Keep an eye on how well in-store clinics work for consumers

Staff writerDecember 8, 2013 

Apparently there’s a lot going on with health care these days. You may have read something about it in the newspaper.

Actually there are two realms of health care news, the political and the real world of delivering medical care. The realm sucking all the oxygen of attention out of the room at the moment is the first, and that’s no surprise.

What happens with the “Affordable” “Care” “Act” aka “Obamacare” — which seems to have been designed to make people nostalgic for the existing system of financing health care by taking its shortcomings and magnifying and multiplying them — will dramatically affect how, where, when, what kind of and to whom that care is delivered. Oh yeah, and the small matter of how it’s to be paid for (current answer: by China, at least as long as it’s willing to continue rolling over and adding to what we owe to them).

But there’s plenty going on in the real-world realm of health care, driven not just by the rolling debacle of “Obamacare” (in which the federal website drama is a mere preliminary) but by technology, demographic changes in the population and shifts in the business model of health care, including some entrepreneurial ventures.

The real-world news manifests itself in continuing mergers, acquisitions and affiliations among hospitals, in the growth of urgent-care clinics (some run by hospitals, others as independents), in experiments such as Franciscan’s online doctor-on-call service (chronicled in this space a few months back) and by two recent announcements from Group Health.

Last week the cooperative and regional retailer Bartell Drugs announced plans to open three in-store clinics in Seattle and Bellevue between mid-January and early March in 2014. Group Health and Bartell say other locations of what will be branded as CareClinic could follow, depending on how the first three do.

This is a fascinating development on several levels, starting with the participants.

In some regards Bartell is a bit late to the party, since national chains Walgreen, Rite Aid and CVS (which is just now moving into Washington) all have some sort of in-store clinic offering.

But in another sense Bartell’s move is perfectly timed. Walgreen says on its website it has 400 in-store clinics nationwide, but none in the Northwest. Rite Aid has two MultiCare Express Clinics in stores in Pierce County. With an established retailing name (one that has withstood the incursion of larger national competitors) and a local identity, Bartell is in a good position to stake out a position in providing these types of clinics and service (which would, not coincidentally, drive business to its pharmacy business) should they prove financially viable and popular with customers.

Group Health’s presence in this venture is even more intriguing. For years, Group Health’s closed-loop design of health care — cooperative members stayed within the system for doctors and hospitals — was seen as a potential model for delivering health care while holding down costs. Indeed, hospital groups have been mimicking that model by building their own networks of clinics and specialty practices.

But the CareClinics, staffed by advanced registered nurse practitioners, will be open to all comers, not just Group Health members.

Earlier this year Group Health announced another venture, this one with Vera Whole Health, to establish worksite clinics that would provide basic health care to employees of participating companies. Lots of companies are now playing in this space; that Group Health wants (or needs) to expand beyond its traditional model of providing services to members of the cooperative at its own facilities is indicative of the changes in health care.

In-store and worksite clinics will mean changes in the way patients get care. That isn’t proving to be too distressing to consumers, who are already used to getting basic services such as flu shots at grocery and drug stores. The Bartell/Group Health announcement says the CareClinics will handle treatments for such common ailments as colds and flus, sinus infections, allergies, minor injuries (burns, rashes, and cuts), pinkeye, sore throat, headaches, head lice, ringworms, warts, sprains and strains, bronchitis, ear infections, urinary tract infections, diarrhea and intestinal infections — all conditions in which the treatment is relatively standard and straightforward.

If going to an in-store clinic is faster, more convenient and less expensive than a trip to the doctor’s office or emergency room, consumers are likely to be perfectly fine with that. The health care industry might benefit as well if moving such routine cases to in-store and urgent-care clinics frees up time and facilities for more serious or prolonged illnesses (the financial effect on doctors’ practices of shifting that business elsewhere will have to be reckoned with).

If they are fine with it, expect to see more announcements like the ones from Group Health this year. If they’re not fine with it — expect to see more announcements, ventures, combinations, restructuring and experiments anyway. Few industries operate the way they did 25 years ago. For the health care industry, as with so many others, the pertinent questions are not “how can we stay the same?” or “how can we postpone the inevitable?” but “how can we make change an improvement?” And perhaps, “how do we keep the people who designed healthcare.gov well away from health care?”

Bill Virgin is editor and publisher of Washington Manufacturing Alert and Pacific Northwest Rail News. He can be reached at bill.virgin@yahoo.com

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