Sunday, December 11, 2005

RNs R Us

The American Thinker links to a Boston Globe article about Big Box Healthcare:

Wal-Mart is experimenting with ways to provide outpatient medical services to its millions of customers by opening walk-in clinics in about a dozen stores. The move by the $285 billion corporation is part of a broader trend that could significantly change the way many Americans get basic healthcare.

Target has opened 12 clinics in Minnesota and Maryland stores, staffing them with nurse practitioners who treat sore throats, earaches, and other minor ailments. The CVS pharmacy chain is aggressively rolling out similar clinics, with about 35 so far in cities like Atlanta, Nashville, and Seattle. Rite Aid, a national drugstore chain, and Duane Reade, a New York pharmacy chain, are setting up pilot programs for similar clinics. And MinuteClinic, a Minneapolis healthcare firm that leases space from Target and CVS, plans to expand to another 100 to 200 retail stores next year.

.... Demand for lower-cost, convenient care is expected to grow as insurance companies and employers, trying to minimize premium increases, move employees to insurance plans with high deductibles. Such plans shift more out-of-pocket costs to patients, making them more likely to shop for lower-priced basic care.

Meanwhile, faster procedures and an increase in the number of nurses trained to provide in-store care have the potential to transform basic healthcare delivery, said Clayton M. Christensen, a Harvard Business School professor and author. The emergence of nurses and clinics in retail stores is a ''disruptive innovation," he said.

''When you can unambiguously diagnose the condition, then a rules-based therapy can be prescribed and you don't need a Harvard-trained doctor," Christensen said. ''Quality is defined on how fast can I get what I need. Speed and convenience and price begins to matter a lot."

.... But the potential for turf wars with primary care physicians will probably push retail stores toward the use of nurse practitioners instead of doctors, said Regina Herzlinger, a professor of business administration at Harvard Business School.''We have this in the rest of our economy. We have fast-food outlets. We have 7-Elevens. We have places that have a limited array of goods and services that are hugely convenient and usually relatively cheap," she said. ''It's what you and I want."

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