Comments

They are making healthcare more accessable and are often high quality as well (i.e. owned and staffed by doctors who have their own separate practice). The early versions were after-hours clinics for pediatric care and provided great value in diagnosing and providing prescriptions that couldn't wait till morning (ask any parent of a toddler with an ear infection).

In addition, they are good supplements to your "regular" doctor for last minute school physicals, the minor bacterial infection when you can't get in to see your doctor, etc.

Posted by Jeff at August 15, 2005 4:34 PM

Sounds like a great idea to me.

Posted by Noel Guinane at August 15, 2005 4:52 PM

I bet the queues will be long enough on double-coupon days! Hey, why not bring the doctor to the people? My only concern would be viral control issues in such public spaces. I wouldn't be too keen having a crowd of infectious 'shoppers' hacking all over my organic lettuce.

Posted by Tom O'Leary at August 15, 2005 5:33 PM

That's interesting. I know my parents are having a hard time finding a new family doctor. They recently moved to Ontario from Alberta where we had the same family doctor as long as I have been alive. In Ontario there is a severe shortage of family practices that can take on new patients. In a case such as that, a medi-clinic/grocer might not be all that bad of an option for smaller, everyday ailments that seniors have to deal with.

Posted by SS at August 15, 2005 6:20 PM

Reminds me of when Sears tried vasectomies in the hardware department because that's where the guys hang out.

The surgery was always a success, but patients discovered that their garage door openers went up and down every time they made love.

Posted by Erick Blackwelder at August 15, 2005 11:10 PM

Val,

Sounds cool & pretty innovative too. Well, if hospitals could have in-house grocery stores for their patients & relatives to shop around in style, why can't grocery stores hav a clinic annexed to them!?

Maybe the new clinics are designed to cut the long wait that can be common in a traditional doctor's office--with patients in and out in 15 minutes or less because there is no prior appointment necessary.

Elsewhere in the United States, retail clinics operate under more than a half-dozen operators with names like QuickClinic, FastCare, or MediMinute to name a few.

The American Medical Association and American Hospital Association say patients could be at risk if a traditional medical doctor is not closely involved and they say they are concerned about the quality of care provided, given the short track record of retail clinics. Also, it would be informative to note that MinuteClinic has treated more than 220,000 patients since it began five years ago....WOW!!!!

A Word of caution for all ppl livin in Illinois:

The state's largest health insurer, Blue Cross and Blue Shield of Illinois, does not yet have a relationship with a retail clinic and has no "contract requests from retail clinic operators to join its [medical provider] network"
Now, that is somethin to be NOTICED and ACTED upon!

Posted by K.Sriram (India) at August 16, 2005 12:36 AM

Think about signing on to these local medical services.

All services, and products, that can be made outside our nation at their lower costs, will be made at their competitive wage price.

Remember your x-ray may be read by five doctor in India, at one fifth your cost, and the results e-mailed to your Rite Aid, or HMO if need be.

If we see the drift of major business out from here, to China, India and all other low wage nations, then don't laugh at Giant Eagle Med Center, and the fact they are holding three jobs in our neighborhood.

Local services that can't be exported to lower wage nations, one to one services, and imported retail products, may be all that will be left for us to work with.

I think we need to sign on to all local self-employment.

Posted by Mike Reardon at August 16, 2005 2:09 AM

How about a funeral parlour at the other end of the store? That would probably upset a few people but think about it: it's a one-stop shop. All your needs from birth, healthcare, food & groceries through to burial - all in one place. Add a creche and a school round the back of the store and you could end up living there...

Posted by Mark JF at August 16, 2005 2:28 AM

Great stuff - thanks for raising this important issue Val

We all know most healthcare is actually 'self care' and to have easy access to health services is clearly the way forward.

Having accessible services in everyday places is not that new.

Over here in the UK healthcare checks are available on railway station platforms in London for the busy commuter/office worker who has not got much time.

The real key to all this is health education and getting people to be aware of there own health status. The more easily available services and professionals become - the more likely the health promotion message gets home.

It is brilliant to see some discussion on Tom's site about healthcare - in my opinion the most untapped area of management and leadership.

I look forward to more health care discussions.

Posted by Trevor Gay at August 16, 2005 3:21 AM

Mark, I understand from confidential sources that that's exactly what Walmart are planning and they're going to include a cinema, a casino and a gym too. Some of them will be on riverboats.

Posted by Noel Guinane at August 16, 2005 3:42 AM

An interesting development.

Sweden would definitely need more of these kind of initiatives.

K. Siriram,

"American Hospital Association say patients could be at risk if a traditional medical doctor is not closely involved and they say they are concerned about the quality of care provided". I am a firm believer in that only the clinics building reputation would survive in the long run - in this new world of freeflowing information.

Trevor,
says that healthcare is probably the most untapped area of management and leadership. I am not in this industry, but from a customer perspective the potential for improvements are tremendous. More deregulation?

Posted by Klas K. at August 16, 2005 4:03 AM

Absolutyely Klas - the world is our oyster on customer care in health.

There is much work to be done my friend.

I have never understood why customer care is not the highest priority among healthcare managers despite my 35 years in healthcare management.

The answer is probably complex but to me it is simple. I run an inter-active role playing workshop called 'TRUST ME I'M A PATIENT' and if all health professionals and managers lived that message we would not go far wrong in my opinion. The patient is always right - EVEN IF HE/SHE IS WRONG :-)

I'm happy to provide details of the workshop to anyone interested - it is all about winning the hearts and minds of managers and clinicians in the healthcare business about involving patients in change.

Thank you for your feedback Klas - great to have a discussion about this topic.

Posted by Trevor Gay at August 16, 2005 5:12 AM

As a dentist, I understand the importance of having immediate, affordable doctor services. I think as others pointed out this clinic is a testament to the the lack of available, affordable health care. Also, it points out that group practices that offer multi-specialty doctors may be more valuable than solo practices so the patient can go to one place to take care of all their medical/dental needs. This is my idea of one-stop shopping.

I believe this clinic in Cleveland will attract more emergency situations than a typical clinic. If patients are going for quick emergency situations or the routine physical for school and then another doctor for other services, where is the contiuity of care?

I'm all for offering different services to patients as long as the patient is the #1 priority.

Posted by Chithra Durgam at August 16, 2005 8:09 AM

Taking the service right to the point of demand (i.e. the supermarket or the train platform) is probably the correct marketing thing to do, but in the long run is it the right healthcare measure? I'm not sure. It seems to me we're encouraging a belief that your health is something of secondary importance - you get a check up while waiting for a train to go off and do something more important; you swallow a few pills and all your problems go away. Is it really that simple?

And it's nuts to believe the supermarkets will handle patients more effectively. How are they going to deal out the proper care and attention to the "difficult" patients like alcoholics, kids on the "at risk" register, drug addicts, timewasters, psycholigically disturbed, just plain poor timekeepers and then the terminally ill folks wanting a chat with the doctor because they're lonely and frightened etc etc.

There maybe some routine, transactional issues that can be farmed out to the supermarket but I have to say I think it's more appropriate to invest time and money and training in getting the established practices up to speed (equipment, expertise, service levels) than just assuming the market will sort it all out.

Posted by Mark JF at August 16, 2005 8:10 AM

Klas,

Agree with u on that one. Reputation, according to me comes from the following, to name a few...

a) Top quality patient care & patient focus
b) Low waiting times
c) Good doctors attending on patients (24 × 7)
d) Affordable pricing
e) Accessible location
f) High success rate in patient care
g) State-of-the-art technology
h) World-class public relations
i) Ability to reinforce the community's perception that the services provided couldn't be exceeded by competitors.
j) Ability to recruit & retain excellent ‘core’ & ‘support’ staff
k) Constant application of efforts to discover, measure, and increase patient satisfaction and engagement.

Trevor, I bet u culd definitely add on to the list (or maybe even come up with a better one)….Looking fwd to ur inputs too for the benefit of the world at large.

Posted by K.Sriram (from India) at August 16, 2005 8:13 AM

I'm missing the reason for 'serious concern' on this one. It's just a health check-up. You can choose not to take advantage of it or you can stop by and maybe pick up some good advice. Maybe not. Either way, you're free to get a second opinion or go see your regular family doctor if you prefer. I really don't see retailers cornering the healthcare market by dispensing stupid healthcare advice. Maybe in time they'll become more, taking on emergency cases for example, and if they're staffed with professionally trained people, i.e., doctors, great! The continuity of care in my view is a matter of having easy access to patient records so that they can be transferred, preferably online, quickly.

I like the convenience of it and also the 'competition' for patients other doctors in local neighborhoods will be exposed to because it will cause them to improve their own services which can only be a good thing.

Posted by Noel Guinane at August 16, 2005 9:08 AM

Hi there K.Sriram - great comments.

I like your list - all of the things you mention are important to patients in my experience.

I am sure we could all add more - we just need to think what it is we want ourselves from the healthcare services. We are all patients after all :-)

One thing I would definetley add to your list is PATIENTS STORY TELLING.

This can really win hearts and minds of managers in healthcare ON CONDITION the managers have the ‘accepting’ mind set.

Sad to say many healthcare managers, in my experience, take the easy road and lock themselves as far away from patients as possible in their nice tidy offices so that they can write those dull and boring reports that no one reads instead of making time to go and listen to patients stories - and the stories of their family care givers.

Another great myth is that to achieve real change and make things more sensitive to patients costs mega-money. My story below illustrates it is a myth really well I think.

MOST (I admit not all) good quality improvement stuff in healthcare doesn't cost money - believe me IT REALLY DOESN'T!!

Here is a little story to illustrate my point.

I know an out-patient clinic here in the UK that provides after care for older people with chest problems.

The managers of the clinic did a patient survey to find out why there was a low return rate to the clinic from patients. They assumed there must be a problem with the service. The replies that came back from patients indicated extremely high levels of satisfaction and the highest possible praise for the doctors and nurses in the clinic. But despite that the patients still did not come back for ‘follow up’ appointments.

The managers decided to do more research and asked patients why did not come back for follow ups.

The answer was interesting. The clinic finished at 3.30 pm which meant that those patients who had to catch buses to go home were on the same buses as all the kids leaving schools and colleges near the hospital at 3.30 pm.

So the clinic managers brought forward the end time of the clinic to 3 pm so that the older people were able to catch an earlier ‘kid free’ bus … and hey presto … suddenly return visits to the clinic soared back up to 100%.

My point is the answer is often staring you in the face and it costs nothing in financial terms to resolve the problem.

Posted by Trevor Gay at August 16, 2005 9:20 AM

I agree with you Noel and as far as I am concerend there is absolutely no need for concern - the more health check opportunities the better as far as I can see.

Patients have always been and will always be the expert on matters of their own health. A real and effective partnerhip with their cllnician is the best model where the clinician supports the patients own aspiration for good health.

One of my best friends is a very highly regarded Vascular Surgeon in England and he reckons the patients who are well informed are the easiest to deal with - he sees them as an equal partner in care. He loves being challenged by patients armed with information downloaded from the web about their condition - he says it keeps him awake and in fact educates him too.

If only everyone had his view of the world of healthcare ......

Posted by Trevor Gay at August 16, 2005 9:27 AM

If we're talking about a basic check - OK. But how do you then ensure the person goes to another clinic if he needs treatment? How does the roadside clinic access his records or pass on their findings? If the person needs a prescription, who issues it?

And it won't stop there: these "basic health check" places will start to offer various procedures and before you know it, there's a 2-tier health system. (Or 3-tier in the UK, with our private / public mix.) Then we'll get a postal services situation: the private sector creams off the easy work and public healthcare gets the difficult jobs, the poor etc.

From a British pov, I can see benefits but I can see dangers. On balance, I think I'd rather see some more effort put into making the existing system work properly.

Posted by Mark JF at August 16, 2005 9:56 AM

Mark JF, actually, Costco started selling coffins early this year, so they are striving for the ultimate one-stop-shop, cradle to grave approach.

I am still a bit concerned with the viral control issue when bringing health care to public spaces, especially places that sell food.

I understand that it isn't uncommon these days in the States for parents to send their children into school when they have a virus/flu, etc. because so many families are double income with nobody home to take care of the child who is sick (but not sick enough to sacrifice a day away from the office in their opinion). I have several teacher friends in the States that have expressed concerns about children being sent into their classrooms when they're not well, and of course, they end up infecting the whole class. Apparently there are also "chicken pox parties" in some neighbourhoods...intentionally exposing chidren to the pox in order for parents to control the timing of the condition.

So perhaps there is a more relaxed attitude about the spread of contagions in the States.

Personally, I don't want my family exposed to viruses because it's 'more convenient' for someone to send their children to school or to pop into the market rather than make an appointment with their physician.

If, like Noel said, these clinics are solely for preventative health checks (blood pressure, cholesterol screening, mamograms, etc.) then I wouldn't have a problem with it whatsoever...and would actually give it 2 thumbs up.

Posted by Tom O'Leary at August 16, 2005 9:56 AM

Great points Tom and Mark

About 80% of healthcare spend goes on hospital treatment and 20% on preventative healthcare work in the community - that balance simply has to change.

Significantly less than 20% of the population use hositals at any one time and well over 80% of us are outside hospitals at any one time.

More investment in the 'preventative route' will reap rewards for ourselves, our children and our grand children - that is where the money has to go.

Having said that I understand the politics of all this and I will be the first to want my healthcare treatment when I need it :-)

There is far too much emphasis on the treatment end - we need more attention given to health education and self care.

Posted by Trevor Gay at August 16, 2005 11:16 AM pfizer viagra india

A few years ago, I was living in New York City and I was flat broke. I had two jobs; a menial one during the day that did not include health insurance and another one at night that I didn't earn any money from because night-time was when I had the free time to do the work that would get me back into my own business.

I knew there was something wrong with my health. I had quit smoking, cut out all the sugar in my diet and started exercising, but I wasn't feeling 'well'. I didn't go to the hospital or to a doctor, partly because I didn't have any health coverage (they don't have the NHS in the States) and partly because I couldn't afford to take a morning off work. We were living hand to mouth on the wages I earned.

During lunch one day, I stopped into my regular health food store, a place I'd been frequenting daily because they sold healthier food and snacks than the deli's did. There was a woman with a stand inside the store offering free iridology examinations, an ancient alternative medicine that basically analyzes your iris to determine your overall degree of health.

Here's some of the blurb: Iridologists discern by observation of the irides the various stages of tissue inflammation - acute, subacute, chronic, and degenerative - and where the inflammations are located. Iridology is mainly a preventative medicine because it can warn a doctor of a person's apparent tendency toward disease. If a person is potentially approaching an illness, this will show up in an examination of his or her iris.

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This 'iridologist' offered me a free examination and I thought, 'What the hell? Why not'. So I sat down and the woman gazed into my eyes for a minute and told me what I already suspected, namely that I wasn't well. What she said was: "Oh my God! You're exhausted and need to see a doctor."

I chatted to the woman for a few minutes, considered her sound and took her advice. That evening I walked into an emergency room because I couldn't afford to go to a doctor and after a bit of fumbling, they diagnosed what was wrong with me. And to make a long story short and cut out all the gruesome bits, I got better.

My point is that if that woman, who wasn't even a 'doctor', hadn't been there that day, I may have kept going without seeing a doctor and collapsed. I remember her as having giving me a free check-up. She didn't diagnose what was wrong. She just confirmed something was. And I'm grateful that that health food store provided that service.

Posted by Noel Guinane at August 16, 2005 11:42 AM

Oh god! get the scientist to innovate a foot and mouth detector, that could be installed at the gate with metal one.

Posted by pankaj at August 16, 2005 12:26 PM

Interesting, let's see what else we can invent to continue on challenging the idea that "what doesn't kill you makes you fatter".

Posted by Omara at August 16, 2005 1:25 PM

Fascinating story Noel and more power to my argument that the expert is always the patient. You knew were not well. The lady confirmed the patients fears.

The average time a patient with diabetes spends per year WITH a health professional in the UK is about 3 hours. That means a diabetic patient spends on average 8733 hours per year WITHOUT a professional - Who is the expert?

I have friend who is married to a man with a progressive illness that will sadly but eventually cause his death. She injects her husband twice daily as his family carer. She has no qualifications whatsovever but she now trains local nurses and DOCTORS in that particular procedure because she is so good at it - Who is the expert?

6 million people in the UK provide care to family memebrs or freinds. The care they provide is worth £57 billion per year - the equivalent of running a second NHS. They do it free from a sense of duty obligation and love. People from all walks of life and backgrounds can become carers - over 3 in 5 people in the UK will become carers at some time in their lives - Who are the epxerts?

I could go on but I rest my case.

Posted by Trevor Gay at August 16, 2005 3:08 PM

I see this as another empowerment of the patient.

Medical care from a licensed clinician (often a Nurse Practitioner) but with the COSTS LISTED UP FRONT!.

WOW! What a concept! Knowing the costs up front before you agree to the procedure/injection. And being able to shop while you are waiting instead of wasting an hour in a doctor's office. Which would you prefer?

To those concerned about the quality of the care: the facilities that I have seen have a limited number of common health issues (low-risk) that can easily be treated by a nurse practitioner. This is not a clinic for getting stitches for a wound or treated for pneumonia.

And for those of you concerned about an increased number of sick individuals shopping with you - NEWSFLASH! - they are already there anyway! At least this way they can get treated and get well faster.

These clinics are not a replacement for traditional health care, but rather an enhancement to what is already offered!

buy brand viagra in canada Posted by Tony Brinson at August 16, 2005 3:38 PM

Brilliant link - thanks Jeff - what a great article.

It really is scary that people in need of most support, empathy and concern are treated worse than animals sometimes in healthcare settings. Sad to say I am not surprised.

Hopsitals are definetely unhealthy places to be.

Posted by Trevor Gay at August 17, 2005 2:55 AM

Sorry, I just read that cool post from Mark on the 16 August, sooo fun LOL
Just the idea of hugh corporations

Posted by Omara at August 20, 2005 6:49 AM

What would really excite me is if a group of Doctors/Nurses got inspired to bring back the ultimate customer-centric offering to our health care strategy...Home Visits! Talk about making a Jillion Dollars!

Posted by Tom O'Leary at August 24, 2005 7:47 AM

素人最高！！

Posted by 素人 at August 26, 2005 2:48 AM

謝謝評論 再請回來 它更加容易講英語雖則 !

Posted by Noel Guinane at August 27, 2005 11:51 AM

残念、私は注意を前に支払っていなかった。私が言った何を次のとおりだった: 注釈をありがとう。再度もどって来られる。多分英語をしかし話すことは容易である。

Posted by Noel Guinane at August 28, 2005 8:35 AM

The issue raised in earlier posts about contagion (i.e. spreading of disease) is a non-issue. Any doctor's office or hospital urgent care or ER has the same problem. Frankly, I wouldn't care if my health insurance covered visits to these clinics if the price is less than what I would have to pay at a regular clinic when I haven't met my deductible yet.

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A rational response if these types of clinics were available in your area would be to drop out of your employer sponsored plan if it is anything less than 100% coverage; purchase a catastrophic coverage policy and get your routine healthcare needs at the local Walmart or whatever clinic. I believe that you would wind up saving money.

To those who want us to preserve local jobs, my response is that you need to figure out ways to adapt your business to provide services/products that can't be provided more cheaply elsewhere. The medical profession is a prime example of a group using regulation/antitrust to extort excessive profits by artificially limiting the supply of providers.

If I need heart surgery, I may just fly to India where I can get the job done in a world class hospital by surgeons who are smarter that Harvard Med School grads who will do the job for half the price.

Posted by Scott Peterson at September 8, 2005 2:01 PM