More people are willing to leave the house for Doctor visitsand share Teladoc (TDOC) It fell more than 45% Thursday. The company warned of a weak sales outlook and higher costs in its post-close earnings report on Wednesday.

Teladoc, along with companies like Zoom (ZM)And Rocco (ROKU) And rubbery (CHWY) They were the main beneficiaries of the shelter economy in place during the height of Covid-19 fears in 2020 and the early part of last year. But all those stocks have now fallen from record highs.

Increasing competition is also a factor. Amazon (AMZN) fired her own Telehealth service And other Teladoc competitors spend heavily on marketing to attract customers. That could dampen Teladoc’s growth, but CEO Jason Gurevich told analysts the platform won’t get involved in the ad spending war.

“We continue to take a disciplined approach,” Gurevich said when asked about marketing. “So we are not going to overspend our way through this and follow the reins of irrational competition.”

Gurevich noted that the increasing competition for telehealth services “has created noise in the market” and that “in the near term we expect this noise to continue.” But he emphasized that Teladoc could be a “long-term winner” in virtual health.

But it may take time for Teladoc to get back on the right track.

Gurevich acknowledged that with many American workers beginning to return to offices, companies’ human resources departments are “under pressure…dealing with major resignations and all hiring and allocating resources to acquiring and retaining talent,” he said.

As a result, Gurevich said, many companies are choosing to focus on existing health insurance plans for workers rather than expanding telehealth options from independent providers like Teladoc.

Wall Street is also concerned. At least fifteen analysts cut their Teladoc price targets on Wednesday and Thursday after the earnings report, according to data from Refinitiv.

“Increased competitive intensity is weighing on growth and margins,” one of those analysts, Citi’s Daniel Grosslait, wrote in a report Thursday, adding, “We doubt we’ll see competition-driven headwinds dissipate anytime soon.”