walmart and the mom & pop shops

[cooldreams]

so, like in recent history, walmart has out sold the competition.

so, check out this article: WALMART-CLINICS

Apparently, in just a few years, Walmart will be launching several clinics around the country. Ever wonder what effect that would have? Take a look at that old family owned shop down the road that your grandparents went to. Oh wait, its not there - mass retailers like walmart put them out of business. Also look at the history of HMOs killing prices of practicing physicians.

Have fun out there... but not too much fun...

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[cooldreams]

NEW YORK (Reuters) - Wal-Mart Stores Inc. said on Tuesday that it will contract with local hospitals and other organizations to open as many as 400 in-store health clinics in the next two to three years.

Should current market forces continue, the world's largest retailer said up to 2,000 clinics could be in Wal-Mart stores over the next five to seven years.

Wal-Mart said the effort marks an expansion of a pilot program it started in 2005, when it leased space within its stores to medical clinics. Currently, it said 76 clinics are operating inside Wal-Mart stores in 12 states.

 

[ajce9]

In order to run the clinics they need doctors and most likely nurse practitioners.

The smart person would "JUST SAY NO".

 

[deleted87716]

Haven't we had at least a half-dozen threads about retail clinics here in the past few months?

It must be a slow day at Reuters. Interesting, too, that Wal-Mart shares fell on the day of this announcement. Retail clinics are far from a proven success.

 

[ajce9]

Yeah, Even if they were, open one of your own in like Macys. Upscale clients with jock itch.

 

[confused_amused]

The national chain pharmacy in our town now has a nurse practitioner working out of it. Unfortunately, a fair number of people have been going there for abx and so forth. She's also blown a few things big time, like missing an (apparently very acute) appendicitis. If people can save $4 or 5 minutes of time, they're going to use these services unfortunately. The optometrists in the walmarts sure aren't hurting for business.

 

[cooldreams]

people are hurting for better jobs. this time last year, there were over a million factory jobs that would be lost. and its not just blue but also white collar jobs. when this monster, walmart, appears with everything you need and everything at the best price anywhere, what do you think you would do, living pay check to pay check just to get by. dont let the shiny world of academics fool you.

 

[cooldreams]

Haven't we had at least a half-dozen threads about retail clinics here in the past few months?

It must be a slow day at Reuters. Interesting, too, that Wal-Mart shares fell on the day of this announcement. Retail clinics are far from a proven success.

please do not post meaningless mumblings about the stockmarket. when google invested in itself, its stock dropped. the following year, it sky rockets as people see the harvest from the prior investment. when sprint fired many of its employees, it saw a great stock gain, only to follow with stock loss as its performance and reputation fall. the people at walmart are no idiots, this is an investment tactic.

 

[cooldreams]

In order to run the clinics they need doctors and most likely nurse practitioners.

The smart person would "JUST SAY NO".

actually they do not need doctors.

 

[cooldreams]

The national chain pharmacy in our town now has a nurse practitioner working out of it. Unfortunately, a fair number of people have been going there for abx and so forth. She's also blown a few things big time, like missing an (apparently very acute) appendicitis. If people can save $4 or 5 minutes of time, they're going to use these services unfortunately. The optometrists in the walmarts sure aren't hurting for business.

even worse, this apparently has very little effect in politics to prevent this from reoccuring. the midlevels lobbying and their retail chain employers lobbying each have far more ear time with our good senators than do the physicians.

 

[Jejton]

I would think this would make the EM guys happy, especially if the clinics have late hours or are open 24 hours because then all the uninsured who use the ER as a clinic will be able to go to Walmart instead.

 

[ajce9]

I would think this would make the EM guys happy, especially if the clinics have late hours or are open 24 hours because then all the uninsured who use the ER as a clinic will be able to go to Walmart instead.

No they would not.

ER is FREE. Emtala says you have to be seen and evaluated.

At wallmart you still have to pay something.

 

[Red Beard]

An important point in the article is that Wal-mart is only leasing space to third parties who will own and operate the clinics. The benefit for the retailer is simply getting a bit more traffic through their door and increasing sales.


I see it as a problem in the sense that it is adds to the nauseating Wal-martization of our society, but I don't see it as the downfall-of-primary-care-as-we-know-it disaster like others around here.

 

[thedman888]

No they would not.

ER is FREE. Emtala says you have to be seen and evaluated.

At wallmart you still have to pay something.

your insurance would still be charged if you have one.
but if i was some avg joe with a sorry insurance plan, i'd go to the walmart for $5 instead for the fast service instead of having to wait 10 hrs in the ED
but then again, i'd also rather visit an urgent care where real docs are instead of seeing a nurse for my health concerns.

 

[ajce9]

your insurance would still be charged if you have one.
but if i was some avg joe with a sorry insurance plan, i'd go to the walmart for $5 instead for the fast service instead of having to wait 10 hrs in the ED

The original post was making a point about the "uninsured".

And it is not 5 bucks. Its more like 35 to 50.

 

[deleted87716]

please do not post meaningless mumblings

Can I ask you for the same favor?

If you actually read the article, it had nothing to do with Wal-Mart's stock price falling; I just found that ironic.

 

[cooldreams]

Can I ask you for the same favor?

If you actually read the article, it had nothing to do with Wal-Mart's stock price falling; I just found that ironic.

actually it does mention walmarts stock price falling.

 

[iatrosB]

Can I ask you for the same favor?

If you actually read the article, it had nothing to do with Wal-Mart's stock price falling; I just found that ironic.

Kent, looks like you should quit responding to this guy/gal. He/she seems to relish pointless arguments.

 

[deleted87716]

actually it does mention walmarts stock price falling.

I'm referring to the article that I linked to.

 

[deleted87716]

And it is not 5 bucks. Its more like 35 to 50.

Which, interestingly, is about what a non-insured, cash-paying patient with a relatively uncomplicated, acute problem would pay if they came to my office (and I can usually get them in the same day, too).

The retail clinic thing is really more about convenience than cost. If you're not already in the store, it's not that much more convenient than going to your doctor (assuming your doctor runs an efficient practice). As for wait times, it's not unheard of to have to wait in line at a busy retail clinic. And, they should be busy...if they're not busy, they're not making money.

 

[Static Line]

I guess right now would be the perfect opportunity for McDonalds to open up heart centers and cath labs and staff it with McDoctors.

 

[sophiejane]

Yeah, Even if they were, open one of your own in like Macys. Upscale clients with jock itch.

Cash only, s'il vous plait.

 

[sophiejane]

Some things never change. I remember in my first year, cooldreams was spouting off about all kinds of things s/he didn't really know about. Now, I am about to graduate, s/he is still not in medical school, but is still causing threads to go on for >2 posts. why is that??

 

[deleted87716]

I guess right now would be the perfect opportunity for McDonalds to open up heart centers and cath labs and staff it with McDoctors.

I'm pretty sure that would violate the Stark regulations against self-referral.

 

[Static Line]

I'm pretty sure that would violate the Stark regulations against self-referral.

My former boss was in Funeral Director school when I was in undergrad. We had an idea to open a business together after I finished med school. How's that for a violation?

 

[ajce9]

Which, interestingly, is about what a non-insured, cash-paying patient with a relatively uncomplicated, acute problem would pay if they came to my office (and I can usually get them in the same day, too).

The retail clinic thing is really more about convenience than cost. If you're not already in the store, it's not that much more convenient than going to your doctor (assuming your doctor runs an efficient practice). As for wait times, it's not unheard of to have to wait in line at a busy retail clinic. And, they should be busy...if they're not busy, they're not making money.

I agree, it is all about convenience. The problem is that if you have a retail clinic in every wall mart or target or wherever then the pool of available patients thins out.

See there were not retail clinics they would have to come to you or their pcp or something like that.

If there were no 7-11 s they would have to go to the supermarket.

The problems is that we are not talking about a pack of gum.

 

[deleted87716]

If there were no 7-11 s they would have to go to the supermarket.

My local Harris Teeter seems to be doing pretty well, despite the fact that I have to drive past four or five 7-11's to get there. The selection at 7-11 pretty much sucks, by the way, unless you're looking for lottery tickets or Philly Blunts.

 

[cooldreams]

i respectfully disagree. using common principles of economics and sociology, family practice is potentially standing in the line of fire.

if you regard this as a pointless discussion, that is your business. my business is to not disregard the potential reaches of walmart in my future.

i would like to also point out, i have not been disrespectful in my postings. please show me the same courtesy Iatros and Kent. I am not going to jump into a fighting match here.

Thanks.

 

[cooldreams]

Some things never change. I remember in my first year, cooldreams was spouting off about all kinds of things s/he didn't really know about. Now, I am about to graduate, s/he is still not in medical school, but is still causing threads to go on for >2 posts. why is that??

now you bash me personally? interesting. do you really believe i am not in medical school? why is that?

anyways, you are posting OFF topic. thanks.

 

[deleted87716]

if you regard this as a pointless discussion, that is your business.

Indeed. Family medicine is my business, which is why I consider your arguments to be needlessly alarmist.

 

[Apollyon]

The selection at 7-11 pretty much sucks, by the way, unless you're looking for lottery tickets or Philly Blunts.

What about Twinkies and 1/4 pound beef hot dogs? Huh? How can you forget dietary perfection? (Twinkies are NOT kosher, by the way.)

 

[thedman888]

i respectfully disagree. using common principles of economics and sociology, family practice is potentially standing in the line of fire.

if you regard this as a pointless discussion, that is your business. my business is to not disregard the potential reaches of walmart in my future.

i would like to also point out, i have not been disrespectful in my postings. please show me the same courtesy Iatros and Kent. I am not going to jump into a fighting match here.

Thanks.

what are those common principles of economics and sociology?

 

[thedman888]

now you bash me personally? interesting. do you really believe i am not in medical school? why is that?

anyways, you are posting OFF topic. thanks.

this is in accordance to your previous posts in other forums, so it's not all that inaccurate.

 

[billydoc]

What about Twinkies and 1/4 pound beef hot dogs? Huh? How can you forget dietary perfection? (Twinkies are NOT kosher, by the way.)

All of the above couldn't be Kosher, even if the tried lol But hey, for a small fee...[Mistuh, mistuh don't be a schmuk take uh chichen ] I'll bless them for you . Actully I insist on the above products to sold right next door "health" clinic at Wal-Mart to ensure continuity of "care".

 

[Apollyon]

All of the above couldn't be Kosher, even if the tried lol But hey, for a small fee...[Mistuh, mistuh don't be a schmuk take uh chichen ] I'll bless them for you . Actully I insist on the above products to sold right next door "health" clinic at Wal-Mart to ensure continuity of "care".

The Twinkies aren't Kosher (or eligible) because they may be made from beef or pork fat (whatever's cheapest or most available at the time).

edit: I wasn't clear, and billydoc points it out below - it's because pork fat may be used that Twinkies are not Kosher. Not all Twinkies are made with it, but may be.

 

[ajce9]

To brings things back to the topic.

cooldreams, although I believe that wallmart or any other mart can have the potential to reduce overall volume in a clinic I do not think your strong belief that they will take over is possible or probable.

The simple fact remains that people like to make a choice.

Since food seems to be the off topic in here lets use that analogy.

People like fast food and they like to go and dine out in a fancy place.

If all you want is hamburgers, you can do that all day long. But if you want to get healthy you might want to go to a better place to eat.

So, If all you want is for someone to tell you you have a cold and it's not going to get better for at least another week and there is nothing I can do for you then you can go to the wallmart quick care.

but if you have a real medical problem or want real advice on your health from someone who takes your health seriously you will seek out that person.

I'm not in here to attack you but I do want to make an observation.

It seems you are afraid that in the future there will be no use for your services. If you really believe this why don't you choose another specialty.
Pick one that will bring you more satisfaction and money.

If you can't do that, after residency (I'm assuming you are a resident, you left that open in your other posts, so we don't really know if you are a physician or not) focous on finding a career that will be satisfying or do both medicine and another career. Many docotor do.

 

[billydoc]

The Twinkies aren't Kosher (or eligible) because they may be made from beef or pork fat (whatever's cheapest or most available at the time).

Though beef can be Kosher, pork cannot be. But there is certainly nothing Kosher about Twinkies

 

[cooldreams]

Though beef can be Kosher, pork cannot be. But there is certainly nothing Kosher about Twinkies

kosher this, kosher that. look at why that was established, pigs are natually very unclean and natually harbor many parasitic and harmful things for people. beef, not really so much.

today, both, when properly processed and inspected to standards, are fine. to define kosher in a reasonable manner, assuming the animal was killed in a clean way, both should be considered kosher.

i believe the Torah to be real and of God.

 

[cooldreams]

To brings things back to the topic.

cooldreams, although I believe that wallmart or any other mart can have the potential to reduce overall volume in a clinic I do not think your strong belief that they will take over is possible or probable.

The simple fact remains that people like to make a choice.

Since food seems to be the off topic in here lets use that analogy.

People like fast food and they like to go and dine out in a fancy place.

If all you want is hamburgers, you can do that all day long. But if you want to get healthy you might want to go to a better place to eat.

So, If all you want is for someone to tell you you have a cold and it's not going to get better for at least another week and there is nothing I can do for you then you can go to the wallmart quick care.

but if you have a real medical problem or want real advice on your health from someone who takes your health seriously you will seek out that person.

I'm not in here to attack you but I do want to make an observation.

It seems you are afraid that in the future there will be no use for your services. If you really believe this why don't you choose another specialty.
Pick one that will bring you more satisfaction and money.

If you can't do that, after residency (I'm assuming you are a resident, you left that open in your other posts, so we don't really know if you are a physician or not) focous on finding a career that will be satisfying or do both medicine and another career. Many docotor do.

i am not being alarmist. i am not running around crazy and frantic. i am pointing out current events to get people to realize that we are losing ground.

i agree that people like choice. today however, fewer people have that luxoury. ideally, you would want to be seen by a personal physician from harvard at your beckon call when you have a sniffle. reality demonstrates that often people go to the ED because they have no money/insurance. reality demonstrates that people would rather be given some random miracle drug that they BELIEVE will help them, even when they have a doctor saying it will do nothing. reality demonstrates, the doctors with the best bedside mannarisms get sued less and are percieved as being more competent, even though that may not be the case as shown by historical records.

reality demonstrates, that unless money is no object to you, then you dont want to spend money on healing yourself, until you are in dire straights. family practice is hurting.

maybe you guys dont see it, i mean, OBVIOUSLY you guys DO NOT SEE IT, but i see it every day.

 

[deleted87716]

i am not being alarmist. i am not running around crazy and frantic. i am pointing out current events to get people to realize that we are losing ground.

What you appear to be doing is trying to convince other people to adopt your point of view, or at least agree with you. You should be aware that this is difficult to accomplish, particularly in an electronic medium. With controversial subjects, you should expect some disagreement. It's usually better to simply state your point of view, and accept that in many cases, you're simply going to have to agree to disagree.

ideally, you would want to be seen by a personal physician from harvard at your beckon call when you have a sniffle.

It's "beck and call," by the way. Sorry, that's just one of my pet peeves...like people who use "a lot" as if it's one word.

reality demonstrates, that unless money is no object to you, then you dont want to spend money on healing yourself, until you are in dire straights. family practice is hurting.

This effects of this phenomenon are not limited solely to family medicine.

 

[Jejton]

kosher this, kosher that. look at why that was established, pigs are natually very unclean and natually harbor many parasitic and harmful things for people. beef, not really so much.

today, both, when properly processed and inspected to standards, are fine. to define kosher in a reasonable manner, assuming the animal was killed in a clean way, both should be considered kosher.

i believe the Torah to be real and of God.

I dont want to go off topic, really I dont, but I hate when I see misinformation presented as legitimate info so I will take a moment to correct this very oft repeated misconception and oversimplification of the truth. Laws of kosher food are not based on physical health. Yes pig is not kosher but its not because of tape worms. Shellfish, swordfish, rabbit and cheeseburgers are not kosher either. Those who choose to observe them for religious reasons due to so because of religious beliefs. Now back to the regular scheduled program folks.

 

[McDoctor]

I guess right now would be the perfect opportunity for McDonalds to open up heart centers and cath labs and staff it with McDoctors.

If this happens, I expect to receive at least a consultant fee.