Mark Perry draws an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.
Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics. Especially when consumers are spending their own out-of-pocket money for health care and they have a choice, they prefer market-driven, consumer-driven options like affordable, convenient retail clinics over conventional physician offices.
I think Perry is on to something. It’s hard to get people out of their established habits. They have a relationship with their own doctor, they accept the long wait for appointments and even treat it as a proxy for high quality (if my doc is so busy he must be great), and just suck it up when it comes to co-pay’s and deductibles. They want access to high tech exams and the latest drugs.
But all these things change over time. MinuteClinic and its ilk are well-positioned to take advantage of these trends in the long run. To take them in turn:
- Relationships aren’t what they once were. Your doctor may or may not remember you. If you have something routine (or even if not) you may be shunted off to see a ’physician extender, ’ such as a nurse practitioner. At least when you go to MinuteClinic that’s who you expect to see
- Wait times for appointment can be lengthy. Under health reform they are likely to get worse, especially since open access scheduling is slow to catch on
- We’ve now reached the breaking point for co-pay’s and deductibles. Even insured people are nervous about going in for treatment and want to save money. They realize it’s only going to get worse
- High tech exams (like MRIs) and drugs have lost some of their allure. Cost is part of it, but the continued news stories of safety problems with drugs are taking a toll, too. I think Americans are finally realizing that when it comes to health care less is often more
Finally, especially for routine issues, MinuteClinics do as well or better for quality. The reason is pretty simple: nurse practitioners are more likely to follow protocols than doctors, and the standardized MinuteClinic model represents a more disciplined approach to operations than the typical physician office.
It will be interesting to see if the substitution of MinuteClinic for the physician office is a trend that holds up over time.
By David E. Williams
David E. Williams is the co-founder of MedPharma Partners who writes regularly on the Health Business Blog.Visit website | More posts by Author
I often thougth that the Minute Clinic concept is here to stay. Since most have the nurse practitioners running them, these are great for the consumer needing a blood pressure check, strep throat swab, check of ears for otitis. I know that if the service I needed for toddlers is simple and something that a nurse practitioner could do, then why not use the minute clinic? Most consumers do not know that the services can be conducted by a nurse practitioner, and at a reduced insurance cost due to incident billing. I do believe that if the services are done right, as the previous commenter noted it is the delivery format that matters, then the model for minute clinics should be here to stay. Less overhead if one is sharing space with a drug store, services are available after most traditional offices close, and they are less than urgent care center costs. The biggest factor in my estimation of success is noting if the consumer knows what services are covered in the minute clinic, and when it is best to use these settings. I often thought that checking kids for otitis, strep throats was often the highest on my scale for getting appointments for toddlers. I have twins and when they were young, it never failed that they would get sick at 5 pm on a Friday, weekend, or a holiday. It's good to know what are ones options for care.
David, while I agree that Perry is on to something, I also believe you're on it more accurately. Perry enthuses about MinuteClinic''s usage stats because he imagines they provide further proof of the systemic impact of account-based health benefits. He does not see, as you clearly do, that it will be the delivery format, rather than primarily the financial cues, that will determine whether the convenient care ''form factor' succeeds or fails. The financial mechanisms are not unimportant, but they are subsidiary to the effectiveness of the form. If the form delivers unsatisfactory care, it doesn't matter how someone may pay for it.