Doctors may be feeling the heat. The American Medical Association (AMA) announced Monday that it would call for investigations into potential conflicts of interest posed by joint ventures between store-based health clinics and pharmacy chains. The AMA cites comments from retailers that the clinics help drive additional store traffic, which can increase sales of prescription drugs and other non-health related products.
“There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics, said AMA Board Member Peter Carmel, MD.”The nation’s physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based health clinics to provide patients with quality care.”
Sounds to me as though someone is running scared. If these clinics turn out to really have sustainable power, as I believe they will, it’s for a reason. Getting in to see a physician can be a hassle and can be expensive, and few practices have evening or weekend hours. Some 20 years ago, when the first “walk-in clinic” wave came through, the model was strictly convenience. Those clinics, such as the Doctor’s Emergency Officecenter, were staffed by physicians, and gained additional revenue from x-rays and pharmacy items. They were often freestanding buildings on main roads. All of these factors drove up the overhead costs of the facility and personnel, making it difficult to turn a profit. The store based model cuts the overhead, mostly by whacking at the facility costs. Occupying a few hundred square feet at most within an existing store, the clinic’s facility costs are low. The presence of the clinics has the potential to draw people in, and once in, to purchase a few pick-up items, whether or not they use the pharmacy.
As I’ve written here before, you can play a role with these clinics. The claims that the AMA is making are a reach – the clinics meet a real need and demand for evening and weekend medical care, at a convenient location and reasonable price. For practices, there are opportunities to work the clinics. You can work with clinics to provide same day follow up physician or testing appointments for clinic patients, you can provide physician support to the nurse practitioners, and you can use them as an after hours site.
One valid issue that the AMA raised is to seek equal treatment for physicians regarding health insurers’ co-payment policies. “Health insurers are allowing store-based health clinics to waive or lower patient co-payments, while forcing physicians to collect these fees, said Dr. Carmel. “The AMA believes health insurers should be prohibited from waiving or lowering co-payments only for patients that receive services at store-based health clinics.” As an alternative to emergency rooms, the insurer’s policy makes a lot of sense. A physician’s office should not be penalized, however, as treatment from one’s own physician is a better way to go.
The overall strategic theme is this: patients need and will seek out off-hours, convenient and low cost options for minor ailments and illnesses. Solve the consumer’s problem, and there is the opportunity for whoever does it well.