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TECHNOLOGY: Quick clinics as part of the Walmartization of health care

For some time various people in health care have been talking about the Walmartization of health care. What they are talking about (and you know who you are Mr. Singerman!) is the development of a low cost generic health care service that could deliver primary and walk-up care very cheaply. Well as iHealthbeat reported the other day, it looks like these quick clinics are indeed turning up in large mall stores, but the first ones are appearing in a Target and Club Foods…..although if they’re a success you know the Beast of Bentonville won’t be far behind. What do these clinics do?

Diagnose and treat several common ailments, provide vaccinations and offer cholesterol and blood pressure screenings. Staffed by nurse practitioners, these "MinuteClinics" use clinical guidelines software to help diagnose and treat patients. The $15 million software incorporates established clinical guidelines and notes patients who come to the clinic frequently with the same complaints so they can be referred to a doctor, said Catherine Wisner, director of national operations for MinuteClinic.

There have also been reports of more and more actual surgery happening overseas, particularly in India and Thailand,and the Brits have been sending patients overseas to buy cheap surgery in France and Spain (at a cheaper marginal cost than building more facilities at home).  So are we at the start of a globalization of surgery, in which the easy stuff will be delivered by low-paid staff backed up by smart computers, and the expensive staff will be contracted out to cheap but well-trained foreigners?  Probably not a reality any time soon, but a trend worth watching.

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3 replies »

  1. Hi!
    This is a followup to my comments of July, 2005, which appear to have been dead on.
    Since my last comments, Minute Clinics has been acquired by CVS, because they couldn’t operate independently at a profit. The clinics could prospectively drive more customers into the CVS stores, hence negative cash flow to Minute Clinics can still mean profits to CVS.
    Also in the interim, RediClinics has come to pass. Steve Case, the AOL founder, is behind this group. Their approach is superior to Minute Clinics, hence have realized greater success, with success being a relative term. By their own admission, they are treating an average of 10 patients per day, which is below break even. But why would Steve Case care. He is partially motivated in his efforts by giving back to the community, which in this case is a valid motivation. The other factor to consider is that as long as the conept attracts expansion capital, no one is factoring profitability per clinic into the equation. The same development formula that has always applied applies here. Use expansion capital to grow the network, and to subsidize under performing clinics. At some point in the future per clinic profitability will be a management issue, but not during expanssion mode.
    The benefits of this concept to the uninsured masses is evident, but again, if the clinics won’t support themselves, what is the future of the concept. The concept will have to be reengineered, making delivery more costly, and eroding the advantage over competitors.
    Another major flaw in the concept has been exposed by healthcare organizations that were early into the quick care concept pulling out. Originally, the quick care concept was seen as a means of capturing patients that could ultimately, some day in time, become prospective patients for more costly services that the healthcare systems could provide. The hoped for referrals never materialized, leaving quick care to profit on its own merits, which has not yet been done.
    Sam Oliver
    Feb. 2007

  2. Barbara,
    I have been so intrigued by the concept as to potentially going head to head with them. But before I do anything, I want to see Minute Clinics generate a profit. I have sat through three years of listening to Ms. Hall Whitman talk about this, that and the other expansion program, that has resulted in a grand total of 22 clinics in three years, but now I’m listening to Mr. Howe talk about seeing 30-35 PPD at each clinic, when their own reports show actual patronage at 15 PPD. By their own publication, 17-19 PPD is break even, so they are not breaking even. Until profitability is proved, their concept is a giant beta test. Do I think that the concept has value in bringing down healthcare costs and allowing access to those in rural unserved areas, yes, absolutely. But is Minute Clinics going to be commercially viable, only time will tell. Do I like your concept of enjoining it within venues offering other services, I think that is how the quick care concept is most beneficially utilized. Over the last three years, during which period Ms Hall Whitman touted 400 additional clinics by EOY 2006. Well, she did 22 of those clinics. The other 378 got opened by not for profits, all of which were done, either physically or referrally, to promote other health network resources, maintain competitive posture, and other applications having no bearing on the profitability of the quick care component. So we have quick care, viable as a loss leader, and hopefully someday provable as a viable commercial venture. Thanks for giving me this opportunity to vent. Sam

  3. As a Practice Admininstrator, I have become more interested in the idea of “Minute Clinics” concepts, but offering this within an office setting. My approach would be to staff NP’s that could provide minor surgical care such “benign mole removals”, to those patients that have coverage but do not want to wait for precerts/authorizations or approvals (cosmetic procedure) from their insurance payers. These patients would be willing to “waive” billing their carriers and paying a flat fee as a private pay patient by signing such waivers. These would be “walk-in” visits only.
    I would be interested in hearing some comments/recomendations/opinions on such practices.

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