Thursday, May 3, 2012

Store-Shelf Medical Care

       Observing the health care industry is about as much fun as getting the bill for a medical procedure. My latest one was some very minor outpatient surgery, the bill for which totalled $28,000. Thank God for health insurance.
        But trends happen where they happen, including health care. ("Mom, that's why you only have like eight followers," my daughter says, when I tell her what I'm writing about.)
        Be that as it may, while doing my job of tracking shopping center vacancies (hey, I get paid), a funny thing began to happen. First, about two years ago, video stores began closing -- Blockbuster, Hollywood Video. First a few of them, eventually all of them, as Netflix conquered the world. Then, some of those former video store spaces began filling up with new takers: Baptist Urgent Care, Kendall Regional Urgent Care. Since then, urgent care centers have become an increasingly common tenant in shopping centers throughout South Florida. 
       And throughout the country, it turns out.
       Urgent care centers have been proliferating nationwide to the tune of some 300 new ones opening every year, according to the Urgent Care Association of American. These facilities  provide less intensive services than a hospital's emergency room, but more intensive services than a physician's office. They're open longer hours, usually seven days a week, and you don't need an appointment. They're suitable for conditions that need immediate attention but which aren't life threatening, such as minor fractures, cuts, infections and dehydration.  Many are equipped with x-ray machines and labs. Most of them take insurance. For self-pay patients, they will cost lest than a visit to an ER.


        By all accounts, urgent care centers are a cost-efficient alternative to the ER for many conditions, not to mention a more convenient one. Pick up your dry cleaning, get a few groceries, and stop in to check that sore throat. There is a growing body of literature from all manner of stakeholders concerning the role of urgent care in the health care conundrum, but what fascinates me is how this very consumer un-friendly industry is now taking a cue from the retail industry, which is all about making the shopping experience easy, convenient, pleasant, practical, one that accomodates itself to the rest of your life.
        This new marriage of health care and retail doesn't stop at the shopping center. An interesting parallel trend is the emergence of in-store clinics at drug stores such as CVS and Walgreens and general merchandisers like Walmart. Talk about one-stop shopping: shampoo, vitamins, mascara, beach chairs and antibiotics, because that ear ache your daughter was complaining about turned out to be an infection, the in-store clinician just confirmed after taking a swab.

       I think payment allocation in the health care industry is a quagmire in which no one has reason to be happy, except maybe health insurance executives. I don't know that urgent care centers and in-store clinics will make any headway in improving the situation. I also think it is more fun to go to the shopping center for a movie rental and a new pair of sandals than for cystitis.
       But I'm beginning to warm up to the idea of medical services getting broken down to the store- shelf level. Some urgent care centers, it is reported, display prices for their procedures on a board, menu style. With any luck, as urgent care centers start popping up in even more shopping centers, there soon will be daily specials and loyalty rewards programs.


  1. I would worry about "thrift-store" urgent care centers. The commoditization of health-care can be good, within reason; otherwise it could become a purely bottom-line driven business --- and that would be the layer of health-care personnel they could afford to pay for to provide the services to the patients.

    [I guess you now have 9 readers... ;-)]