In-Store Clinics On The Rise

[secretwave101]

This topic has been debated regularly here: The WalMart clinic staffed with ARNP's. At one point, it looked like they were struggling...but no more.

http://money.cnn.com/2009/04/13/new...etailclinics/index.htm?postversion=2009041307

My take: This doesn't hearald the demise of doctoral-level primary care. But it DOES force the hand of traditional medical care and add some competitive pressure to a, frankly, crappy product delivery model.

What kind of business doesn't advertise prices? What kind of place makes you wait for up to an hour before they even begin to address your needs?

Business-wise, the most valuable asset the store clinics have is the cash-only model. They've managed to finally sidestep the iron grip of insurance companies, thus actually make what they charge and saving a ton on billing and paperwork time. Family Doctors need to take this to heart and fight back against for-profit insurance companies, either with laws or with their own creative business plans.

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[AFSmiley]

It can be done.

From AAFP February 2006:
"2,500 Cash-Paying Patients and Growing"

It's not perfect, but I'd say it's a pretty good start.

 

[medicienne]

In many countries outside of USA they follow the cash-based model. This is one of the top reasons why generalists like FPs and internists have higher job satisfaction, patients complain less about medical expenses, and primary care is very popular with med students in these countries.

 

[deleted87716]

It's not all puppies and rainbows for in-store clinics.

http://walmartwatch.com/blog/archives/23_wal_mart_clinics_unexpectedly_close/

 

[medicienne]

My personal reservations about these in store health clinics is the possibilty of transmitting airbone disesases into the general population of shoppers. I would have great concern as to the BestMangement Practices in ANY health clinic in ANY venue where foodstuffs are sold,and large numbers of shoppers congregate. What safety procedures are in place to avoid outbreaks of communicable diseases. Someone going to these clinics may have diseases such as T.B. and not know it-yet put others at risk. I always wondered why these clinics were not in a seperate facility,perhaps attached ,instead of instores. This is one BIG reason I believe in a border fence. Should a biological outbreak or attack occur,we NEED to be able to colse our borders for quarantine purposes. Nobody EVER talks about that. Did anyone see the History channel show recently about the Spanish influenza of 1918,recently. Hundreds of thousands died?Might we not heed the lesson?

ddrb in
Tuesday, January 29 at 01:03 PM

Quoting an interesting point from the article above

 

[AFSmiley]

In many countries outside of USA they follow the cash-based model. This is one of the top reasons why generalists like FPs and internists have higher job satisfaction, patients complain less about medical expenses, and primary care is very popular with med students in these countries.

What countries in the western world have a cash-based model for primary care?

 

[medicienne]

What countries in the western world have a cash-based model for primary care?

"Western" would narrow down things but here goes the list:
http://en.wikipedia.org/wiki/Health_care_system

 

[secretwave101]

It's not all puppies and rainbows for in-store clinics

Personally, I've had enough poor interactions with shallow mid-level medical analysis to avoid using a clinic like that for my family.

But elements of their business MODEL should be instructive to the traditional FP model. Store clinics have finally managed to circumvent the craven claws of insurance companies. Thus, their prices are fixed and not inflated. Additionally, the wait is minimal and they are extremely available. This is just good business.

 

[deleted87716]

Store clinics have finally managed to circumvent the craven claws of insurance companies.

Actually, most of them will file insurance, if patients have insurance.

Thus, their prices are fixed and not inflated.

Most of the published fees that I've seen are actually quite comparable to the cost of the same services in my office.

Furthermore, there's nothing to stop physicians from offering uninsured patients discounted fees if they pay cash at the time of service. Most doctors simply aren't yet that interested in attracting those patients.

Additionally, the wait is minimal and they are extremely available

For the most part, that's because they're not very busy.

 

[DrJosephKim]

Cash-based practice makes me think of concierge medicine. Is that what you're interested in?

 

[secretwave101]

BD - Have long been impressed with your office, based on your descriptions over the years. I'm not trying to say that in-store clinics are good thing. On the contrary, I think they're a serious dumbing-down of American medicine.

My point is that they are profitable and growing. The reasons for that are, I think, rooted in successfully sidestepping some of the worst problems in traditional American medicine. I think that success should be regarded as instructive to traditional primary care offices.

No, I'm not really a fan of concierge medicine, mainly because I REALLY like my time OFF. None of this, "Here's my cell phone, my address, my schedule, my sperm count and social security number. You're my patient, I'm your slave. You own me. Now I'm happy and free as a doctor."

 

[deleted87716]

My point is that they are profitable and growing. The reasons for that are, I think, rooted in successfully sidestepping some of the worst problems in traditional American medicine.

I think they're more a symptom of what's wrong with American medicine than a real solution to those problems.

There's an old saying in the business world that when it comes to products and services, you can have it:
a) Fast
b) Cheap
c) Good
Pick any TWO.

I think this holds true in medicine, as well.

 

[secretwave101]

I think they're more a symptom of what's wrong with American medicine than a real solution to those problems.

Totally agreed. Not the right solution to the problem. At all.