News & notes on convenient care, from Healthcare 311Nice ~14 minute interview conducted by ReachMD nurse practitioner Mimi Secor with The Little Clinic’s Dr. Roger Green (VP Western Division). Good sound quality, and an information-filled brief overview of the state of retail clinics in 2013.
Good start for National Nurses Week!
TweetProminent articles on retail clinics published in the past 3 weeks range from the sublime to the ridiculous.
The Sublime: Retail Clinic Visits and Receipt of Primary Care, Rachel O. Reid, J. Scott Ashwood, Mark W. Friedberg, Ellerie S. Weber, Claude M. Setodji and Ateev Mehrotra, Journal of General Internal Medicine, 11/1/12), Ateev Mehrotra’s latest report on retail clinics, which examines retail clinics’ impact on individuals’ relationships with primary care physicians. While the study did produce some empirical evidence that retail clinic usage might diminish an individual’s engagement with a primary care doc, Mehrotra et al take pains to examine the tenuous nature of that evidence at present. For instance, the research team urges that “[f]uture studies should assess the impact [of retail clinic usage on primary care MD relationships] over the longer term” given that the study only looked at subjects’ treatment visits to clinics and/or primary care doctors over a 12 month span.
We feel too many of the articles on the Mehrotra report belong on the Ridiculous end of the Sublime/Ridiculous spectrum, inasmuch as they zoom in so eagerly on the “clinics are probably bad for your health!” angle, while ignoring evidence that, for instance, clinic usage does not derail patients’ receipt of care from primary care physicians for preventive care or diabetes management.
Articles in this vein from leading news outlets are particularly egregious: Retail Clinics May Cut Into Primary Care: Study, Chicago Tribune/Reuters, 11/1/12).
The Ridiculous: 10 things walk-in clinics won’t tell you, Jen Wieczner, MarketWatch/Wall Street Journal, 11/2/12)
Purposefully ‘controversial’ at a 10th-grade level of comprehension of that term, this “top 10″ style article, which draws on the Mehrotra study, features ‘alarming’ assertions of this kind throughout:
“1. “We might put your family doctor out of business…””, and even MORE ridiculously, “6. “We practically self-regulate.”"
Ms Wieczner seems like an earnest, industrious individual – she’s apparently written a number of articles for various publications – but she cannot be legitimately described as an authority on health care topics generally or clinic-based care specifically. Her profile confirms this. However, we are prepared to wager her observations on parties in the Hamptons or horseracing are nonpareil.
TweetWhen the count topped 18, we stopped totting up the recent articles taking approving note of the ‘sharp increase’ in retail clinics visits uncovered by recent research from Dr. Ateev Mehrotra and Judith Lave. Mehrotra & Lave’s study, published in Health Affairs last week, documented a fourfold increase in retail clinic visits from 2007 to 2009.
Not so fast.
Now, nearly six million clinics visitors is certainly nothing to sneeze at. But there’s a devil or two in the details of the visits data that should give at least a few of those uninhibited cheerleaders pause.
We anticipate that retail clinics vaccination counts since 2009 have plateaued, or will do so soon. And the growth rate for non-vaccination services has been considerably more gradual – see the green line in the chart below;
Invisible in this nifty retail clinics growth chart from Tom Charland’s Merchant Medicine by way of a 6/27/12 Wall Street Journal article is the ‘force’ (forces, maybe) that helps explain why retail clinics appear to have bumped into a stubborn ceiling:
Have you guessed it? No?
It’s urgent care clinics. For extra credit, it’s urgent care clinics plus community health centers.
There are over 10,000 urgent care clinics; there are approximately 1,200 community health centers. Both deliver a lot of routine non-emergency health care to people in the US. Neither populate the graph of retail clinics above.
TweetThe 3rd installment in Sean Deale’s series of reports on retail clinics (Retail Clinics: The Evolution of CVS’s Minute Clinic, Sean Deale, In-Store Trends, 5/9/12) zeroes in on industry leader MinuteClinics and specifically the barriers to more rapid growth of clinics for MinuteClinic and other industry participants.
(Installment 2, posted April 19, ably recounted the establishment & growth to date of Walgreens’ Take Care Clinics, but failed to mention anything about Take Care’s initiatives in the area of operating on-site clinics for employers – which to be fair is probably in keeping with In-Store Trends editorial charter).
Sean asks this pair of keen questions in installment 3:
Why has the Minute Clinic not made its way into ALL of CVS’ 7,300 stores in the US? Is there a major barrier to entry for retailers considering the introduction of retail clinics?
In answer, Sean identifies five major hurdles for clinics operators generally. We found all basically on point, especially the first:
Awareness – the overall concept and availability regionally has been slow to penetrate consumer awareness beyond for flu shots
We feel Sean may have overlooked the role that the existence of urgent care clinics has played in the gradual introduction of retail clinics. His post does consider the opportunity that long ER wait times and waits for physician appointments present to clinic operators, but it does not take into account the existence of between 7 & 9 thousand urgent care clinics, which serve a market quite similar to that targeted by retail clinics.
Our back-of-the-envelope calculations indicate that if clinics are intelligently sited, there is plenty of demand to go around; for example, considering only visits to emergency rooms that might be more appropriately treated at retail or urgent care clinics, each current clinic would be faced with 40 to 50 patients per day.
But the key word with respect to siting is intelligently. Maybe locating smart is part of what is taking retail clinics so long to grow in numbers.
TweetOur three takeaways from this post featuring Forrester Research graph of smartphone users’ most likely health care uses:
quickly now: which is the 2nd most-cited activity respondents mentioned using their smartphones for?
Very nice (and mobile-formatted!) summary at Supermarket News of what is undoubtedly a nice report from Merchant Medicine’s Tom Charland (In-Store Clinics Primed For New Growth, Christina Veiders, 2/27/12).
Most of the story covers the not-all-that-new news that many observers guess about 100 to 150 new clinics may appear during 2012. Here are the things we thought you should zoom in on:
Ok, that’s not mentioned in this article, and probably not in the Merchant Medicine report. We just thought we would point it out.
We tour retail and walk-in clinics’ location search tools irregularly, out of curiosity, and on the chance that we’ll learn something new.
Recently it occurred to us that some of you may do the same – and that you have lived to tell about it.*
So we’ve created a short poll to make it easy for you to tell us which ones you like. (Note that we have NOT made it easy for you to belittle our choice of poll name….)
We’ll go first: we’re not big fans of any of the leading firms’ location search tools.
And we feel they’re getting worse, rather than better.
We’re not convinced the clinic chains are really thinking about what people in the market for their clinics’ services are looking for when they’re looking for a clinic to treat them, or someone they know.
Our ideal locator would sweetly satisfy more than one of the following needs:
We feel none of the leading clinics locator tools satisfies many of these criteria. Sweet is scarce among them.
But enough about our biased attitudes: which clinic’s location search tools are your favorites? To make it easier for you compare them, we’ve provided links to 5 of the largest retail & urgent care enterprises’ search utilities:
Concentra
MinuteClinic
RediClinic
TakeCare Clinic
The Little Clinic
(note that there is NO search utility for Walmart’s The Clinic At Walmart locations. Walmart’s low-tech solution to learning where their clinics are? A PDF listing them all. We’re serious. That’s it, for the clinic operator with the 3rd-largest number of clinics.).
We plan to leave the polls open through Friday, February 24th, and announce the poll results Monday the 27th. Vote early and often!
Shameless Clinics Location Search Tools Popularity Contest Poll
* A twitter friend in St Louis had this to say about the search tools of the 2nd leading pharmacy-based retail chain:
Tweet“LOL @ Walgreen’s Take Care Clinic website using static images for a dropdown menu, then hitting you with a modal on click”
“There’s a fundamental usability issue with what the Take Care clinic was doing with the menu system.”
We’re picking on them because we’re fans – but something’s missing from the “Cost Per Episode” portion of this chart from a December 20, 2011 investor presentation by MinuteClinic President Andrew Sussman:
We just think the dollar distinction amongst venues is more significant – and more favorable to retail clinics – than the chart, as presented, suggests.
To be fair, there are several interesting slides in the full presentation deck. We especially liked slide #10, which covers a growth projection for the non-acute treatment share of MinuteClinic visits. Doctors, are you watching…?
We also liked the socko finish of Sarah Kliff’s post at Ezra Klein’s WonkBlog, in which this information originally appeared last Tuesday (our emphases):
Tweet….CVS-Caremark’s stock surged last Tuesday afternoon in the hours after this presentation. Retail clinics aren’t the health-care system we’re used to — but when what we’re used to are long wait times and expensive care, that could be a welcome change.
Fixing Healthcare Costs: A Look at Business Models of Insurers and Hospitals. http://t.co/r3mBPxRWgw
RT @ADVANCEforNPPA The Evolving Role of Genetic Counselors http://t.co/lTHBNn8zra
Happy #FF! @powdoug @ClincalAdvisor @ADVANCEforNPPA @AAPAorg @PAProNow @innovaterisk @MayoClinic #followfriday
RT @peterngrantPro: Retail Clinics May Help Reduce Hospital Readmissions: http://t.co/pP113xbbpV #readmissions
#retailclinics
Retail Clinics May Help Reduce Hospital Readmissions: http://t.co/pP113xbbpV #readmissions
#retailclinics
AAPA Booth 573, board review resources @PAForum @AAPAorg @PAExchange @ADVANCEforNPPA @CanadianPA http://t.co/6R5gMuPtBH Employee vs. Contractor Status: Since there are quite a few jobs out there and it's likely that many of you ar... http://t.co/66fakGG6TB
Join Us! NPNY May 16th CE Program New York, NY Thursday, May 16 2013 at 6:00pm ET http://t.co/w30tvUnkRM @AANP #nurse @ADVANCEforNPPA Have you visited our LinkedIn group recently? We have a lot of new discussions on our page today. Click here to join! http://t.co/apuqzreImd
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Apr 12
Retail Clinics: Status Update
If you’re looking for a no-nonsense digest of where retail clinics are today, we dont’ know why you haven’t already clicked through to acquire this new KnowledgeSource report: Retail Clinic Growth Has Resumed (Knowledge Source, April 2012)
No, really – what are you doing still here?
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