When It Makes Sense to Add In-Person Hours to a Telemedicine Practice in Arizona

Most telemedicine providers start out intending to stay fully virtual, and many do. Then a patient needs a blood pressure check, a procedure, or an exam that a camera cannot give you, and the practice has no room to do it. That moment is usually the first sign that a hybrid model might fit. It is not the only one, and it is not a reason to rush into a lease.

Start With What Your Patients Actually Need

The cleanest test is clinical. Look back over the last quarter and count the visits where you wished you could lay hands on the patient. If it happens once or twice a month, you probably need a referral partner. If it happens weekly, and the same kinds of problems keep coming up, you have a service gap that in-person hours could fill.

Specialties differ a great deal here. A psychiatrist or a therapist may rarely need a physical room. A nurse practitioner managing hormone therapy, weight management, or chronic conditions will want vitals, labs, and a physical exam at regular intervals. Dermatology, women’s health, and anything involving injections or minor procedures lean heavily toward in-person care.

Check The Rules That Depend On A Physical Visit

Some in-person needs come from regulation rather than medicine. Arizona law does not generally require a first visit in person for a telehealth patient, but that does not settle things everywhere. Your malpractice carrier, your payer contracts, and your own clinical standards may set stricter terms. Some health plans reimburse certain services only when specific elements are documented, and a few treatment programs expect periodic face-to-face assessment.

Controlled substances deserve a careful look. The DEA’s telemedicine flexibilities, which let many providers prescribe without a prior in-person exam, have been extended through December 31, 2026. A special registration rule has been under federal review for some time, and as of this writing the final text has not settled what comes next. If you prescribe Schedule II through V medications, assume that in-person evaluation may become part of your workflow again in 2027, and plan for it now rather than in December.

Think About Where The Patients Are

Arizona’s Phoenix metro area is large and spread out. A practice that draws patients from Scottsdale, Mesa, Gilbert, and Tempe has a different geography problem than one serving a single neighborhood. Before you commit to a location, look at where your current virtual patients actually live. Ask a sample of them how far they would travel for an in-person appointment. The answer often surprises people, and it changes which part of the valley makes sense.

Match The Space To The Volume

This is where many providers overspend. A traditional lease usually means a multi-year term, a build-out, furniture, equipment, utilities, and a front desk, all before you see the first patient. That math works if you will fill the schedule five days a week. It does not work if you need eight or ten hours a month.

There are three practical ways to start small. You can partner with a local practice that has open room time. You can rent an exam room by the hour or half day in a medical office that already has the equipment, the cleaning protocols, and the waiting area. Or you can take a part-time membership with set days each week. Each lets you test demand before you carry fixed costs, and each lets you scale up when the schedule fills.

Whatever you choose, ask a few questions before you sign. Is the room configured for the exams you do? Who handles biohazard waste and sterilization? Can you store supplies securely? Is there reliable parking and accessibility? And does the arrangement support the address you list with licensing boards and payers, if you plan to use it that way?

Know The Signs You Have Outgrown Part-Time

You will see it in your calendar. When your in-person hours are booked three weeks out, when you turn patients away, or when you start stacking appointments at awkward times because the room is only available on certain days, the arrangement has done its job. That is the time to look at a larger commitment, not before.

The reverse also applies. If your in-person days run half empty for several months, the data is telling you something. Many providers go back to a mostly virtual practice with a small number of scheduled office hours, and that is a perfectly reasonable model.

A Final Word On Timing

Adding in-person care is easier to do early than late. Patients who first meet you on video and then see you in person tend to stay longer, and the visit builds trust that is hard to reproduce on a screen. Build it into your plan as an option, set a clear trigger for when you will act, and let the numbers guide the decision.

If you are weighing it, Viva MedSuites has medical office locations in Scottsdale and Mesa with exam rooms available on flexible terms, from hourly use to full-time membership. You can learn more at vivamedsuites.com or call 480-616-2400.

John Groberg is the founder of Viva MedSuites, Arizona’s largest medical coworking community, with locations in Scottsdale and Mesa serving independent practitioners since 2017.