September 28, 2005
Shoor, hon!! The healthcare is over there by the cabbage…
Distributed healthcare takes a step, and the medical establishment trembles. It is a force not to be denied. The consumer is here.
As was widely reported in the media, including the Indianapolis Star, "an emerging medical trend in Indiana makes simple treatments as accessible as fast food."
Like the movie industry facing television, some physicians will stand around and whine and wring their hands while others will understand the opportunity and engage the change.
Pharmacy chains are doing it. Grocery stores are doing it. The king of retail, Wal-Mart, is doing it. What? Retail medicine. Fast service at affordable prices. WOW!!!
After several decades or more of a frozen delivery system controlled by a cartel of interest who restrict access and give you whatever color you want as long as it’s black, retailers are answering a consumer need. At the same time they are addressing a badly battered consumer experience in receiving healthcare services.
Consumer experience has been steadily deteriorating for years. Long waits. Increasing paper forms to fill, perpetually, and redundantly. The famous $50 visit to a physician simply to get a prescription refilled. No exam needed. Sorry it’s not covered. Where do I go for something simple? Walk-in to the doctor for $80 and a lot of hassle? Emergency room of a hospital for $300 and mega-hassles? Why is everything so complicated?
The retail solution is simple. Have a small clinic in a retail space. Highly visible and easily accessible. No appointments. Only walk-ins. Staffed by a nurse practitioner with off-sight physician back up and support. Limited acute care visits only. Colds. Flu. Minor things. Vaccinations. Wellness care and testing. Fast, 15 minute turn arounds. Linkage to physicians for follow up and standard care. No follow up visits to the clinic. Standard and easy to understand pricing. Extended hours for convenience.
One of the early entries into this market is Minneapolis-based MinuteClinic. “The private company, led by a former chief executive of fast-food chain Arby's, is on the leading edge of an emerging shift in U.S. health care that could push many routine medical tasks away from doctors' offices and emergency rooms to low-cost clinics open evenings and weekends. The idea is to give patients more convenience and lower costs for common medical procedures.”
The consumer movement in healthcare is seeking convenience and good value, but also choice, control, and access to information. Distributed healthcare is about providing improved access, choice and control by pushing the means to deliver healthcare as close as possible to the consumer of the service.
“Some business heavyweights are impressed by the concept of bringing fast-food efficiency into health care.”
“Many current methods for treating patients 'just plain overshoot customers' needs,' Clayton Christensen, a noted Harvard Business School professor, wrote in his recent book, Seeing What's Next. It's overkill to treat a child's earache in an emergency room, for example.”
“He has called MinuteClinic's approach a 'disruptive innovation' -- an innovative change that fundamentally can change a marketplace or its pricing structure.”
“MinuteClinics…has a total of 40 clinics, with locations already in Baltimore; Nashville, Tenn.; and Minneapolis/St. Paul, Minn. The company wants to open hundreds of clinics nationwide. MinuteClinic says it has had nearly 300,000 patient visits since 2002 and has not faced any malpractice suits.”
Are physicians worried about this trend? You betcha’. Should they be? No.
It has been extremely difficult to bring disruptive innovation to the point of service of care delivery. This is a move in that direction. Bring the appropriately trained level person to the point of service who can focus on the problems within the scope of care of that person and triage and refer everything else to physicians or emergency rooms as needed. It makes sense. If participating instead of fighting, this is a feeder to physicians’ offices.
“Some physicians, however, are wary of the approach.”
"Part of me is worried that we have a consumer-driven mentality that my health care is a commodity and it's up for the best bidder," said Dr. John Turner, assistant professor of clinical family medicine at the Indiana University School of Medicine. "That's very concerning because that's not the way health care should be delivered."
“Dr. Kevin Burke, president of the Indiana State Medical Association, said some patients might forgo visits to the doctor for the spot care of specific ailments. But regular visits to a physician, he said, can reveal major health concerns such as high cholesterol, high blood sugar or high blood pressure.”
Mostly these are lame barriers to access and veiled income protection in my opinion. Nurse practitioners can and do perform at a very high level of expertise. It is simply true that some minor acute problems do not need a physician. Chronic care and more complex problems will be sent to physicians.
These retail medicine approaches are a step in the direction of busting the access bottle neck and leading to the service transaction and the financial transaction occurring between the same two people. I say, "Hooray!"
