Practice Notes

What physicians fear most about retail clinics

by Anita Joseph

Last month, Walmart announced that it’ll launch self-branded primary care clinics in Texas, South Carolina, and Georgia. Visits will be priced at $40 for the general public, and just $4 for Wal-Mart employees.

At this year’s national meeting, we asked hundreds of physician leaders what they think about the presence of such retail clinics in their neighborhoods—whether they see them as a potential partner or as a competitive threat.

With a few notable exceptions, the leaders we’ve spoken to feel very threatened by corporate retail operators, for three reasons.

‘They’ll prune away the healthy and leave us with the sick.’

Medical group leaders fear that retail clinics will take away healthy volumes from traditional primary care clinics and leave the health system with primarily high-acuity visits.

According to these leaders, this would have an effect not just on margins, but also on physician engagement. Physicians like to balance complex cases with basic cases throughout their day and retail threatens to force them to see 15 acute, complex and emotionally draining patients every day. Medical group executives worry that primary care physicians are not always receptive to this “ED-style” work profile.

Broadening Access Opportunities: Expanded Hours, Convenient Care, and Virtual Visits

‘They’ll retrain patients to value convenience over relationships.’

Many leaders in this camp believe that retail represents a fundamental disruption of the health care industry, for the worse. They believe that by offering “radical convenience” and de-emphasizing a personal relationship with a provider, retail is retraining patients to value different competencies.

This echoes what we heard from the leader of a major urgent care chain—although health systems value care continuity, patients increasingly don’t.

‘They'll make us a downstream commodity.’

Medical group executives fear that if this is true, and retail operators do not intend to limit their scope of services, then the medical group’s entire delivery model is in danger. These executives believe that retail clinics will secure patients, expand their scope of services to include higher-acuity primary care services and lower-acuity specialty care services, and become direct competitors to the medical group’s core competencies.

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In response, some medical group leaders want to fight to take back this territory. “Why let [retail] get anything?” said a CEO in the Midwest. They are building out their own self-branded retail clinics, often going around big-box companies and partnering with local businesses.

Yet others suggest that medical groups could allow retail clinics to occupy a piece of the health care ecosystem. They believe they could, in essence, concede low-acuity visits to retail clinics while aggressively strengthening the medical group’s core competency: physician relationships with patients.

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