In less than a decade, telehealth has expanded from a sideshow of health care to an industry worth tens of billions of dollars. Companies like Hims & Hers and Teladoc have become household names, their ads interrupting streaming TV and flooding social media feeds with the promise of quick, convenient care.

Despite their popularity, few patients understand who’s actually taking care of them when they click through a telehealth site.

National telehealth brands present a unified front to patients across the country. But in more than 30 states, it’s illegal for corporations to practice medicine. So behind the scenes, telehealth companies work with distinct, independent medical groups. Owned by physicians — who often hold 50 state licenses at once — those practices are meant to act as a firewall, making sure that clinical decisions are driven by patients’ needs, not the profits of the corporations they deal with.

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