I first heard about Sollis Health the way most of us hear about the good parts of American healthcare — from a friend.

His parents were visiting Los Angeles. His mother got sick at the hotel, and the hotel did not send them to an emergency room. It sent them to a Sollis clinic, where they were seen quickly, worked up thoroughly, and sent on their way. My friend told me the story with real wonder. He had just discovered that competent, unhurried acute care exists in this country, and that it had been available the entire time — for a price.

I have been thinking about that wonder ever since. It tells you very little about Sollis. It tells you a great deal about everything else.

Sollis operates 14 clinics across New York, California, and Florida. Membership starts at $4,000 a year and covers unlimited visits to emergency medicine–trained clinicians, 24/7 telehealth with those same clinicians, and unlimited access to a care navigation team of EM-trained physician assistants. House calls, imaging, and elective labs cost extra, at cash prices printed on a one-page list every member receives before anything happens.

It bills no insurance and is credentialed with no payer. CEO Brad Olson told me it has close to 20,000 members nationally. He would not discuss financials.

The clinical footprint is more serious than the concierge label suggests. Each site runs a laboratory Olson compares to a community hospital's, with results in minutes. CT and ultrasound run around the clock. Clinicians can give IV antibiotics. Olson says Sollis sends a patient on to a hospital emergency department in fewer than one percent of cases. For comparison, he puts the referral rate at a typical retail urgent care at seven to nine percent — meaning roughly one in ten people who walk into an urgent care will end up in an emergency room anyway. If his numbers hold, that is not a marginal difference in capability. That is a different category of facility.

And its physicians see roughly one patient an hour, against the three to five a busy ED shift demands. That is not a marketing statistic. That is the entire business model, expressed as a ratio.

The CEO's story is a patient's story

Olson is not a healthcare person, and he did not found Sollis. The company opened its first clinic on the Upper East Side in 2016 under different leadership. Olson arrived in 2022 as its second chief executive. He came up through Bain, then Starwood, where he ran the Starwood Preferred Guest loyalty program, then Peloton, where he was chief business officer while the subscription base grew a hundredfold. He is, by training and instinct, a customer experience executive.

What brought him to healthcare was being a patient. Olson was diagnosed with multiple sclerosis in 2016 — he is now a trustee of the National MS Society's Greater New York chapter — and manages it on immunosuppressants. He caught COVID in late 2021 and went to an emergency room for the first time in his life. It was rural, and it had no monoclonal antibodies, which was the one thing he needed. So he made his way to a leading academic medical center in New York.

He was there nine hours, part of it in a curtained space beside a patient recovering from a stab wound. The hospital would not accept the COVID result from the first hospital — both run Epic — so he waited three more hours for a test he had already had. He told his husband afterward that if a consumer business operated this way, it would be closed the next day.

Six months later a recruiter called on behalf of the Sollis board. Olson had never heard of the company. He joined as a member before he accepted the job, on the principle that he has to believe in what he sells, and used it soon after. What converted him was not the speed. It was that the physician, the nurse, and the ultrasound tech were all in the room together, so he told his story once — and that while the scan was running, the Sollis physician got his primary care doctor on the phone.

The objection I always raise

Pull a function out of the system and you create discontinuity. The patient gets a beautiful experience inside the carve-out and falls into a void on the way back to everything else. I have made this criticism of a dozen models over the years, and I made it to Olson.

His answer is that continuity is the product. Sollis calls the member's PCP on every visit. It makes and tracks specialist referrals. It sends the records. It has built working relationships with the major hospitals near its clinics, so when the triage line hears something that sounds like a heart attack, the patient goes to the nearest emergency department and an EM-boarded physician — often one who takes shifts at that same hospital — calls ahead with the story. When surgery is indicated and a slot is open, Sollis sends the patient straight to the surgical team with the CT, the labs, and the write-up in hand, skipping the ED entirely.

The hospitals cooperate, Olson says, because Sollis takes a little volume out of crowded departments and sends back only patients who genuinely need them. I believe him.

The question I actually wanted answered

You can sell a $4,000 membership to a finite number of Americans. Stack it on a $16,000 concierge primary care retainer and the number shrinks further. So I asked Olson what I ask everyone who arrives in this industry from outside it: what would it take to productize this so that it solves access — not access for people who can pay?

He pointed to his former employer Peloton, where the bike cost more than $2,000 and everyone assured him it was a product for the wealthy, and where public school teachers eventually turned up in the member base. Innovation, in his telling, starts small and starts with people who can pay out of pocket, because that is how you test and learn.

Then he said something I did not expect from a sitting CEO. He does not believe Sollis is going to save the American health system, and he does not believe he is either. He believes that if the company can demonstrate a better way, people with more experience and more leverage may do something with it.

The demographics, he told me, surprise him constantly. Young families whose children are perpetually sick. Older adults with chronic conditions, a group in which he counts himself. And a meaningful number of people no one would call wealthy, who have watched their commercial coverage give them less and less, moved to catastrophic plans, and redirected money they were already losing from their paychecks into direct primary care, or Sollis, or whatever else they have decided actually works.

That is not a consumer trend. That is a verdict.

We have normalized the abnormal

Olson attributes emergency department crowding largely to uninsured patients using the ED as a safety net. That is part of it. The larger driver, from where I sit, is that primary care is no longer primary care, and the emergency department has become the front door by default.

It has become the place Americans go when the rest of the system has told them no. No appointment for six months. No one answering the phone. No specialist who takes their plan. No after-hours option that is not a parking lot off the highway. So people wait, and avoid, and wait some more, and then at three in the morning they go where the lights are on.

A friend of mine recently spent eight hours in an emergency room outside Boston, then eight more the next day at a specialty hospital across town for visual symptoms. Two working days consumed. Nobody involved found it remarkable.

He fared worse than typical, but not by as much as he should have. A recent study by the EMR software review site, FindEMR , tabulated the median time from emergency department arrival to departure for every reporting hospital in the country using CMS data. For the year ending June 2025, the typical American ED visit that ends in discharge ran about 3 hours 10 minutes. Massachusetts, where my friend spent his two days, runs 4 hours 2 minutes — third longest in the nation. New York is fifth, at 3 hours 46 minutes across 138 hospitals and nearly 8 million visits a year. California is tenth, at 3 hours 27.

Two features of that measure flatter it. These are medians, so half of all visits run longer. And they count only patients who go home. Patients who get admitted — the sickest people in the building, the ones boarding in hallways while someone hunts for a bed upstairs — are excluded from the measure entirely. What CMS publishes is the good news.

The spread should embarrass us. Maryland is worst at 4 hours 17 minutes. South Dakota is best at 2 hours 17. Two hours of difference, same country, same medicine, same training. The variable is almost never the physicians. It is whether a hospital can move a patient upstairs, and whether the record follows the patient across town — which, as Olson learned between two Epic installations, it often does not.

The waits nobody is selling a membership for

CMS reports the same measure separately for patients whose principal diagnosis is psychiatric. Maryland: 8 hours 18 minutes. Tennessee: 7 hours 44. Texas: 7 hours 28. Massachusetts: 7 hours 8. In most states the psychiatric figure runs roughly double the general one.

There is no membership for that, and there will not be one. The patients waiting longest in American emergency medicine are precisely the ones no cash-pay model will ever organize itself around, because what they need is an inpatient psychiatric bed and there are not enough of those at any price. A membership can buy a faster path to a CT scan. It cannot conjure a bed that does not exist.

The geography makes the same point more quietly. New York and California are top-ten states for length of stay, so Sollis is answering a real local failure. Florida is not; at 2 hours 44 minutes it sits in the faster third of the country. The footprint tracks concentrated wealth at least as closely as it tracks dysfunction — which is what you would expect of a well-run membership business, and what you would not want of a solution.

I am not writing as a bystander

I should be careful here, because it would be easy to admire Sollis from a comfortable distance and leave it at that.

I run a health plan. The system that made Sollis necessary is the system I work in and help to build. When one of our members cannot get a primary care appointment for six months, that is not somebody else's failure. When two hospitals on the same electronic health record cannot trade a test result and a patient sits for three extra hours, the organizations that finance those hospitals — mine among them — have never made interoperability a condition of doing business. When emergency departments fill with people who should have been seen in an office three weeks earlier, that is a downstream consequence of decisions made upstream by people like me.

Sollis did not cause any of this. Sollis is what grows in the gap. The uncomfortable question is not what Brad Olson should do differently. It is what those of us with far more leverage than Brad Olson have chosen not to do.

There has always been a back door in American healthcare. It is the donor's phone call, the board member's text, the physician who knows a physician. Its currency has never been money, exactly. It has been proximity to the right people.

What Sollis has done — and I said this to Olson directly — is democratize the back door. It has taken a privilege distributed by social accident and turned it into a product with a published price. There is something honest in that. A one-page price list is more disclosure than most Americans will ever get from a hospital they are legally obligated to pay.

I don't begrudge Sollis its members, or those members their $4,000. Olson has scaled something clinically real and operationally disciplined, and he has been more candid about its limits than most executives in his position would be.

But the measure of Sollis is not whether it reaches every major city, which it probably will. The measure is whether the rest of us are sufficiently embarrassed by the conditions that produced it. A country that sells a subscription to emergency care that works has already told you what it thinks of the emergency care everyone else receives.

The goal was never a better back door. It was a system that did not require one.