Changing nature of healthcare is reflected in new push for services to become a retail commodity

December 7, 2011 – 11:34 AM | By Jim Stommen | No comments yet

“Okay, hon. I’m headed over to MammothMart. Need to grab some beer and munchies for the Monday night game, a replacement shower head for the bathroom and maybe that new Michael Connelly book.”

“I might as well get the oil change and lube done on your SUV while I’m there. And while I’m there, I’ll get that loose pair of glasses tightened at the optical shop. Oh yeah, and I guess I’ll have them check out that stomach pain I’ve been having off and on.”

If any of the above seems to border on crossing the line between imagination and reality, you haven’t been paying much attention when you have visited, say, your local outpost of global retail colossus Walmart.

There, alongside a bank branch, beauty salon, nail emporium (or whatever they call such places) and whatever chain sub shop is that particular store’s choice for providing sustenance to the shopping hordes, you’ll find an in-store medical clinic that is aiming at doing nothing short of changing the face of individual healthcare in the U.S.

Whether it’s within one of the sprawling Walmart outposts or part of a decidedly less frenetic shopping site such as CVS or Walgreens, the retail healthcare clinic now looks like it’s here to stay.

The fact that the mere existence of such care has brought out the usual bleating from those who look down their nose at such things is proof enough that, after some less-than-smooth stops and starts, retail medical care may truly be ready to build on what is an admittedly small footprint. As a concept whose time has come – and gone – on more than one previous occasion, retail care now seems to be trending upward.

While there are other players dabbling in the retail care concept, the aforementioned trio of retailers seem most serious about it at this point. CVS operates somewhere around 550 of its MinuteClinic units within stores, while Walgreens total about 335 Take Care units. Walmart at present is lagging behind with clinics in less than 150 of its stores, but think about it, folks, when have you seen the executive team in Bentonville, Arkansas, settle for being last in a retail category?

Last month, the leaking of a confidential document sent by Walmart to potential healthcare service partners indicated the world’s largest retailer’s clear interest in becoming a considerably bigger player in that sector. The document involved a request for information from organizations that could, for example, help monitor patients with diabetes, asthma, high blood pressure, heart disease, obesity and other conditions.

While Walmart gave the public appearance of backing away from parts of its own document, saying it did not intend to build a “nationally integrated” primary care platform, that’s really just a bit of posturing. That’s more a result of the widely fractured state laws governing the way healthcare services are provided than it is an acknowledgement that Walmart doesn’t intend to be Numero Uno in this space.

So what’s behind apparent growth in both the numbers of and usage of retail-based clinics? Convenience, for one. As in the example I used back at the beginning of this piece, if you’re going to be shopping at either a megastore or retail pharmacy anyway, why not take the opportunity to have some health problem looked at?

Another, and one that is cited by both providers and patients, is the certainty of costs up-front, with rates for various services clearly posted, as opposed to the crapshoot of charges that results from visits to more traditional outposts for care.

Part of the latter point is that costs for those services at these store-based clinics generally are considerably lower – 30% to 40% lower in many cases, and as much as 80% lower than at that other popular option for care, the closest hospital’s emergency room – than at those more traditional points of care.

More and more employers, especially the smaller companies that are going to be even more financially challenged when new federal requirements for health insurance coverage take effect in 2014, are seeing such clinics as offering cost-effective opportunities for screening and wellness programs. Hiring a company to come in and conduct wellness programs would be costly, but partnering with a retail-centered clinic to provide blood tests, conduct nutrition counseling or organize diabetes management programs could sharply bring such costs down.

Then there’s the impending shortfall of primary care doctors, estimated by one study to total 21,000 physicians by 2015. Use of the nurse practitioner model in retail clinics will help lessen the effects of that shortfall.

As for the “look down their nose” crowd, that kind of mystifies me. I have recently asked several friends what they think about “Walmart healthcare,” and the near-universal response has been “Oh no, I’d never go there for healthcare.”

In the Atlanta area, where I live, the estimable Emory Healthcare organization has teamed up with CVS Caremark to provide services at 31 MinuteClinic locations around the metro area. Somehow I can’t see Emory cutting any corners in providing care through those clinics.

Maybe my friends would have a different outlook if they were uninsured or had had enough bad experiences with overscheduled, understaffed and vastly overpriced traditional primary care providers. My feeling is that it’s an idea whose time is coming, if not totally here yet.

Truth be known, I haven’t used such a clinic myself. But with the vast majority of my healthcare encounters being of the every-six-months “wellness visit” variety, I’m pretty open to the idea. My wife and I do get annual flu shots from our friendly local CVS pharmacist in lieu of the much longer treks we previously made to our respective primary care physicians, so a more convenient wellness visit may be a very logical next step.

(Jim Stommen, retired executive editor of Medical Device Daily, is a freelance writer focusing on healthcare issues.)


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