August, Tammy MacDonald found herself among the roughly 17% of adults in America without a primary care physician.
MacDonald needed to find a new doctor right away. Her blood pressure medications were due for refills, and she wanted to book follow-up care after a breast cancer scare. She called 10 primary care practices near her home in Massachusetts. None of the doctors, nurse practitioners or physician assistants were taking new patients. A few offices said a doctor could see her — in one-and-a-half to two years.
“I was just shocked by that because we live in Boston, and we’re supposed to have this great medical care,” MacDonald said. “I couldn’t get my mind around the fact that we didn’t have any doctors.”
The shortage of primary care providers is a national problem, but it’s particularly acute in Massachusetts. A report out earlier this year said the state’s primary care workforce is shrinking faster than in most other states. Some medical groups, including the state’s largest hospital network, Mass General Brigham, are turning to artificial intelligence for solutions.
In September, as MacDonald started running out of blood pressure meds, Mass General Brigham launched a program called Care Connect. MacDonald found the link at the bottom of a letter from the medical network.
She downloaded the app, and spent about 10 minutes chatting with an AI agent, or chatbot, about why she wanted to see a doctor. The AI tool sent a summary of the chat to the doctor who would see MacDonald via video. In some cases, if patients have a cold or nausea or sprain for example, the AI tool sends the doctor a suggested diagnosis and treatment plan.
Mass General Brigham’s Care Connect employs 12 physicians who log in remotely from around the U.S. to help patients 24/7.
MacDonald had an appointment in less than 48 hours.
“I could finally calm down,” MacDonald said. “It was just such a difference from being told I had to wait two years.”
Care Connect is one of many AI-based tools that hospitals, doctors and staff are testing for a range of medical tasks, from note-taking and reviewing diagnostic results, to billing and ordering supplies.
Proponents of AI say these programs can help relieve burnout and worker shortages by reducing time spent on administrative tasks. Some research shows they may improve diagnoses. But critics worry that AI agents can miss important details such as overlapping medical conditions, whether patients can afford or get to follow-up care, and family dynamics that personal physicians understand because they treat patients long-term.
MacDonald has used Care Connect four times. Most involved an eventual conversation with a doctor, but once, to make an appointment for travel-related shots, she only interacted with the AI chatbot. Her virtual visits have all been with the same doctor. MacDonald likes the program’s convenience, but she still wants a primary care provider who can examine her health in person.
“This is a logical solution in the short term,” said MacDonald. “At the end of the day, it’s the patient who’s feeling the aftermath of all of the bigger things going on in health care.”
Many factors contribute to the shortage of primary care providers. Most primary care doctors are angry about earning 30% to 50% less, on average, than specialists like cardiologists or anesthesiologists. At the same time, their workload has been increasing for at least 20 years. Primary care doctors often describe days packed with complex patient visits, then evenings spent updating medical records and responding to patient messages.
When MacDonald signed onto Care Connect, she was one of 15,000 patients in the Mass General Brigham system without a primary care provider. That number is growing as primary care doctors leave for rival hospital networks.
"What if they’re just using my interactions with patients to train their AI and boot me out of my job?"
Dr. Madhuri Rao, a primary care physician and union organizer at Mass General Brigham, said she’s staying for now but is frustrated with the system’s leaders.
“They don’t make any effort to ease the shortage,” she said. “They put their money into specialties. Primary care feels like a peripheral part of the system when it really should be a central part.”
Earlier this year, Mass General Brigham pledged to spend $400 million over five years on primary care, which includes the multi-year contract with Care Connect.
“Care Connect is just one solution among many in this broader strategy to alleviate the primary care capacity crisis,” said Dr. Ron Walls, Mass General Brigham’s chief operating officer, in an emailed statement. “Our investment supports retaining our current physicians as well as recruiting new ones.”
Walls would not say what the hospital network is spending on Care Connect. The system plans a rapid expansion for this virtual-only option. Through mid-December, Care Connect physicians were seeing 40 to 50 Mass General Brigham patients a day. By February, the network plans to make it available to all Massachusetts and New Hampshire residents who have health insurance and will add providers to the program as needed.
Dr. Helen Ireland, a primary care physician who manages the program for Mass General Brigham, said patients can use it like urgent care, or make one of the doctors their permanent primary care provider.
“Some patients want in-person care,” said Ireland, the senior medical director of enterprise ambulatory operations at Mass General Brigham. “But I do believe there’s a subset of patients who will appreciate the 24-hour, seven-day a week model and choose to be a part of this.”
Ireland said Care Connect is not for patients who need emergency care or a physical exam, and patients who need tests are referred to clinics or labs. But she said these doctors can manage the same issues that all primary care doctors do: colds and flu, allergies, nausea and chronic conditions like diabetes, high cholesterol and depression.
"I would rather these patients get care, if that care can be safe, than not get care at all."
Many primary care physicians disagree. Dr. Steven Lin is chief of primary care at Stanford University School of Medicine and founded Stanford’s Healthcare AI Applied Research Team.
“In its current state, the safest use of this tool is for more urgent care issues,” Lin said, “your upper respiratory tract infections, your urinary tract infections, your musculoskeletal injuries, your rashes.”
For patients with overlapping chronic conditions like high blood pressure and diabetes — or for patients with especially serious conditions like heart disease or cancer — Lin said nothing beats a human who sees you regularly.
Still, Lin said the AI chat summary can help the physician be more efficient, and he understands the practical appeal of a virtual option.
“I would rather these patients get care, if that care can be safe,” he said, “than not get care at all.”
K Health, the company that developed the AI platform for Care Connect, says the program is delivering safe, effective care to patients with complex, chronic ailments — many of whom have no other option besides a hospital emergency room.
“ America’s got a big problem with health care, issues with cost, quality and access,” said Allon Bloch, the company’s CEO. “To solve it, you need to start with primary care and you have to use technology and AI.”
K Health partners with five other health care networks in addition to Mass General Brigham, including the Mayo Clinic and California-based Cedars-Sinai. In a K Health funded study, researchers at Cedars-Sinai Medical Center found the AI recommendations were more accurate than those from doctors at Cedars-Sinai. But the study also found the adjustments doctors made after speaking to patients were important.
Some wonder how long that will be true. Dr. Rao, at Mass General Brigham, is choosing not to use other AI tools that transcribe her conversations with visiting patients. She worries patient information could be shared, and said she doesn’t want to educate her potential replacement.
“What if they’re just using my interactions with patients to train their AI and boot me out of my job?” she said.
Ireland said that’s not the goal, and all decisions about patient care are still made by doctors.
“We are not replacing our in-person primary care,” said Ireland. “It’s still important, and the majority of patients still have in-person primary care.”
But some primary care doctors at Mass General Brigham say Care Connect is eroding the in-person option. They argue that instead of spending a chunk of the network’s $400 million pledge to shore up primary care on AI, the network should use more of its funds to attract and increase pay for primary care staffers.
“We’re using [Care Connect] to basically fill a gap,” said Dr. Michael Barnett, who sees Mass General Brigham primary care patients and is also helping organize a union for colleagues. “That sounds like a Band-Aid for a broken system to me.”
This segment aired on December 21, 2025. The audio for this segment is not available.
Martha Bebinger is a correspondent for WBUR. She covers health care and other general assignments for the outlet.
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