Few Americans Visiting In-Store Clinics
Perhaps it
is because in-store health clinics are still largely
a new phenomena, but few Americans are visiting the facilities to
seek treatment for common ailments, according to the Health
Tracking Household Survey conducted by the Center for Studying Health System
Change for the Commonwealth Fund.
A total of 2.3 percent
of American households report ever having visited an in-store clinic while
only 1.2 percent had done so over the past year. While the pace of new
clinics has slowed in recent months, there were 1,100 operating in the
U.S. by midyear, up from 60 at the beginning of 2006.
It’s been said that
retail clinics would appeal to consumers based on convenience and price.
The price aspect appears to be playing itself out, with 27 percent of clinic
users not having insurance coverage. This percentage, the report points out,
is much higher than the ratio of the uninsured in the general population.
Those with insurance can, for the most part, visit a clinic knowing they
accept major plans.
The research also found
that Hispanics were more likely to visit a clinic than white consumers
and families with kids were more likely to go an in-store location than
those without children.
Discussion Questions:
What do you see as the future for in-store health clinics? How high will
clinics’ household penetration go?
In Canada, we’re challenged with a shortage of doctors and long wait times in emergency rooms. There are a number of private ‘clinics’ that have operated successfully over the years. Now with the introduction of in-store health clinics, I can only imagine that customers here will be very receptive to the idea. With our universal health care plan, price isn’t an issue. Merely the increased convenience, and hopefully, decreased wait times. Bring them on…we’re ready for them here!
As the cost of employer-sponsored healthcare benefit plans continues to increase, more and more Americans will begin enrolling in High Deductible Health Plans (HDHP). Many of those individuals will open Health Savings Accounts, and they will then be paying for routine/non-emergency doctor visits with their own dollars. These individuals will find that visits to in-store health clinics are more affordable then visits to their PCPs–and they will more than likely opt to pay less for equal (or even better) care.
Current in-store health clinics are probably a bit ahead of their time, but as the insured are forced to start covering more and more of their healthcare costs, the insured will become better healthcare consumers. At that point, more consumers will warm up to the idea of in-store health clinics.
In-store clinics are something that retailers would prefer, but in-reality, consumers prefer to go to a “full service” facility when they are truly sick. Americans are also used to getting full-scale care (or having that option available to them). These clinics do not offer this, nor do they give Americans the options that they truly want. Discounted healthcare, in this fashion is not a demand that retailers can fill.
Don’t count convenience clinics out. The sour economy has caused consumers to trim their healthcare costs in various ways, e.g., skipping physician and dental exams, and finding ways to extend their scripts, like skipping dosages and slicing pills. Let’s also remember that there are few (if any) industries that can overcome the current economic conditions to realize growth, and that the actual number of clinics is still small compared to the overall population.
Once consumers feel better about spending, I think convenience clinics will continue to grow. The practical convenience is one draw. The low-cost access to everyday healthcare is another. But also look for the clinics/retailers to begin to differentiate themselves–a trend that was already underway before the economy went south. For example, look for more specialized services, like focusing on children and/or seniors. And we’re likely to see more alliances between clinics and employers, as well as alliances with traditional healthcare institutions (hospitals) as a way to better handle an already overburdened system.
One final point, I don’t expect we’ll see America’s healthcare ills get healed anytime soon. So years from now, it’s likely consumers will still be clamoring for affordable access to the basic healthcare that’s increasingly out of reach. The simple, practical, thrifty convenience of convenience clinics is a salve on a still-open wound.
It doesn’t require huge market share to make 1,100 clinic locations profitable. Compare that figure to the number of doctors’ offices or number of hospitals. So if 75% of the population won’t go to an in-store clinic, it doesn’t matter, as long as the number of locations stays reasonably low. On the other hand, many new concepts take time to gain acceptance, and it isn’t clear just how long clinic owners will let them lose money. Since most are owned by retail chains, and retailers generally want instant results, my guess is: not more than a year for a typical location. The chain store can always rip out the clinic and use the space for something else.
If the economy keeps going the way it is, I expect to see a big increase in the use of these in-store clinics.
The issue is not in-store clinics but–in general–alternative places that provide medical services. These locations are providing a service and will continue to grow as more and more people get frustrated with the cost and inconvenience of traditional medical service.
Over the next several years there are going to be more changes in the structure of healthcare in this country and those changes, regardless if private or government insurance will support the concept of clinics. Medical costs will be forced out of the system with the most efficient supplier of healthcare growing the fastest.
Assuming cost is a factor, the growth will be competition between the in-store and free standing clinics. I am guessing the main differences will be that overhead will be less in the in-store clinics but breadth of service will be greater in the free standing clinics. Consumers may actually segment the two services themselves based on the urgent need. In any case, the growth of both will be part of a major structural change is how healthcare services are performed.
I still haven’t come across one of these clinics in my area, but I believe I would be inclined to use them for myself and my children. Personally, anytime I’ve had to seek medical care for a cold, infection or other common ailment, I prefer to see a nurse practitioner and not my doctor. For these routine type of health issues, I’ve found a nurse to be much more attentive to my needs.
Doctors, on the other hand, can take hours to get an appointment with and usually are very curt in treating “common ailments.” Plus, if you need a script, it saves you the trip. If the drug stores are able to market these clinics effectively, they should be a home run in serving common medical needs of families.
While trial of in-store clinics remains low, satisfaction is remarkably high. Further, consumer awareness of the clinics also remains low as the leading providers; CVS and Walgreens, are only recently adding advertising messages to promote the services and the convenience benefits of the clinics.
In addition, many health plans are starting to waive copays for clinic usage. It would seem to us that any potential avenue to reducing health care costs is a viable proposition, particularly with the new administration taking on health care reform in a meaningful way. We’d say they are here to stay, particularly in high store volume settings.
I’d like to disagree with some of the comments about the utility of these clinics. Twice I’ve been away on business and gotten ear infections. Both times I ended up at a Take Care clinic at the local Walgreens. In both cases, the Nurse Practitioner was able to diagnose the issue, script over antibiotics to the pharmacy and had me on my way within the hour. For anything serious, of course there’s an emergency room, but for something so simple as a basic ear/throat infection, these clinics are great.
I agree that these clinics have their place. The waits alone at a doctor’s office (WITH an appointment, no less), emergency room, or urgent care facility makes these a very viable option. They need to invest some money in Marketing themselves to distinguish their benefits from the other medical facilities (convenience, price, speed, access to pharmacy). In other words, give people reasons to use them.
If you do experience significantly higher prices at some of these, they won’t last long. People are willing to pay a little for convenience, not a lot.
In-store clinics have a very powerful and appealing message to consumers, and, given the issues that surround healthcare relative to cost and access, they provide a real, and I believe extremely valuable, service. There are still some barriers to overcome, but, based on the success that many pharmacies have with flu shots and other similar services in bringing customers to the store, in-store clinics will build over time.
Some of the barriers include the reaction of traditional medicine, particularly physicians, as well as a lack of coverage. In-store clinics are a relatively new phenomenon, and, using George’s statistic of about 1,100 being in place currently, there is but one in-store clinic per 250,000 population. Moreover, at the end of last year, only 30 states had clinics. The issue of coverage aside, performance on a per-clinic basis really isn’t completely shabby. Some 1.7 million families visited an in-store clinic in the past 12 months, so if you take 1,000 clinics in operation (an overstatement for the full 12 months), that’s a floor of 1,700 family visits annually. It’s certainly a start.
In addition, the usage data seems to be saying that in-store clinics are fulfilling their promise of easy-access, cost-contained healthcare. Uninsured use them. Minorities use them. Nearly half of those visiting did so for diagnosis and treatment of a new illness. Vaccinations scored high. Physical exams for camp, school, etc., were a reason. Two-thirds of clinic users went to one because hours were more convenient than other healthcare sources. Ditto for convenient location. A little more than half went to one because they didn’t have to make an appointment. A little less than half went to one due to cost. It looks to me that the world of healthcare has a winner here.
I think that as long as the Urgent Care or Med Express clinics are delivering on their promise to patients, the majority of consumers are not going to accept in-store clinics. True they are convenient, but most consumers have a preconceived idea of what is acceptable for medical care. I don’t see much growth at all and many of the existing units may not last.
I don’t see much future for them. Every time I go by one the nurse is just sitting around reading a magazine or trying to look busy. Lets face it, they really can’t treat anything. Everyone gets a cold, virus, or sore throat now and then and it will go away on its own without having a nurse hold your hand. Flu shots and preventive shots can be had for pennies on the dollar at the local county health departments or free clinics compared to these expensive in-store clinics.
I recently got a shot for $7 at the county health department and the clinic inside Walmart wanted $65.
My guess is if you go to an in-store clinic with any type of illness they will only end up charging your $59 and referring you to doctor. For poor people they are very expensive because these clinics expect to get paid. The emergency room has real doctors and the poor will just ignore the bill when it comes.
America will slowly get over one of our deeply ingrained health care paradigms, which is “I’m either sick enough to go to the doctor or I’m not that sick.” In other words, we don’t accept anything other than a “real doctor” as capable of handling our medical needs. This attitude goes hand in hand with others such as treating health insurance as “prepaid health care” and largely rejecting preventive health care, relying instead on “cures” after we get sick.
We will gradually accept alternatives such as in-store clinics over time. The first to adopt them will either have a financial need or they will be immigrants who don’t yet have America’s “I deserve a real doctor” attitude yet. The current recession should help that along some–although minor health care is one of the things people tend to forgo all together during tough times as opposed to “trading down.” But it will happen.
I agree with Noelle Abarelli about the compatibility of in-store health clinics, High Deductible Health Plans (HDHP) & Health Savings Accounts.
‘AWDrive’ & Carol Lauer expressed what I think about marketing the clinics.
Ben Ball may have a good point–“We will gradually accept alternatives such as in-store clinics over time.” As in-store clinics improve & people become more aware of them, they’ll feel more comfortable.
I agree with Gene Detroyer: “These locations are providing a service and will continue to grow as more and more people get frustrated with the cost and inconvenience of traditional medical service. Consumers may actually segment the two services themselves based on the urgent need.”
I add: Marketers should guide & influence consumers by segmenting consumers, so it’ll be easier for them to segment the clinics (or products, services or businesses). By using marketing to link a particular niche with a product/service or business, it becomes easier for people to realize their situations are compatible.
I’d like to pretend I wrote what Tim Henderson & Mark Lilien wrote because their insights seem accurate.
An analogy: If I remember accurately, when penguins feel uncomfortable about going into some water because of a possible predator, they gather around it. As they crowd around & get closer to look in, eventually a penguin will be pushed in. If that penguin survives, the others will dive in.
Humans are like that. When enough people look & see patients surviving—living to talk about it, more will use the clinics.
I think ‘mikeb22’ & I have had similar experiences. For years, I had chronic sinus infections that were misdiagnosed as depression until I had an appointment with a Nurse Practitioner. She referred me to an Ear Nose & Throat specialist. Until then, I couldn’t convince a doctor I had a physical, medical problem, not just a mental health problem.
Years later, when I knew I had another sinus infection, I had an appointment with the same Ear Nose & Throat specialist. It was a self-referral, not a professional referral He didn’t believe me. He finally condescendingly ordered a CT scan for my sinuses. At our next appointment, he had the arrogance to look at the CT scan images, then point & say, “You have a sinus infection there.”
If I have to get a Nurse Practitioner to refer me just to get a doctor to realize I have a real problem, it’s worth the investment.
I almost hesitate to write this (I’m not disloyal to my gender), but it may be a salient point. Multiple male medical doctors have told me I didn’t have a problem when I knew I did. They may have many years of training & experience. But I have 48 years of experience with my anatomy. I know when something is wrong. My lack of medical training is almost irrelevant when a highly educated & trained medical doctor is so unqualified.
I have far more faith in female Nurse Practitioners than I do in male medical doctors.
What’s in the PDF—George gave us the link for “Retail clinics are often referred to as a ‘disruptive innovation’” As Clayton M. Christensen teaches about disruptive innovations, these should compete with non consumption marketed to non consumers. In healthcare, non consumers probably used traditional services when they could, but they probably need nontraditional services.
I remember reading about physician collaboration or supervision of medical technicians or Nurse Practitioners. Some “Doc in a Box” services have doctors observe via a camera.
I’m almost tempted to submit to service from a medical doctor only if a Nurse Practitioner supervises.