The Hybrid Practice Model: Why More Telemedicine Providers Are Adding Local Clinic Space
For the past few years, the pitch for telemedicine was simple: go fully remote, skip the overhead, see patients from anywhere. A lot of practices built their entire business around that promise. But heading into the back half of 2026, a growing number of telemedicine providers are quietly walking back the all-remote model and adding a few hours a week of in-person clinic time. Not because remote care stopped working. Because the regulatory and clinical reality of running a serious practice increasingly calls for both.
This shift has a name now: the hybrid practice model. It isn’t a retreat from telemedicine. It’s an acknowledgment that certain patients, certain visit types, and certain compliance requirements still need a real exam room, at least occasionally.
Why Fully Remote No Longer Covers Every Need
The federal telehealth flexibilities that made pandemic-era virtual care possible have been extended repeatedly, and they’re still in place. DEA and HHS renewed telemedicine flexibilities for controlled substance prescribing through December 31, 2026, meaning Schedule II-V prescriptions can generally still be issued via audio-video telehealth without a prior in-person evaluation. A permanent DEA rule, including the long-discussed special registration pathway, is expected before the extension runs out, but nothing is finalized yet.
Medicare has its own wrinkle. Congress extended most Medicare telehealth flexibilities through December 31, 2027 under the Consolidated Appropriations Act, and CMS has said it won’t enforce the underlying in-person visit requirement for behavioral health telehealth until 2028. But the requirement itself is real and already on the books: patients who started telehealth mental health services after January 30, 2026 need an in-person visit within six months of that first session, and established patients need one at least every twelve months. Enforcement delay is not the same as the rule disappearing. Practices that wait until 2028 to figure out where that in-person visit happens will be scrambling.
Add to that the simple clinical truth that some conditions, some new patient intakes, and some difficult diagnostic questions are still better handled in person, and you get a practice model that can’t live entirely on a laptop.
What Hybrid Actually Looks Like In Practice
The providers making this work aren’t opening full clinics. Most are renting a single exam room for a half-day or a day a week, often in a market where they already have a growing telemedicine patient base. A psychiatrist based in another state might see thirty Arizona patients by video and fly in once a month to handle the annual in-person visits Medicare now requires. A nurse practitioner running a hormone therapy practice might hold Friday afternoon hours at a shared clinical space to do the physical exams and labs that don’t translate well to video.
The defining feature of this model is flexibility. The clinic time is scheduled around actual patient need, not around a lease term. That’s a very different cost structure than the traditional model of signing for 1,500 square feet and staffing it five days a week whether patients show up or not.
The Financial Logic Of Part-Time Space
A traditional medical office lease in the Phoenix metro comes with a multi-year commitment, buildout costs, furniture, a receptionist, and utilities, whether the provider is in the building four hours a week or forty. For a telemedicine practice that only needs local presence occasionally, that math rarely works. It’s a lot of fixed cost to support a small fraction of total patient volume.
Medical coworking space flips that equation. A provider pays for the hours or days they actually use, shares reception and waiting room infrastructure with other practitioners, and can scale up or down as their local patient base grows. It also solves a problem that’s easy to underestimate: DEA registration and Arizona licensing both expect a real, verifiable practice address, not a mail drop. A part-time clinical space with an actual exam room satisfies that in a way a virtual office never could.
Building Real Local Roots
There’s a less obvious benefit to holding regular in-person hours, even just occasionally. It gives an out-of-state or fully virtual practice a genuine local footprint. Patients trust a provider more when they know there’s a real room they could walk into if they needed to. Local referral sources, other practitioners, physical therapists, specialists, take a hybrid practice more seriously than one that exists only as a phone number and a video link. Over time, that local presence tends to generate its own referral volume, something a purely remote practice never sees.
For telemedicine providers weighing whether a hybrid model makes sense, Viva MedSuites offers flexible membership options at both Scottsdale and Mesa locations, from a few hours a month up to full-time office space, without the commitment of a traditional lease. If you’re trying to figure out how much local presence you actually need, or where in the Phoenix area to put it, we’re happy to walk through the options. Visit 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.
