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[18 comments]

Pediatricians try to scare parents away from in-store clinics

February 26, 2014

Attention parents: the American Academy of Pediatricians (AAP) wants you to know that in-store clinics do not provide "the high-quality, regular preventive health care children need."

While clinics may be much more convenient and less expensive than going to a doctor's office, AAP argues that optimal care requires a "medical home" for children with a pediatrician managing and coordinating care.

AAP has raised its red flag as the number of clinics in stores continues to climb in anticipation of millions of newly insured consumers entering the market as a result of the Affordable Care Act. CVS, off its decision to end tobacco sales, is looking to have 1,500 MinuteClinics operating inside its stores by 2017. Walgreens will have 500 clinics operating inside its drugstores by year's end.

Tine Hansen-Turton, executive director of the Convenient Care Association, issued a statement pushing back against the AAP. She called in-store clinics "a more convenient option for parents with sick children than the alternative, which is often waiting for an appointment or spending hours in a high-cost emergency room for a minor pediatric complaint."

Research in 2009 funded by the California Health Care Foundation and the National Center for Research Resources, part of the National Institutes of Health, found the quality of care provided by in-store clinics for ailments such as ear infections, sore throats and urinary tract infections was on par with MD offices and better than emergency rooms.

FINANCIALS:     [NYSE:CVS] [ ]

Discussion Questions:

Do you expect in-store clinics to take off in the next couple of years? Will retailers out-market MDs to gain greater share of the overall healthcare market?

While we value unfettered opinion, we urge you to show respect and courtesy for people or companies about whom you comment. Keep in mind that this is a public, professional business discussion. RetailWire reserves the right to edit or refuse the publication of remarks that we deem unsuitable. We may also correct for unintended spelling and grammatical errors.

Instant Poll:

How big will the market opportunity be for in-store clinics over the next five years?

Comments:

As long as the quality of care for basic treatment of minor problems is good, these clinics should continue to grow. If we believe that shoppers are looking for good value, these seem to be a leader in an often-opaque pricing venue.

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Dr. Stephen Needel, Managing Partner, Advanced Simulations

There was a time when becoming a doctor was a really great thing: guaranteed high income, the chance to help people within their community or in hospitals, and have the prestige of being "a doctor."

Over the past 20 years, first hospitals and health insurance companies (or maybe it was a concurrent thing), and then insanely high malpractice insurance have whittled away at doctors' ability to practice profitably.

I suppose retailers are a good choice for flu shots and other routine tasks, but honestly, I don't like the idea of sick kids wandering around in places where there's unpackaged food to be purchased. CVS and other drug stores...well, I've started realizing I have to use hand sanitizer when I go there anyway, but I am pretty creeped out by finding them in my local grocery.

I think it's somewhat inevitable, but I really don't like it notionally.

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Paula Rosenblum, Managing Partner, RSR Research

This reminds me of the good old days when the music industry tried to scare people away from listening to the radio because it would ruin the quality of the listening experience. That went well.

Unfortunately the lesson will continue to be learned the hard way (by the AAP and countless other organizations). Why can't executives realize that they don't need to "own" their customers in order to profit from them?

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Peter Fader, Professor of Marketing, The Wharton School of the Univ. of Pennsylvania

As a parent of two, I can attest that children rarely get sick when it is convenient. There's the Friday or Saturday night "I don't feel so good" that leads to "I'm sorry, honey, but you're going to have to wait until Monday afternoon when I'll be able to get the first available appointment." With so many illnesses dependent on catching them early - flu can be stopped or minimized by Tamiflu, but only in the first 48 hours, strep throat can be minimized with the rapid application of antibiotics - the 9 to 5, M-F pediatrician just isn't going to cut it.

Besides, the last time my kids were sick, we didn't see the pediatrician. We saw a PA, who did the swab tests and called in the Rx. No doctor to be found. Sure, for the regular check-ups and the weighings and measurings, a regular visit to a regular doctor over regular periods of time provides consistency. But in my experience, that's more fantasy than reality anyway.

Sounds more like sour grapes over erosion of a once-cushy business model to me. Worked great for doctors, but for patients (and parents), not so much.

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Nikki Baird, Managing Partner, RSR Research

 
10

There's a tidal wave of change coming in this area, not just the location of clinics to stores but that care is often provided by a PA, or NP (state dependent) which is a lower cost alternative to an MD's office with some debate (IMHO, unwarranted) as to the quality of that care. Different stakeholders will argue to their own benefit, but there is no question that massive change featuring new competition is en route.

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Peter J. Charness, SVP America, Global CMO, TXT Group

The medical profession is finding itself somewhat adrift in a sea of change. Examples are large groups versus sole practitioners or small groups. Who is actually treating the patient, an NP or PA instead of a doctor?

We have seen the physical environment move from medical buildings and hospitals to clinics - Doc in a Box - to now, Doc in a Kiosk (clinics instead supermarkets and pharmacies). I expect we would have seen more of the retail-based clinics regardless of the ACA. The convenience of these facilities is too great to ignore.

Whether it is for a flu shot (Walgreens is where I have gotten mine for several years) or minor ailments, they are here to stay. Doctors may want to look at this in this way, that it frees up their time to handle the more serious medical issues that arise, especially in an aging population.

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Steve Montgomery, President, b2b Solutions, LLC

Nikki is correct. The convenience factor drives the in-store clinics and will continue to. The ones in the pharmacies have the added convenience of being able to get the prescription filled in the same stop, should medicine be needed. With the increased trouble getting a near time doctor's appointment, and the horrible situations in off hours emergency rooms, these clinics are an idea whose time has arrived.

'Liatt'

This market will only grow over the next several years because of, as said, the Affordable Health Act. Be that as it may, these clinics are not only good for young children, but adults as well, especially if one has a problem at night or over a weekend. Doctors don't want to be bothered then. I tried to reach my cardiologist one evening and felt like I had to jump through hoops. Never able to get to him until I called his cell (which I should have done first).

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Ed Rosenbaum, CEO, The Customer Service Rainmaker, Rainmaker Solutions

The AAP is probably correct in saying that in-store clinics aren't the right place for regular preventive care. But any parent who's had to care for a baby with an ear infection on a Sunday morning knows that waiting for Monday isn't always an option. Their reaction is overblown; regular pediatric offices won't be going away anytime soon.

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Cathy Hotka, Principal, Cathy Hotka & Associates

For unexpected and urgent-but-routine care, in-store and quick clinics can be a boon for parents. But pediatricians make a fair point about continuity and planned preventive healthcare. Using mini-clinics leaves the onus on parents to keep tabs on their children's medical history, vaccinations, and to connect the dots between various caregivers.

I have some sympathy for medical practitioners who see their business model being altered by this new competition, and I believe most are also sincere in their concern for patient well-being.

Maybe the AAP would do well to work on defining more contemporary and relevant practices too. A HIPAA-compliant portable patient record card might be worth exploring, so parents can more easily integrate their emergency visits with planned checkups and vaccinations at their regular pediatricians. ACA coverage should make this affordable for families while helping to reduce costly and soul-crushing emergency room visits.

Well I'm no expert in these matters. Just trying to think constructively.

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James Tenser, Principal, VSN Strategies

I think the decision and trend has been determined. Economics, level of care required, location, etc. have all played into it. Shoppers/consumers demand it and we are not going backward. Having said that, I agree with Paula and have also been very much turned off at the thought of someone coughing over or handling fruits or other foods I then purchase. It may be happening now without my knowledge or awareness (I am not that naive), however, I don't want to be reminded of it every time I go shopping.

I am not in favor of the movement, but cannot deny that it is happening.

What I would like to see retailers do is take a lead in PREVENTION through nutrition and food choices rather than in CURING once the illness has occurred. Will that happen - remains to be seen.

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David Zahn, Owner, ZAHN Consulting, LLC

Is it just me, or are today's questions cynical? Rather than worrying about what's best for the user - or patient - we're talking about "monetizing" and "share of...healthcare." (Then again, it IS a retail forum.)

Anyway, no I don't see a "takeoff' in clinics...why should we? People have been getting sick since the apple gave Adam acid reflux, and ways to deal with it have been around nearly as long. Yes, the ACA changes things, but logically it will change them the most with the higher cost services, not the lowest. And medicine-as-a-sideline providers are always going to face a conflict - keeping costs low, while maintaining credibility, and skirting liability...just wait until a few misdiagnosed "ear infections" turn into 8 figure settlements (or more specifically, the publicity that surrounds them).

'notcom'

In-store clinics will continue to grow in the coming years, they fit nicely in today's busy family with working parents who don't always have the time for booking appointments that fit with doctors' time but not theirs. Many of these working families don't have much health care, and once again, these clinics offer a lower priced solution for minor pediatric needs.

Doctors should try to work "with" these clinics, getting referrals when clinics feel the health need may need a physician. Things change, including how we access our health needs. The family doctor is not what it was - nor do we want or need it to be.

Donna Brockway, President, FutureRetail

Retailer in-store clinics will continue to gain acceptance. Dealing with a sick child requires immediate attention, not at a convenient time for the doctors office so a clinic makes sense, particularly when considered against an ER visit. As part of a drug store with extended hours, clinics works fairly well.

Some health care systems have urgent care clinics affiliated with hospital networks, providing an alternative that makes patient records available, very helpful, but limited right now. It's all about location and value for time and money. Many will be watching this - tremendous needs and challenges ahead.

Anne Bieler, Sr. Associate, Packaging and Technology Integrated Solutions

In-store clinics will definitely grow. I would guess that they have already taken a good chunk of the adult vaccination business. If you've already been to Walmart or Walgreens for a flu shot, why not bring the kid there for her next DTaP? The switch however, may not happen as quickly as some might expect. In my industry (optical), we are five decades past the first retail clinics. You can now find one in almost every mall or big box store. 44% of eye exams are still done by an independent doctor of optometry.

'tmlens'

Everybody wants a piece of the healthcare very deep dish pie. The large Drug Store chains are in a good position to succeed where hospitals, medical practices, insurance companies and the government have all failed. At one time in the not so distant past pharmacists made a lot of money and there was no sight of an end to the highly profitable career. This has all changed and the same formula will be applied to all aspects of the medical industry. Big businesses always have a way of finding a way to win. Especially when there is a tremendous opportunity for a large ROI.

'gjarnoldjr'

They are cheaper and easier to access with more convenient hours, plus the pharmacy is already there. Why go to a pediatrician who really doesn't spend time with your kid and whose physician's assistant is the only one you talk to anyway?

Kate Blake, Social Media Manager, Take Five with Kate Blake

If the quality exists, the convenience of in-store clinics will drive continued growth of the "care share." As with all markets, MDs are going to have to adapt to the times, understand their customers, adapt their value proposition, and continue to deliver value.

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Verlin Youd, Principal, VPY LLC

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