Walmart has recently shared its intent to step into primary medical care , joining CVS and others in an emerging trend of retail based medical clinics. In a document seeking partnering doctors, the Arkansas based retail giant’s stated goal is to “dramatically…lower the cost of healthcare…by becoming the largest provider of primary healthcare services in the nation.” With growing uncertainty about the future financial models for established, office based primary care physicians, Walmart perceives a competitive space in the market by offering low cost and convenient healthcare.
While this might be a helpful offering, particularly for the under-employed or unemployed, patients and potential partnering physicians need to consider key questions surrounding retail based healthcare before jumping in with both feet.
Will patients’ care become fragmented?
Patients often use a retail health provider for self-diagnosed conditions they view as minor, reserving a trip to their General Practitioner for “serious matters.” This practice bifurcates the patient’s medical information prohibiting both the retail medical practice and their General Practitioner from having a comprehensive picture of the individual’s health. There are times when supposedly benign symptoms coupled with previous patient medical information can raise a red flag of a more serious condition. This problem can be avoided if the patient was willing to make a retail provider his sole primary care physician, but this has, thus far, not been shown to be the typical patient pattern, as 65 percent of consumers agree they are worried about retail staff qualifications and missed diagnoses. Because of this perception, retail based healthcare providers follow a seasonal, flu based preventative trend of patient volume.
Will Walmart’s continual demand to drive down vendor cost result in diminished care?
The big box retailer is notorious for hammering vendors to continually reduce costs. If this same model is applied to their healthcare partners, will Walmart become the “big brother” of which treatments the doctor recommends based upon their profit margins? While this practice would assuredly not be official policy, it has the potential to creep into the treatment model doctors select when a highly revenue vs. expense retail overseer is involved. This continual cost diminishing mindset might easily slip towards a “cattle call” model, where patient volume becomes the all consuming metric of profit and doctor success. Such a model would likely include a higher percentage of patients seeing physician assistants and nurse practitioners.
“Maybe Walmart can deliver a lot of this stuff more cheaply because it is an expert at doing this with other types of widgets, but health care is not a widget and managing individual human beings is not nearly as simple as selling commercial products to consumers,” says Ann O’Malley, a physician and senior health researcher at the Center for Studying Health System Change, a nonpartisan Washington think tank.
This is not to say that any of these potential problems are unique to retail primary care providers. Similar concerns could be had about established, office-based practices. Still, it remains to be seen if Walmart will treat medical care vendors like they do overseas TV manufacturers.
In 2007, Walmart changed their motto from “Always Low Prices. Always” to “Save Money. Live Better.” It seems they think living better involves being their customers’ doctor. This is an emerging model to watch.
Jordan Fowler Sr. Account Services Manager