Comments

After hearing this very morning, a filmaker talking about making an expose on Walmart, saying things like "If two employees talk about organizing to join a union they are dubbed 'time stealers' and a special squad comes over and makes everyone stay in the store after closing while they show videos and preaching to them about the evils of unions." Two thumbs down!

Posted by Alex at October 31, 2005 4:36 PM

Why aren't they worried about people with upper respiratory infections, etc., mingling with all the Wal-Mart shoppers?

Posted by Marianne Powers at October 31, 2005 10:44 PM

The concern I have with people "ordering just what they need" is: how do they know? Are they medically qualified to self-diagnose? I think it's right to bring medicine to the people but it needs to be done carefully. As a Brit, you'll have to excuse my scepticism but (especially with this trialling in the United States of Litigation) I'd bet it won't be long before someone claims they were given the wrong treatment or something wasn't diagnosed and both the hospital and WalMart find themselves in court.

Posted by Mark JF at November 1, 2005 3:15 AM

I like it. Remember who the market are! It's the uninsured or those with high deductibles. This sure beats sitting for hours in a hospital emergency room with kids puking on you.

Posted by Mike Linacre at November 1, 2005 5:27 AM

Mike: As long as those kids don't puke in my shopping cart while they're waiting for the Wal*Mart nurse to see them!

What would WOW me is if they created a truly customer-focused experience by bringing back house calls. Why make the sick, elderly or handicapped drive to Wal*Mart at all? The reason? Because Wal*Mart wouldn't benefit from that truly customer-focused approach.

Posted by Tom O'Leary at November 1, 2005 7:03 AM

What's a (wink wink) house call? Certainly my kids (17 and 20) never had that experience! You hit the nail on the head, Tom O'Leary. Ouch that puts a sting in driving the PSF idea home!

Posted by Tom N at November 1, 2005 8:24 AM

Alex - you've been drinking the Kool-Aid in excess. Wal*Mart thrives because they keep pushing the creative class envelope - this is a prime example - it wouldn't surprise me if they morphed in to a Health Care business with wholesale / retail as a sideline - Lord knows we need health care innovation in the USA/UK.

Posted by Sean at November 1, 2005 8:43 AM

Okay, let's completely ignore the Walmart connection for a minute. Let's pretend Walmart has nothing to do with this at all.

1) Not having to waste 20+ minutes in a waiting room is a brilliant idea. (Although I guess I'll kind of miss reading outdated issues of People Magazine.) Giving me a chance to get some shopping done while I wait is pretty cool. There's value to that, at least in my little world.

Someobody will have to work out the kinks though. A slow-moving patient that happens to be standing at the opposite end of a Super Walmart store might need 5-10 minutes to make it back to the doctor's office. There's an efficiency issue there that needs to be tweaked.

2) Patients' shopping carts need to find a temporary home while they are inside the doctor's office. That takes up space. Retail space is valuable, so there's some planning to be done there.

3) I like the fact that patients are given more control over the types of services they want to come in for. We have the weird notion in this country that our own health is someone else's responsibility: Show up, let the doctor check you out, walk out with a prescription, repeat. That's crazy.

As adults, WE are in charge of managing our own health. We decide if we are going to smoke, never exercise or eat unhealthy foods. We decide if we are going to take a cholesterol-reducing drug or get knee surgery or take aspirin.

Doctors are there to tell us what's wrong with us. Doctors are there to help us make healthy decisions. Doctors are there to explain to us what treatment options (plural) might be right for us and what risks might come with each one. And finally, doctors are there to administer medical care once a decision has been made.

Except in situations of life and death, we - not doctors - are responsible for our own health. Doctors are not medical nannies.

So I don't find the menu idea all that bad. It'll most likely be limited to basic categories of care (annual physical, STD screening, prostate exam), so it's harmless. But if it makes "patients" more aware of the active role they need to play in their own health management, that's definitely a step in the right direction.

Posted by Olivier Blanchard at November 1, 2005 9:01 AM

Have you ever been to a marriage that you know is doomed to fail. Like - Why give them the $100 as their wedding present -they are going to break anyway soon - give them a $3 card instead !!

yeah thats the kinda feeling that I have with WALMART right now. They have driven down prices but at what costs ?? Now they tier into medical health assitance and housing- at what costs and to whom ??

Posted by /pd at November 1, 2005 9:08 AM

Isn't there a law that prohibits banks from getting into retail/wholesales and other types of businesses? It should work the other way as well..a store cannot be a bank nor a hospital.

We are talking about a company who hires people and tells them they can't have healthcare via Wal Mart but they are more than happy to show them how to apply for public assistance..in other words they pass the cost of their healthcare onto the people of this country!

Posted by Alex at November 1, 2005 10:15 AM

All together now "Boo, Hiss! Wal-Mart!" Now, now, I bet even Darth Vader would have good idea or two (and, I bet he would make the space shuttles run on time too. ;-)

Seriously folks, I agree with Oliver - if we take Wal-Mart and all the associated emotional response out of the equation - It's a good idea. Most of us grown-ups know when it's "just a cold" and given that a growing number of people can't afford health insurance - such a user-friendly, low-cost, quick option could work. Of course, there are still kinks (as Oliver notes).

Full disclosure: I wouldn't be caught dead (or even sick) at Wal-Mart - little things like the way they treat their employees...

Posted by Mary Schmidt at November 1, 2005 10:29 AM

All the evil Wal-Mart implications aside, I think it's a positive step to let people know how much their medical care is going to cost.

I'm a 40-something woman who went to a hospital outpatient clinic for a mammogram this year. The first question I asked was, "How much is this going to cost?"

And the admitting person said she didn't know. It would depend on my insurance. So I asked her to pretend that I didn't have insurance; that I was going to write her a check right NOW. She wouldn't tell me.

I asked her to ballpark me. She couldn't.

Within a hundred dollars, I asked. She couldn't.

Anyway, six months later, and I was still getting little bills. $20 for some lab I never heard of, who read my file. Another $27 from a doctor I never saw. $127 from the hospital itself. Then a bill the next month for $247... from the hospital again. Something they forgot? I don't know.

And people wonder why women don't get these screenings. The mammogram itself was painless, but I'm not going back for another one. The stress from all the bill bombs could kill me before the cancer would!

How are people supposed to be able to budget if medical providers aren't being upfront and honest about how they do business? Because let's face it: medicine is business.

Give people information on how much basic services are going to cost. It's only fair.

Posted by Laura Bergells at November 1, 2005 10:38 AM

That's a good point Laura..where I live we have free prostate screenings once a year and I'm sure that encourages many men here to visit.

Posted by Alex at November 1, 2005 11:17 AM

Well, the Doc-in-a-box isn't Wal-Mart's. They just rent the space. Like the McDonald's and the shoe repair and hair salon. There are other healthcare areas that have been doing something similar. My dentist is in retail mall. About 15 years ago, my dentist was in Sears. Maybe this is how Wal-Mart employees can finally get reasonable healthcare.

As to the cross infection of ordinary shoppers, they might need a separate entrance. The best I heard about keeping patients away from other patients was in CA years ago. A physician purchased an older motel and put a long hallway across the back of all the units. You drove up to the registration desk and they assigned you a room. Drive to the door, into your private room and wait for the physician to come in from the back hallway. No waiting room with other patients but probably the old editions of People, Reader's Digest and Golf are still there.

Posted by MikeC at November 1, 2005 11:43 AM

I agree with Laura that the health care system is business so I don't understand why placing a health center in a shopping mall could surprise anyone or even bother them. I see it as a clever idea from the point of view of a business. Let's imagine that you are prescribed to eat more veggies, for instance, then you just go a buy them straight forward, don't you?.

The main issue with the health care system nowadays are not these kind of selling strategies but the unpersonality in the relationship of patients with doctors and other health care professionals. Neither doctors nor other stuff know fully your health history, your habits, your strenghs, weaknesses, what works best for you, etc. It's like Oliver said above: go to the doctor-get your prescription-repeat...crazy. Until you get the perfect prescription, treatment or finally know what the real problem was and how to avoid it, you have had many occassions for feeling like kidded. This seems just the sin of our times; the solution lies most probably in that taking full responsibility for our personal health.

Posted by Omara at November 1, 2005 5:23 PM

With regards to sorting out the sick from the well as they enter Wal-Mart, the bad news is those sick folks are already walking around the store. Have been for years. I have no doubt each of us has been there/done that at least one time in our lives, although maybe not specifically at a Wal-Mart.

At least now we can get diagnosed and pick up our prescriptions without a two-hour-plus detour to the doc's office. This is especially helpful if you're a parent with young children, a tight schedule and an even tighter budget.

One of the pleasant "side-effects" of retail-based health care is the pressure it will put on physicians to tune up their business models. The smart ones will adopt same-day appointments as the norm. Heck. If I were a doc I'd buy one of these retail clinics and let my nurse practitioners handle the bread-and-butter stuff. I'd be happy with the built-in referrals.

As for Wal-Mart, I would stop short of defending them. But it's not as if an overwhelming majority of retailers are heaping benefit upon benefit on their employees either. Wal-Mart is a big symptom of a much bigger problem.

Now, if you want to swim upstream of the issue a bit and talk about how American consumerism contributes to the exploitation of workers in other countries like China, Wal-Mart would have some "company" at the table.

Posted by Chris at November 2, 2005 12:25 AM

Let's have more of this I say. I have advocated for as many years as I care to remember ‘health promotion’ and ‘ill health prevention’ and also that health services simply need TO GO TO WHERE PEOPLE GO. The UK health system is gradually waking up to the fact that the rest of the economy is now customer driven and customer responsive 24/7. If I want to get money at 3 am in the morning - though God knows why I would - then I can get it. Health care providers are gradually realising health care is not actually about Monday to Friday 9-5 and 95% of healthcare is not based in hospitals. Healthcare is actually about self care, supporting ourselves our families and our friends. If we can't sort it out then we go along to the local pharmacist for help advice or pills. If that fails we see our family doctor. If the very worst comes to the very worst then and only then do we go to hospital - and remember hospitals are bad for you anyway - you are more likely to pick up an infection in hospitals than you are at Wal-Mart over there or Tesco's over here. The experts are US for God sake!

More power to self care health regime I say and if it is accessible where you go and do your shopping then for me that sounds a fantastic marriage to me Val. Phew … I feel so much better for that rant!!! :-)

Posted by Trevor Gay at November 2, 2005 7:59 AM

"you are more likely to pick up an infection in hospitals than you are at Wal-Mart over there or Tesco's over here" So true Trevor.

viagra with no prescription To add to your sound advocation about bringing care to the people, I would only bring it one step further and recommend that care is brought to the homes of people. Nobody wants to get into their car on a wet, windy day when they aren't in the best of form. Bring back house calls, or improve the old system of house calls by providing mobile nursing stations that visit the local populace. Hospice does a great job of this at the unfortunate end of our lives when battling cancer or other terminal conditions. Why should we only do it when the end is nigh?

Posted by Tom O'Leary at November 2, 2005 9:08 AM

Amen Tom O’

You won’t find me disagreeing with a word you said my friend. I spent the last four years of my healthcare career working from an office base in a Hospice - it is fantastic work those staff do. I am in absolute awe of those folks. More care in the home? - Absolutely - the quality of care in the home will always be better - why - because the one component at home that does not exist in hospital and clinical environments is love. I accept that not all family situations are perfect and yes there will sadly be the occasional bad scenario. However, in my opinion about 99.999% of families do show love and care for members of the family who need help at times of illness and suffering. If health professionals could visit homes more - rather than the traditional option of taking people out of the loving environment then the closer we would get to a caring service. I have a friend who was one of two doctors in a part of Africa covering a 500,000 population with 100 hospital beds. The two doctors did everything between them and the quality of care was superb – less is more and all that. And yet the questions remains – how come they could run a service based on 100 beds for half a million people? One answer lies in the fact it was a third world areas but the real truth is that most care was provided by families. We like to think we live in a modern technological society that has all the answers but we overlook genuine caring, love and concern – the softer stuff - at our absolute peril in healthcare. Windening the discussion - everyone knows that caring doctors do not get sued. The highly competent technical doctors who can’t talk to patients are the ones who get sued!

Posted by Trevor Gay at November 2, 2005 9:39 AM

Seems to me like Tom O' and Trevor have got the ticket!

Posted by Omara at November 2, 2005 2:48 PM

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