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Think of a Live Well Visit as your roadmap to better health — for your body and your mind.

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Ever put off a doctor’s appointment due to money, anxiety, or another reason? You’re not alone — in 2022, nearly 40% of Americans skipped or delayed necessary healthcare .

However, it’s never too late to get back on track. And One Medical , an innovative, membership-based primary care practice, is making it even more convenient — and actually enjoyable — to check in with your doctor in a meaningful way.

How? Simply put: access. With four locations across the Triangle (Brightleaf Square, Cary-Fenton, North Hills, and Raleigh Village District), you don’t have to wait six months to see a provider. Raleighites have the ability to book same- or next-day appointments, remote appointments, and 24/7 virtual care via video chats on their app, so they can connect with a provider when it’s convenient for them.

One Medical’s redesigned offices feel like you’re taking a trip to the spa.

What else sets this medical group apart? Its unique approach to an annual physical.

Live Well visits: like a physical, but better

Unlike traditional physicals, this appointment isn’t one-size-fits-all. A Live Well visit is an annual physical that gives you time to build a relationship with your provider ( read: more conversation, less examination). Before your appointment, you’ll complete a questionnaire to highlight the health issues that are most important to you .

Thanks to longer appointment slots, One Medical providers get to know you and your unique needs, plus address topics including mental health, metabolic and endocrine screenings, sports medicine and mobility questions, diet and nutrition counseling + more. The best part? You’ll walk away with a tangible personalized care plan to help you reach your wellness goals.

Referrals for when it matters most

For more serious medical situations, One Medical leverages its partnership with Duke Health to connect members to 2,000+ world-class specialists.

One Medical providers diagnose and treat a wide spectrum of illnesses, so you get the care you need without having to visit the ER or see specialists.

Membership model + pricing

This type of access won’t cost you an arm and a leg. Annual memberships are $199 per year. That’s less than the cost of some streaming service subscriptions, for context. Annual visits (including Live Well appointments) are typically covered by insurance.

The One Medical app allows you to send and receive secure messages with a provider.

Ready to experience the One Medical difference? RALtoday readers can try a 30-day free trial (available for both adults and kids of all ages) when they use code TRY1MRDU.

Explore all services + specialties and book an appointment. Get my free trial.

What type of appointment do you feel most comfortable with?

A. In-office — the face-to-face aspect is important to me B. Telehealth — I prefer to do the visit in the comfort of my home

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Your Annual Wellness Visit: What to Expect

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Your annual preventive health exam (aka well visit or annual physical) is scheduled with your primary care physician to catch potential health issues early, before they become serious, and to help you focus on wellness and a healthy lifestyle while identifying important screening tests, vaccinations and other necessary testing.    

Most insurance plans cover your annual wellness exam—no copay required. However, says Dr. Adam Stracher , Chief Medical Officer , Director of the Primary Care Division and Associate Dean at Weill Cornell Medicine, you may find the actual components of a wellness visit a bit confusing .

Read on for answers to your FAQs—and learn what to expect when you visit your doctor’s office, in times of sickness and in health. 

What is included in a wellness visit?  

Your annual wellness visit includes the following:

• A review of your medical and surgical history  
• Screenings  
• Blood tests  
• Immunizations  
• A physical exam  
• Counseling to prevent future health problems    

How should I prepare for my visit?  

“ You can check in via Connect   up to 5 days before your visit to make sure we have your most up-to-date information , including your medications, medical history and insurance. You will be able to update these, along with your preferred pharmacy . And you can also review and update your responses to your health questionnaire ,” Dr. Stracher says.    

Please fast for at least 4 hours prior to your visit. You may drink water or black coffee, and take your maintenance medications.  

On the day of your appointment, please arrive on time and bring your insurance card and ID.  

What if I need to ask my doctor about a specific medical issue?  

Specific issues, whether raised by you or identified by your physician during the visit, are considered part of a follow-up or “sick” visit, he explains. “These aspects of your visit will be billed to your insurance, and you may be responsible for copayments, coinsurance or deductible payments, based on the terms of your policy. If you would like to address non-routine concerns during your wellness visit,” he adds, “let us know about these issues when you schedule your appointment. Depending on their complexity, we may need to deal with them at a later time."   

What does a follow-up or “sick” visit include?  

• Treatment of a chronic condition such as diabetes, asthma or high blood pressure  
• Any new problems or complaints  
• Your need for new medications or tests  
• Referrals to a specialist  
• Additional treatment options  

What is a Medicare annual wellness visit and what does it include?  

The Medicare annual wellness visit, covered by Medicare, allows your health-care provider to conduct a health risk assessment and propose screenings and prevention strategies. As well, your provider will make sure all your immunizations, cancer screenings and other screenings are discussed and scheduled.  

Your Medicare wellness visit does not include a detailed physical exam or management of chronic or new medical problems. Your physician may be able to perform a complete physical and address new or existing medical issues during your Medicare annual wellness visit, but you could incur additional charges.  

What to expect during your Medicare a nnual w ellness v isit  

At your Medicare annual wellness visit, y our health care provider will :  

• Review your blood pressure, heart rate, height, weight and body mass index (BMI).  
• Review your current health problems, as well as your medical, surgical, family and social histories.  
• Review your current medications.  
• Conduct a health risk assessment.  
• Provide nutrition counseling.  
• Discuss an exercise plan to fit your lifestyle.  
• Discuss smoking cessation and arrange for counseling, if needed.  
• Discuss fall prevention.  
• Discuss advance care planning.  
• Discuss preventive screenings recommended by evidence-based practice guidelines that are indicated for you based upon your age, risk factors and family history

How t o p repare for your Medicare wellness visit  

Bring these items to your visit:  

• Immunization records  
• A list of current prescribed medicines, supplements and over-the-counter medications  
• A list of your patient care team—any specialists you see for various types of care  
• Be prepared to review your family medical history.  

Can I combine a Medicare or non-Medicare wellness visit with a physical exam?  

Combining a wellness visit with a physical or follow-up office visit will save you time by eliminating an extra appointment, but doing so may affect your costs. Additional concerns beyond a wellness visit may be billed to your insurance, which can result in unplanned out-of-pocket costs to you. For these reasons, Weill Cornell Medicine Primary Care recommends that you schedule your annual wellness visit and any follow-up or sick office visits separately.  

What are the most important points I need to keep in mind?  

• Review your insurance plan’s summary of benefits before your appointment to understand what your insurance company will or will not cover.  
• When scheduling a wellness visit, clearly state that you would like to make an appointment for your annual wellness or preventive care exam. That will help the practice prepare for your visit and bill your insurance company appropriately.  
• When you speak with your doctor or other practitioner, let them know you are there for a wellness exam. Or, if you need to discuss a specific concern that may require treatment, make sure to bring their attention to any non-routine concerns at the start of your appointment.  

You can schedule your annual wellness or follow-up office visit with a provider in Primary Care  .

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The 5 things that matter most from your annual exam

Updated October 23, 2019.

You’ve seen the signage around the office and you’ve heard the not-so-subtle hints: “Be sure to get your annual exam!” Maybe your company even requires it. Or maybe it’s your yearly opportunity to prove to your spouse that you’re still as fit as you were at 18.

Well, I hate to be the bearer of unsettling news, but here’s the truth: most of what you know about the annual exam is wrong.

Those Hollywood depictions of treadmill tests and hammer-to-knee reflex exams? They’re of no value for most people. The manual rectal exam so many men fear? Probably not your problem. And the ears/eyes/throat checks you think signify a clean bill of health? Those aren’t as important as you think.

The truth is, there are a few key parts of your annual exam that really matter. As a family nurse practitioner with over 25 years of experience, I’ve fielded a lot of questions about the annual exam and I’ve seen experts in the field battle it out over which numbers, tests, and measurements truly matter.

Confused? So are most people–and that includes a lot of primary care physicians. According to a 2002 study , 66 percent of patients polled believed that in addition to regular care, an annual exam is necessary and more than 90 percent felt that the heart, lungs, abdomen, reflexes, and prostate should be examined during this yearly appointment. In 2005, the same group of researchers found that most providers still believe that an annual exam is an important way to detect illness, despite recommendations that the annual exam isn’t all it’s cracked up to be .

But the annual exam does matter in ways you may not expect and knowing what to ask and what’s important can make a big difference in your health.

The Annual Exam Does Matter — Just Not the Way You Think

None of the above info is to say that an annual exam isn’t worthwhile and for anyone with a chronic illness or complicated medical history — it is important. But for most healthy people, the value of getting an annual exam has little to do with the reasons that you, your employer, or even some of your past providers may expect.

The providers at One Medical are trained to think differently; we don’t apply the same outdated template to every patient. We customize our care to meet our patients where they are and we collaborate with them on a plan that makes sense for them. And that includes how we approach and utilize the old school annual exam.

So regardless of what you’ve been told, here’s what really matters and what you should expect from your annual exam:

1. Most of the annual exam isn’t actually a physical exam.

In fact, the non-physical parts matter just as much, if not more in some cases. The list of must-check physical issues is actually pretty short: blood pressure, weight, height, cholesterol, and maybe a blood sugar test depending on your specific risk factors or family history. That hammer reflex thing? Utterly useless if you aren’t having unusual or new symptoms. And the eyes/ears/nose/throat/neck/belly check? They provide little value in determining your overall health status.

The numbers that really matter are the ones that help you and your provider understand what conditions you may be at risk for. Documenting these lets you know where you stand, but your provider may or may not choose to do anything depending on what they are.

2. Your health is more than a blood test result

Blood tests as part of your annual visit are not needed for everyone. Why? Think about it like this: you take your MacBook to the Genius Bar and ask, “My computer is working well. Can you just run all of your tests on my MacBook?” They may look at you funny. More tests are not necessarily better in health care either. Your body is far more complicated than a computer, and running unnecessary tests can lead to more harm than good.

Instead, we recommend partnering with us to identify health issues you may be at risk for and which lab tests are right for you. If there is a test you are wondering if you should get, simply ask and we’ll be more than happy to discuss how that test can affect your health.

3. What matters most is what’s important for your health.

We do have certain guidelines that recommend what we should cover during the annual exam, but a good provider is one that tailors those parameters to you and your health goals. Building a trusting relationship with a primary care provider who knows you well is possibly the biggest benefit of the time spent in an annual exam. Ideally, you want this relationship to be a long-term one. Even if you don’t see this person often, you want to make sure he or she is someone you trust, who listens to you, and with whom you feel comfortable collaborating. Consider the annual exam your chance to align on goals and values.

4. Cover sex, drugs, and rock and roll.

Most people walk into their annual exam ready to divulge the details of their diet or exercise, but few are prepared to talk about what they do in the bedroom or behind closed doors . I can’t stress enough how much this stuff matters. In some cases, having an open, honest conversation about these topics can do much more than an arbitrary test. What is ultimately more likely to impact your health are your sexual risk factors, your mental health status, substance use, sleep quality , and whether you’re experiencing any kind of abuse. All of these topics should be covered in your annual exam and you should feel safe being completely candid.

5. Cancer screening, cardiovascular risk assessment, and immunizations are musts.

These parts of the annual exam are the high-value items, but many people are surprised to find they don’t necessarily have to be annual. For most women, receiving a Pap every three to five years is perfectly safe, and getting a mammogram every other year is fine too. And despite what many men believe, prostate screening may not even be something they need at all . Once you’ve built that trusting relationship with your provider, they will help guide your choices and keep you up to date on all the important stuff.

Whether you haven’t been to a doctor in years or you’re ready to establish a relationship with a provider , be sure the care you’re getting is customized to fit your needs. Your actual health is more important than checked boxes or outdated guidelines.

The One Medical blog is published by One Medical , a national, modern primary care practice pairing 24/7 virtual care services with inviting and convenient in-person care at over 100 locations across the U.S. One Medical is on a mission to transform health care for all through a human-centered, technology-powered approach to caring for people at every stage of life.

Any general advice posted on our blog, website, or app is for informational purposes only and is not intended to replace or substitute for any medical or other advice. 1Life Healthcare, Inc. and the One Medical entities make no representations or warranties and expressly disclaim any and all liability concerning any treatment, action by, or effect on any person following the general information offered or provided within or through the blog, website, or app. If you have specific concerns or a situation arises in which you require medical advice, you should consult with an appropriately trained and qualified medical services provider.

One Medical

Sponsored membership for faculty, staff and students.

Georgetown University provides benefit-eligible employees and students with membership to One Medical – a primary care practice that prioritizes your time, emotions, and individual requirements. From routine wellness check-ups to addressing everyday health concerns, and even managing chronic conditions such as diabetes and depression, One Medical is your go-to destination for both physical and mental well-being. With swift access to appointments across various locations nationwide and round-the-clock virtual care, rest assured they’ll always be available whenever you need their support. Please be aware certain services aren’t available to Kaiser members .

See the One Medical experience 

• Access to offices nationwide
• 24/7 virtual care, including Video Chats, via the One Medical app
• Same/next-day appointments that start on time
• Online appointment booking and prescription renewal requests via the app or web

What can I get care for at One Medical? 

One Medical isn’t just here for when you’re sick or injured. They can also help you meet physical and mental health goals, manage chronic illnesses, and live a happier, healthier life. Think of One Medical as your healthcare home base. Get help with:

• Colds, flu, and COVID-19
• Anxiety, depression, and stress
• Women’s health
• Annual physical / preventive care
• Labs and prescriptions
• Skin issues
• Travel health
• Family health / pediatrics

One Medical has family practice offices in most markets (and growing) where everyone in the family can get care, from babies to teens to in-betweens. Learn more about One Medical Kids availability and pediatric services. 

What will I pay for care at One Medical?

The annual One Medical membership is normally $199/person per year for access to their services, but we are fully covering this cost for you, your spouse/partner, and your dependents. 

One Medical is in network with our medical plans – with the exception of Kaiser Permanente – and most major insurance plans . In person or remote visits scheduled in advance or with a specific provider are billed to your insurance like a standard doctor’s visit. And great news: on-demand 24/7 care through the One Medical app is cost and claim-free for all eligible faculty, staff and students, including members of Kaiser Permanente. I

How to get started

1. sign up today.

Join today — on us — using your Georgetown University email address and enjoy care that fits your life. And don’t forget to sign up your spouse/partner and dependents as well. 

    How to register dependents for One Medical

Option 1 (Code): 1. Visit  onemedical.com/georgetown (new window) 2. Click “Activate now” 3. Enter dependents first and last name and date of birth 4. Enter employee or students @ georgetown.edu (new window)  email and activation code:  GUXONEM 5. Complete the process of creating a One Medical account

Option 2 (Employee’s Account): 1. Sign in to employees  One Medical (new window)  account 2. At the bottom of the page under “Register your dependents” click “Start Registration” 3. Select “Spouse or adult dependent” 4. Complete the form and click “Register” 5. Dependents will receive an email notifying them of their new One Medical account. To claim their membership, they click on “Complete registration.” 5. Dependents then create a password, agree to the terms of service, and complete the process of creating a One Medical account

2. Download the One Medical App

[ App Store ]  [ Google Play Store ]

You can use the free One Medical app for 24/7 Video Chat, prescription renewal requests, messaging providers, appointment booking, and more. Watch this app demo. ——>

3. Book a Live Well Visit and make a plan to live a healthier, happier life

One Medical has redesigned the annual physical around you. However you currently feel, a Live Well Visit gives you the chance to build a relationship with a provider, discuss physical and mental health goals, and make a plan to meet them. Most insurance covers the full cost of one physical every 365 days (excluding some lab work and vaccines).

Already a One Medical member? Simply visit your membership settings, select “ Update Sponsored Membership ”, and enter the prompted information. 

Questions? You can reach the One Medical team at [email protected] anytime. They’ll be happy to help.

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FAQs About Your One Medical Membership

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I became a member of One Medical, a primary-care practice that charges a $200 annual fee and has plans to double over the next two years. Here's what it was like.

• I signed up to be a member of One Medical, a primary-care practice that charges a $200 annual fee and also bills your health insurance.
• One Medical has plans to double its footprint over the next two years after an infusion of $350 million in funding that valued the company at $1.5 billion.
• Here's why it's going to be the primary-care startup to beat, as far as having a service that helps you book appointments online and easily connect with a provider.
• I tried out One Medical as part of an experiment to get all my healthcare taken care of via new models that aim to make getting healthcare easier.
• Visit Business Insider's homepage for more stories.

Over the past decade, a number of different efforts have popped up to disrupt the way primary care is provided.

Some come with monthly fees and don't take insurance, some use additional technology, and some are geared toward employers or toward the elderly in the US.

To understand how healthcare is changing, I tried to get all my healthcare done via startups that promise to make getting care easier. That included picking out a place to get primary care. 

Thinking of my own healthcare needs, I landed on One Medical, a company that charges a $200 annual fee and offers same- or next-day appointments with doctors or other healthcare professionals that users can book online. The company in 2018 raised $350 million in funding , and it's expecting to double the number of medical clinics it operates over the next two years. It currently has 72 locations in nine cities. 

Read more : Healthcare startups like Flatiron Health, One Medical, and Oscar Health all use an eerily similar font

Initially, I'd tried to sign up for an annual visit and a well-woman's visit as part of the appointment. It seemed like my only option after selecting the annual visit. I then picked a time slot.

I was surprised to find that there weren't any doctors available to meet with me at my nearest location, though there were appointments with other medical professionals such as physician assistants and nurse practitioners. I went back to One Medical's website and saw that there was a doctor at the Wall Street location, but she wasn't accepting new patients.

Not a big deal, as I remembered meeting mainly with PAs in my other New York primary care visits, so I went for it anyway. Since I booked my appointment, I noticed that there's now a doctor at the Wall Street location who is accepting new patients, so the shortage might have been temporary.

Jenni Vargas, One Medical's chief strategy officer, said that there's usually a mix of providers in each One Medical office, though the company finds that nurse practitioners and physician assistants have comparable customer satisfaction scores to doctors.

The day before my appointment, I got a call from One Medical. It turns out, I hadn't hit the right buttons as I was signing in. Initially, I'd planned to use the visit as my annual checkup, but since I'd basically done that earlier in the week at Tia, and because I'd have to reschedule, I decided to switch to a check-in visit to discuss some pain I'd been feeling in my knee after running a half marathon in March.

My appointment was at One Medical's Wall Street location, a few blocks from my office. It was slick getting up to the office, and the views prompted me to take a photo.

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We were on the 45th floor, and it was cool to see out over the water, with One World Trade to the left of my view.

The exam room I was in had an equally nice view. It tempted me to take a selfie when I had a minute to spare.

During the visit, I explained what was bothering me, what I assumed might've happened (the route took me over the Manhattan bridge, which was incredibly cool but also a steep downhill I hadn't trained for). My provider examined my knee and asked where I was feeling pain.

I had been stubborn and running on my knee as usual, which didn't do me any favors, so hearing from a professional that I should give it a rest was helpful. She gave me a course of action (rest, alternative exercise, knee brace, icing, and ibuprofen would all be key), and passed along a referral to a physical therapist should I need it.

I used One Medical's messaging feature to follow up about the progress of my knee and to make sure I wasn't missing anything. It was nice to have that communication channel open.

On my way out, I checked in with the front desk, which informed me that I didn't have to pay anything today, but I would have coinsurance associated with the visit. I called my health plan after, and the plan informed me that since my visit wasn't preventative, it would go toward my deductible, meaning I'll be on the hook for the full negotiated rate. I still haven't received a bill.

Vargas told me that now that I'm a member, I'll start to receive notifications for things like coming in to get my flu shot, or things I should do to keep myself healthy. So far, I've gotten messages about measles and seasonal allergies. The allergies one advised me to use my One Medical app (which I downloaded at Vargas's suggestion) to get care without coming in for a visit. Usually I just muddle through a few weeks of pollen-covered New York City, but if it gets bad, I might turn to the app for relief. 

The expectations One Medical has to live up to

Because I'd only have time to use One Medical once before submitting this, I turned to Ariel Schwartz , an editor on our science team who's a longtime One Medical member, to get her perspective on the company.

Schwartz had been using One Medical in San Francisco for a number of years and found it convenient (an office was in her office building).

But since moving to New York a year ago, she's been less excited about the service. For one, she found it hard to book an appointment with a doctor, rather than a PA or nurse practitioner.

And some of the perks that initially drew her to One Medical, like messaging and booking online, are now routinely available at other doctor's offices, making her rethink the annual fee.

That's a challenge for One Medical. As healthcare practices get more tech-savvy and customer-friendly, potentially all covered by a traditional copay rather than additional fee, One Medical will have to work harder to stand out.

I came into this assignment assuming that One Medical would be geared toward me, a healthy 26-year-old who usually goes in once a year for an annual exam. I'm less sure now if it's worth the additional $200, since I'm pretty hands-off. 

Also, with my high-deductible plan, I'm anxious to see how big my bill will be for the quick check-in visit.

But the jury's still out. Going forward, I'm interested to test out some of the more virtual features to see if it can prevent me from getting hit with a high office visit bill, given the high deductible health plan I'm on. If it can save me money on say, an urgent care visit down the line, it might be worth it. 

Are you a One Medical user? We'd love to hear about your experience. Contact the author at [email protected]. 

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Leaked documents reveal patient safety issues at Amazon’s One Medical

Patient safety issues have increased since One Medical shifted care to a call center staffed by contractors, employees say.

Since Amazon acquired the primary-care service One Medical, elderly patients have been routed to a call center — staffed partly by contractors with limited training — that failed on more than a dozen occasions to seek immediate attention for callers with urgent symptoms, according to internal documents seen by The Washington Post.

When one patient reported a “blood clot, pain and swelling,” call center staff scheduled an appointment rather than escalating the matter for medical evaluation, according to a note in an internal incident tracking spreadsheet dated Feb. 19.

Over the following two days, clinical staffers flagged four more call-center errors involving elderly patients with urgent complaints, including stomach pain and blood in stool, a spike in blood pressure, an insect bite and sudden rib pain, according to the internal spreadsheet.

The call-center incidents were among dozens flagged by doctors, nurses and assistants at One Medical Seniors between Feb. 19 and March 18 in the documents, a year after Amazon acquired the primary-care service. One Medical began routing elderly patients to the call center in Tempe, Ariz., staffed partly by newly hired contractors with limited training and little to no medical experience, according to internal documents seen by The Post and interviews with four current and former One Medical workers.

Since Amazon formally acquired One Medical in February 2023 in a $3.9 billion deal, the company has alarmed patients and employees by eliminating free rides, shortening appointments and laying off staff . Now evidence of potentially life-threatening situations at the Tempe call center is raising fresh concern that Amazon’s frugal approach to health care may be imperiling patient safety.

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“There were a lot of things slipping through the cracks,” said a former One Medical employee, who like others interviewed for this article spoke on the condition of anonymity to avoid professional retaliation.

With its devotion to “customer obsession” and convenience, Amazon argues that it can add value to America’s broken health-care system, which is plagued by long waits, high costs and rampant inefficiencies. But since launching a push into health care in 2018, Amazon has struggled to protect patient privacy , deliver quality care , and find a business model that works for customers .

In April, Amazon CEO Andy Jassy acknowledged that the company’s approach to health care “can sometimes feel random.” But he said he remains optimistic and Amazon recently ratcheted up its efforts, offering One Medical membership discounts to Prime members.

When Amazon acquired One Medical, it included two businesses: An upmarket $199-a-year subscription primary care service that allows patients to use an app to book doctor appointments at clinics throughout the United States and Iora Health, a clinic for chronically ill patients largely reliant on Medicare.

In 2022, the year Amazon bought One Medical, Medicare funding made up a little over half of its annual revenue of $1.05 billion. Amazon declined to provide updated figures to The Post.

Amazon said it created the Tempe call center for its senior patients last year “to increase access and quality of care.” Amazon founder Jeff Bezos owns The Post.

Asked to respond to the incidents, Amazon spokeswoman Dawn Brun responded via email: “While we are confident in our safety protocol … we take feedback from our providers seriously and will always address anything that is less than a great experience.” Brun added that Amazon doesn’t get involved in One Medical patient care decisions.

Amazon said it was not aware of any patients who were harmed because of call center errors.

Natalie Benda, an assistant professor at the Columbia School of Nursing, said creating a call center like the one in Tempe could indeed improve patient access to medical care. But “if it’s not done by someone who is trained appropriately,” she said, “I can see how it would be a patient safety issue.”

‘Mission Control’

Internally, the Tempe call center is referred to as “Mission Control.” Calls are fielded by a mix of full-time employees and contract workers hired by Teksystems, a staffing agency.

The contract workers are not required to have experience in the medical field, and the main qualifications are being able to use a computer and phone, according to job listings and two staffers who worked in the call center. Call center workers undergo two weeks of classroom training before they start taking patient calls, according to a former call center employee, who spoke on the condition of anonymity for fear of retaliation.

Amazon said its contractors take calls under supervision for two weeks after classroom training, followed by a week of coaching. The company pointed to job listings that say new hires should be “comfortable navigating or learning all things health care.” Amazon said it’s more efficient to hire through Teksystems, which has its own sick leave policy, and that its training program is adequate.

One Medical’s competitors in geriatric primary care, CVS’s Oak Street Health and ChenMed also use call centers to field inquiries from patients. (Archwell Health, another competitor, allows patients to place calls directly to clinics.)

According to training documents obtained by The Post, One Medical is aware that “speaking with someone from outside the office might conjure concerns about delays in patient care or diligence,” especially for patients who were previously able to call their doctor’s office directly.

“We do not need to draw attention” to who is “handling patient concerns,” the documents say. “However, if a concern is expressed, our goal is to reassure the patient that we are a trained and skilled One Medical Support Specialist and Part of their Care team.”

But two former call center employees called that guidance misleading, and disputed the claim that call center workers are sufficiently “trained and skilled” to handle patient calls.

One of them, who worked as a manager, said the company tries to cram too much information into two weeks in the classroom. He said he suggested extending the training period and hiring more employees directly rather than as contractors, but management denied his request.

“My feedback to them was, fine, but understand, if we try to pump these people out of these classrooms, you’re going to have an increase in patient safety issues. Which we did,” said the manager, who noted he was fired in March.

According to One Medical training documents seen by The Post, if a senior patient calls in with one of 17 “red flag” symptoms such as shortness of breath or sudden headache, call center employees are supposed to escalate the call to One Medical’s virtual medical staff.

But identifying these symptoms when talking to patients can be difficult, current and former One Medical staffers said. As a result, there were patients “who should have been triaged to emergency rooms or urgent care, and that wasn’t happening,” the former Colorado-based employee said.

For example, on March 7, a doctor in Colorado flagged a call from a patient experiencing chest tightness. According to the spreadsheet, the call center staffer had scheduled an in-office appointment the next day.

The first of the 17 red flag symptoms is “chest pain/pressure/heaviness.” The doctor who flagged the call noted that it should have been escalated and expressed concern that call center staff don’t “understand that they are triaging patients themselves.”

Such errors increased concerns that call center staff were making medical decisions they weren’t qualified to make, the current and former employees said.

Amazon said the call center worker involved in the incident was retrained and that the patient was not harmed.

‘I don’t want Amazon taking care of me’

Amazon said it created the Tempe call center as part of a centralized support system intended to answer patient phone calls faster and free up clinic staff to focus on patients. The company said patient visits recently increased from around five per day per doctor to as many as 14 per day.

But not all One Medical patients see the changes as an improvement.

Late last year, Mary Ann Stone, 92, was experiencing confusion, pain, impacted bowels and a recurring urinary tract infection — symptoms her daughter said were “hard to describe to a call center, especially a call center that has no experience with this kind of thing.”

One Medical encouraged her to come in for an appointment, but Stone ultimately wound up in the hospital. Her daughter said she doesn’t blame One Medical, but wishes she’d taken her mother there sooner: Stone died in March.

“I don’t want anyone to have to go through this,” said the daughter, who spoke on the condition of anonymity because she fears retaliation. “I don’t want Amazon taking care of me.”

A Colorado patient who said he called One Medical three times and waited between 30 and 90 minutes to talk to someone was “concerned with the lack of communication access,” according to the internal documents. Another patient’s daughter said she was worried her mom “may not try to contact [One Medical Seniors] for medical concerns if she believes no one will answer,” incident reports said.

Marilyn Overcast, 79, a One Medical patient in Shoreline, Wash., said she waited hours for a call back about her thyroid medication. “It’s frustrating,” said Overcast, who said she also was shocked when her doctor abruptly left the company.

Amazon said One Medical clinicians operate independently of Amazon and that “quality of care and positive health outcomes are their number one priority.”

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Ukraine war latest: Putin and Kim sign new defence deal - as UK says 'bizarre scenes' should be warning

Vladimir Putin and Kim Jong Un have signed a new deal in Pyongyang, making a vow of mutual aid if either of their countries is attacked as both face escalating stand-offs with the West. Got a question on the Ukraine war? Submit it below for our specialists to answer.

Wednesday 19 June 2024 21:39, UK

• Vladimir Putin visited North Korea for the first time in 24 years today. He has now arrived in Vietnam
• Catch up: Everything you need to know about Putin's visit
• Kim and Putin share 'pent up inmost thoughts'
• Russia and North Korea sign new defence deal
• Analysis: China keeping close eye on cosy friendship
• A limousine, a dagger and artworks - the leaders swap gifts
• 'Bizarre scenes' should be warning, UK says
• Listen to the Daily above and tap here to follow wherever you get your podcasts

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In an opinion piece timed for his Vietnam visit, Vladimir Putin has applauded the country for supporting "a pragmatic way to solve the crisis" in Ukraine. 

Vietnam, which officially pursues a neutral foreign policy, has abstained from condemning Russia's invasion.

As well as praising Vietnam for its "balanced" stance on the war, Mr Putin listed progress on payments, energy and trade between the countries in the article published in Vietnam's Communist Party newspaper Nhan Dan.

"Putin's visit to North Korea and Vietnam is to demonstrate that Western attempts to isolate Russia are not working and that Russia has partners in Asia," said Carl Thayer, an expert on Vietnam security at the Australian Defence Force Academy in Canberra.

The Southeast Asian country will be the third nation Mr Putin has visited, after China and North Korea, since he was sworn in for a fifth term in May.

"No country should give Putin a platform to promote his war of aggression and otherwise allow him to normalise his atrocities," a spokesperson for the US embassy in Hanoi said this week.

Russia has historically been Vietnam's major military supplier, so any potential arms deals will be closely watched.

Vietnam has been gearing up for a full state welcome for the Russian leader's first visit since 2017 and his fifth in total. 

Vladimir Putin has arrived in Vietnam, Russian news agency RIA-Novosti reports.

It is a state visit aimed at strengthening ties with a longtime partner of Moscow's.

In Hanoi, the Russian leader is scheduled to meet Vietnam's most powerful politician, Communist Party general secretary Nguyen Phu Trong, then the new president, To Lam, and other politicians. 

The trip has resulted in a sharp rebuke from the US embassy in Hanoi.

It comes after Mr Putin's first trip to North Korea in 24 years, where he and Kim Jong Un signed an agreement pledging mutual aid if either country faces "aggression". 

Germany is holding up the 14th package of EU sanctions on Russia, sources say.

Officials from the bloc's 27 countries have been debating the package for over a month, which would make EU operators responsible for sanctions violations by subsidiaries and partners.

Germany's hesitation was due in part to an internal disagreement between its foreign ministry and the chancellor's office, diplomats and a source familiar with the matter told Reuters.

The roadblock remained despite the scrapping of a clause that Berlin found problematic - one that would have forced subsidiaries to "contractually prohibit re-exportation to Russia and re-exportation for use in Russia".

The EU's sanctions efforts have been undermined by circumvention via third countries. The inclusion of this clause would have further tightened the bloc's measures. 

Ambassadors will continue the debate tomorrow, they said. 

Volodymyr Zelenskyy has announced two more signatures have been added to his Peace Summit communique. 

He said the Organisation of American States, which represents countries in North and South America, and Antigua and Barbuda have signed it.

"We view the entire world as equals, and this is our ideological difference from Russia in international relations," the Ukrainian president said.

"Putin, however, wants only his voice to matter, or those he chooses. This is a typically colonial world view that we, together with all our partners, must break." 

He said the format of the Peace Summit will ensure "fair treatment for every nation", including, of course, Ukraine. 

Nearly 80 countries have already approved the final communique covering steps toward nuclear safety, food security, and the release of prisoners and deportees, including thousands of children abducted by Russia.

One person has been killed and three others have been injured in a Russian shelling attack in Donetsk, Ukraine's police force has said. 

In a post on Telegram, it said there had been 2,291 strikes in the eastern region in the last 24 hours. 

Russia used "aviation, rocket salvo systems and artillery", it added. 

Over the past few months, fighting has been surging across the frontline in the eastern Donetsk region. 

Russian forces have been trying to reach the key hilltop city of Chasiv Yar and other strategic hubs in the region. 

Russian troops also launched an offensive in Ukraine's northeastern Kharkiv region. 

Mr Putin said he wanted to establish a buffer zone there to prevent Ukrainian cross-border attacks.

The offensive drew some Ukrainian fighters away from Donetsk, but many remain. 

Reuters captured these photos of Ukraine troops operating in the area. 

Russia has been attempting to replace "significant losses" by recruiting soldiers from African countries, the UK's defence ministry has said. 

Ukrainian intelligence has been reporting increased Russian efforts to recruit from several African countries in recent days. 

"This recruitment campaign is likely an attempt to replace significant battlefield losses and sustain offensive activity across the front," the MoD said. 

"Russia is likely expanding its recruitment across the global south to avoid additional mobilisations within Russian itself."

It added that previous mobilisations within Russia had resulted in a record labour shortage and the mass departure of skilled workers. 

Vladimir Putin's visit to North Korea has come to an end, with the Russian president leaving Pyongyang after a busy day of diplomacy.

His next stop is Vietnam.

The headline from Mr Putin's visit is no doubt the agreement signed between the two countries that, its leaders say, covers security, trade, investment and cultural and humanitarian ties among other things.

The deal has triggered plenty of reaction from around the world, with Washington and Seoul among those expressing concern about the growing military ties between Russia and North Korea.

Below, we've taken a look at exactly how Mr Putin's visit shaped up.

Opening remarks

The warm words between the Kremlin and Pyongyang started before Mr Putin's plane had even touched down, with the Russian leader penning an open letter in North Korean state media.

It was here that we first got confirmation of an agreement that would be signed by the two countries. Mr Putin called it a partnership that would help in the "fight against the imperialist hegemonistic policies of the US and its satellites against the Russian Federation".

There was also some appreciation shown for North Korea's "firm support" for Russia's ongoing invasion of Ukraine. 

Mr Putin claimed the US were doing everything they could to "prolong and inflame" the conflict, which Russia began in February 2022.

'Rock star' welcome in Pyongyang

When Mr Putin arrived in Pyongyang in the early hours of the morning, he was met personally by Kim Jong Un, a red carpet and a bouquet of roses.

State television then showed his motorcade driving through brightly lit neighbourhoods, with the 105-storey Ryugyong Hotel glowing with LED lights that said "Welcome Putin".

The streets of the capital were lined with hundreds of thousands of people holding flowers and waving Russian and North Korean flags, welcoming Mr Putin back on to North Korean soil for the first time in 24 years.

There was then a lavish ceremony in Pyongyang's main square, crowded with people and colourful decorations, where Mr Kim introduced key members of the North Korean leadership.

As a military band played, the two leaders walked down another red carpet and greeted dignitaries. Artillery guns fired a welcoming salvo.

As our Asia correspondent Nicole Johnston put it, North Korea gave Mr Putin "a rock star's welcome".

The 'comprehensive strategic partnership pact'

Fundamental to this trip for both Russia and North Korea is the document signed by the two nations, which both of its leaders have been at pains to describe in bold terms.

Mr Kim calls it the "strongest ever treaty", while for Mr Putin, it's a "breakthrough document".

The two leaders were first joined by ministers from both countries for initial talks. They then engaged in one-on-one talks that lasted two hours, according to reports.

This new agreement marks a new period of relations between the two countries, one that, according to North Korea's leader, is "incomparable". 

It reportedly covers everything from investment to strengthening cultural ties and cooperating on health, medical education and science. 

But it's the inclusion of a mutual defence clause, in case of "aggression", as Mr Putin put it, that stands out.

Mr Kim told reporters that North Korea will respond "without hesitation" to "incidents or wars" facing either his country or Russia. 

He did not elaborate on what the response will entail, though he did say the agreement is "defensive and peaceful in nature".

Russia also doesn't rule out the "development" of military-technical cooperation between the two nations. 

There's already an assumption that North Korea is sending Russia ammunition to use in Ukraine, while there are fears that Moscow will pass on aid for Pyongyang's nuclear and missile programmes in return. 

The signing of this agreement will do little to subdue those concerns.

Gifts and goodbyes

With business out the way, Mr Putin and Mr Kim spent the next few hours having a bit of fun.

There was the exchanging of gifts, with the Russian leader receiving works of art depicting himself.

For Mr Kim there was a tea set, an admiral's dirk (a type of dagger) and a Russian-built limousine, which both leaders took turns at driving.

Mr Putin then laid a wreath at the Liberation monument in Pyongyang, which was erected in 1946 in memory of Red Army soldiers killed liberating the Korean Peninsula from Japanese occupation.

Keeping with that theme, both leaders took their seats at a gala concert, where songs performed all evoked war and defence of the nation.

Russian state media reported the concert included excerpts from wartime songs, including Where the Motherland Begins, We Need One Victory and Katyusha, as well as song by groups who regularly support Mr Putin at political rallies.

Putin's opinion piece

As Mr Putin heads for Vietnam, a newspaper in the country has published an opinion piece he has written. 

In the piece, he praised Vietnam for its "balanced" stance on the Ukraine war and applauded the communist-ruled country for supporting "a pragmatic way to solve" the conflict. 

He also said Russia and Vietnam shared "similar assessments of the situation in the Asia-Pacific region".

He is due to arrive in Hanoi overnight and plans to meet Vietnamese leaders tomorrow, on the heels of his trip to North Korea.

It will be his first trip to the country since 2017.

One of the gifts given by Vladimir Putin to Kim Jong Un during his visit to North Korea today was a luxury Russian limousine. 

We're now got footage of the Russian president driving his host around, and other highlights from his trip...

Vladimir Putin has praised Vietnam for its "balanced" stance on the Ukraine war in an opinion piece published in the newspaper of Vietnam's Communist Party.

In the piece, timed for his state visit to Vietnam tomorrow, the Russian leader applauded the communist-ruled country for supporting "a pragmatic way to solve the crisis" in Ukraine.

Energy, he said, was "an area of strategic importance in bilateral cooperation" and cited Russia-Vietnam joint ventures on fossil fuels in the South China Sea and in northern Russia.

The comments were published in the Nhan Dan newspaper.

Vietnam, which officially pursues a neutral foreign policy in its relations with major world powers, has abstained from condemning Russia's war in Ukraine.

Mr Putin is due to arrive in Hanoi overnight and plans to meet Vietnamese leaders tomorrow, on the heels of his trip to North Korea.

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Tracking Abortion Bans Across the Country

By The New York Times Updated June 13, 10:25 A.M. ET

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Twenty-one states ban abortion or restrict the procedure earlier in pregnancy than the standard set by Roe v. Wade, which governed reproductive rights for nearly half a century until the Supreme Court overturned the decision in 2022.

In some states, the fight over abortion access is still taking place in courtrooms, where advocates have sued to block bans and restrictions. Other states have moved to expand access to abortion by adding legal protections.

Latest updates

• The United States Supreme Court upheld access to a widely available abortion pill, rejecting a bid from anti-abortion groups to undo federal approval of the medication. The pills account for nearly two-thirds of all abortions.

The New York Times is tracking abortion laws in each state after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization , which ended the constitutional right to an abortion.

Where abortion is legal

In a few states that have enacted bans or restrictions, abortion remains legal for now as courts determine whether these laws can take effect. Abortion is legal in the rest of the country, and many states have added new protections since Dobbs.

Ban in effect

Note: TK note here.

Legal for now

State details.

More details on the current status of abortion in each state are below.

An earlier version of this article misstated the legal status of abortion in Utah. As of 4 p.m. on June 24, the state attorney general had issued a statement saying the state’s abortion ban had been triggered, but it had not yet been authorized by the legislature’s general counsel. By 8:30 p.m., the counsel authorized the ban and it went into effect.

A table in an earlier version of this article misstated which abortion ban is being challenged in Texas state court. Abortion rights supporters are challenging a pre-Roe ban, not the state’s trigger ban.

An earlier version of this article referred incorrectly to the legal status of abortion in Indiana. While Indiana abortion providers stopped offering abortion services in anticipation of an abortion ban taking effect on Aug. 1, the law did not take effect.