Medical clinics where you shop

Last week, I wrote a story about the mini-clinics inside grocery and drug stores. It included this paragraph:

“Most treatments are priced at 59 dollars. You’d be billed twice or three times as much at a traditional urgent-care clinic. MultiCare accepts insurance and Medicaid, so most people end up with just a co-payment either way. To break even, the mini-clinic needs to see at least 25 patients a day. That covers rent and the salary for the Nurse Practitioner who staffs it. The one-person staff keeps costs down – along with treating only minor ailments. Is this the next big trend? Not yet, despite hype from some chains. It’s been moderately successful in other parts of the country – but not a revolution.”

For Tacoma’s MultiCare health system, the key is integrating the retail clinic with their larger system. Many of the patients (including the two that I interviewed in the drugstore) were referred from MultiCare’s traditional urgent-care clinic, which was overcrowded.

The question I did not address, but hinted at, in the story is this: Are these retail clinics a good indicator of how much you pay for inefficient overhead during your basic medical appointment? We’ve been hearing for years how wasteful the medical system is, and how paperwork eats up a big share of every dollar. But this seems to be a graphic illustration, at least for all those visits that didn’t need fancy MRI machines and surgical suites nearby.

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Medicine and shopping

I’ve been watching the trend of drugstores (and supermarkets) adding mini-medical clinics inside their stores. It’s an interesting idea, sort of an end-run around all the hassle of trying to get an appointment with your doctor and be seen in a timely manner. Instead, just walk into the nearest drugstore and have your minor ailment checked out. And, it’s supposed to provide an option for people without insurance.This started on the East Coast, and Bartell Drugs first tested it here in Washington a couple years ago, by contracting with a chain called Minute Clinics. Apparently, that didn’t work out so well.

Now, Rite Aid is trying a new angle, at two of its stores in Tacoma. It’s teaming up with a local health-care provider, in this case MultiCare Health System. MultiCare is huge in Tacoma, the dominant medical provider, with four hospitals, and a network of primary care and Urgent Care clinics. MultiCare is staffing the mini-clinics (with ARNP’s — Nurse Practitioners) as one more branch of its network.

According to a story in the Puget Sound Business Journal, these clinics do better (financially) when there’s a shortage of primary care providers — so, outside major cities. In Houston, they’re converting the mini-clinics to telemedicine clinics, because it was too expensive to pay a nurse to sit there all day.

Will this ever be an important trend in medical care? Is it helpful to have a service like this? Or does it just seem like a new type of marketing?