April 8, 2013
Will Walgreens Succeed Treating Chronic Illnesses?
Walgreens will become the first retail chain to offer the diagnosis and treatment of chronic diseases like diabetes, high cholesterol, asthma and hypertension.
While not aiming to replace a patient’s primary care physician, the drug store chain sees itself as a viable after-hours or more convenient alternative than an emergency room or urgent care center. In some cases, Walgreens’ nurse practitioners and physician assistants in its in-store clinics will work in coordination with the primary care physician to co-manage treatment.
The expanded care services also include additional preventive health services, including recommending screenings and laboratory tests based on a patient’s age, gender and family history.
Clinics at CVS/Pharmacy, Target and Walmart also help consumers manage chronic illnesses, but only after they’ve been diagnosed.
Prices range from $65 for a diabetes, cholesterol or blood pressure screening and counseling session to $122 for a full exam and treatment of ongoing health problems.
The move addresses numerous health care challenges, including a physician shortage, aging population, a growing prevalence of chronic diseases and up to 30 million people projected to gain insurance coverage in 2014 through the Affordable Care Act
"As innovative care delivery models emerge, we are uniquely positioned to play an integral role in addressing the needs of patients, payers, and providers and to help shape the future of health care delivery in the U.S," said Heather Helle, divisional vice president, consumer solutions group, Walgreens in a statement.
Walgreens pointed to a recent Rand Corporation study that showed the use of walk-in retail clinics has increased 10-fold over the past two years. It also noted that studies have found retail clinics provide care for routine illnesses at a lower cost and similar quality as physician offices, urgent care centers or emergency rooms. Walgreens finally noted that retail clinic industry estimates show more than one in three patients do not have a regular physician.
Not surprisingly, some doctors groups warned that a broader role of in-store clinics raises risks, including those from transferring records or test results, while disrupting the primary physician’s relationship with patients.
- Take Care Clinics Expand Scope of Health Care Services to Include Chronic Condition Management and Additional Preventive Health Offerings – Walgreens
- Walgreen to expand health care services – Chicago Tribune
- Walgreen clinics add care of chronic illnesses to boost sales – Bloomberg News/The Denver Post
- Walgreens listens to your heart – really – USA Today
- Affordable Care Act to Boost Retail Clinic Business – RetailWire
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Recent Discussions
Discussion Questions
Do you think in-store clinics are taking the right path by getting involved in diagnosing and treating chronic illnesses? What do you see as the perceived benefits versus the risks?
Poll
In-store clinics are definitely taking the right path in diagnosing and treating chronic illnesses. Health care needs to be accessible to people in a much more convenient way than relying on traditional doctors and hospitals alone. And from the pure business perspective, why not treat patients on the spot where they also happen to be consumers of related medications, OTC, HBC, and health care products?
This could be a great way to get a second opinion, among other things. And providing competition for established healthcare operations will benefit everyone. Kudos to Walgreens for putting a stake in the ground.
I think it will be all over the first time a misdiagnosis results in a death and, shortly thereafter, a lawsuit.
Serious questions need to be addressed before I’d endorse this idea.
Who, for example, will carry the malpractice burden for these offers? How will drug chains indemnify themselves? What are the long-term implications for this offer once we understand how the ACA pans out? If it works, how will the customer demand cycle work? One can’t have a “waiting room” full of patients standing around a store and there is a danger to limited time exams.
And, most compellingly, how will drug chains compete with physicians’ offices replete with a dazzling assortment of digital technologies? Medicine is — for better or worse — coming down to access to diagnostic technologies.
My CVS can’t keep the POS system in the pharmacy working for more than three days at a time. Good luck with the EKG machine!!
Given the reported looming shortage of doctors, anything that expands the availability of quality health care is a good idea. The underlying issue here is whether a PA is able to provide an accurate diagnosis. I doubt that Walgreens would run the risk associated with a misdiagnosis if they didn’t believe their clinics could handle it properly.
This is not a substitute for a family doctor, as Walgreens cannot write a prescription for anything without a doctor’s consent, so I am curious to see how this works out. Do you think the doctors are going to like seeing their practices threatened by these clinics? Obamacare has more pitfalls every day, and this solution has to be a win win for the pharmacy and the doctors as well for it to work.
I see this as a way to push people into a system that is overburdened to start with, and it could get tougher and tougher to find the rural family doctors to move out to these areas in the first place.
In my area the in-store clinics are poorly run and understaffed. The “walk-in” component is completely misleading as they are getting more traffic than they can handle. If you walk in without making an appointment ahead, you’d better be prepared to wait a few hours to see someone.
I can’t imagine them taking on additional responsibilities like this. The execution does not live up to the press release, in my opinion.
I think a lot of the potential success or lack of will depend on how we define chronic illness and what the pharmacy clinics will be able to treat. I question what scrips they can or should be allowed to write without a physician, and the liability factor that surely will cast a big shadow.
Duly noting Ryan’s comments about liability—I think this situation will play out in one of two ways.
We could find out that the reverence with which we have come to regard physicians is overblown (a la the purported pain of the Sequester) and the healthcare system emperor will be found to have no clothes —at least the General Practitioner that most of us call our “primary care” physician.
Or, we (and the affected retailers) will find out that mixing real healthcare with retailing just isn’t a very good idea. Either because it provides inadequate healthcare, or it distracts retailers from their primary job.
This one really could go either way.
I occasionally visited Walgreens when I needed something I didn’t expect to find in the grocery store. I was generally underwhelmed with their merchandising and price points. Then I switched drug plans and Walgreens is the only preferred provider in my area so I visit more often. I don’t know if the plan to treat chronic disease and to be the preferred provider for certain drug plans is part of a larger marketing strategy, but maybe it explains the lack of competitiveness in the other areas.
When I first read about the chronic disease plan I thought it made a lot of sense. If one of your primary revenue streams depends on prescriptions and the number of general practitioners available to issue prescriptions is rapidly declining, then what better way to protect your revenue stream than to begin issuing prescriptions yourself? This seems to be the strategy for Walgreens and it makes sense for the patient who has been on a stabilized treatment regimen for many years.
The challenge I see with all these options is that they create a very confused environment for patients. My personal experience was a recent sports injury playing tennis. I fell going after a lob and my glasses cut my eyebrow. It was a weekday afternoon so I called my regular doctor, he doesn’t do stitches. I waited overnight and went to an urgent care center the next morning. They would not address anything over 12 hours old. I went to the emergency room (which was what I was trying to avoid all along) but they don’t do anything on the face. They did however have a plastic surgeon on call who came in and stitched my eyebrow. If there had been no urgent care center I would have simply gone to the emergency room as my only option.
For all the reasons mentioned in the article, healthcare delivery is going to change over the next ten years. It is smart for Walgreens to be flexible and try to address the opportunities.
With the Affordable Care Act passage (Obamacare), and the Supreme Court’s tacit approval in 2012, Walgreens, and others will have to fill the void that will be created with fewer physicians. Socialized medicine, unfortunately, is likely to grow. My comment there is not political, but an economic view. Localized, trustworthy retailers like Walgreens will fill that void.
Walgreens’ challenge will be to find the appropriate number of qualified healthcare professionals to provide the service. They have worked diligently to meet that need among pharmacists. It will be a larger challenge in filling needs with nurse practitioners, D.O.s, and others that they may seek.
The long slog “forward” will have numerous side-steps, but having private enterprise entering to support it, will put a comfort floor in place. Unfortunately, these retailers will have to expand their legal departments, as well as the health care teams — the sharks will be circliing over the next 10 years.
Nurse practitioners and physician assistants writing prescriptions under a doctor’s protocol is well established. As long as they stick to easily diagnosed chronic conditions like diabetes, hypertension and high cholesterol, it should work out just fine.
Execution still needs work for sure, but this is simple math; Obamacare + demographics + chronic disease trends.
And by the way, this is only one of the healthcare related opportunities for retailers. Watch also for big advances around new consumer devices (i.e. spit on a dongle attached to your smartphone and find out if you have the flu).
Smart move by retailers to focus here.
Retail pharmacies can reach health consumers where they “live, work, play and pray” as the Surgeon General says. Health is lived largely outside of the doctor’s office, and pharmacists are highly trusted members in people’s health ecosystems. So Walgreens and Take Care have the opportunity to become key members of the primary care team. This will work optimally if patient data generated through the encounter at Walgreens’ clinics can transfer into the patient’s electronic health record at the PCP’s medical home.
But in the interim, pharmacies can expand the limited primary care supply in many communities where newly-insured and under-insured people lack access to PCPs. For more on this phenomenon, see my paper written for the California HealthCare Foundation, “Primary Care Everywhere.“
I have a hard time seeing this actually working: aside from all the liability issues mentioned, there’s an inherent conflict-of-interest in having someone who makes their money from selling drugs—i.e. “treating” and also being the diagnostician.
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In-store clinics are definitely taking the right path in diagnosing and treating chronic illnesses. Health care needs to be accessible to people in a much more convenient way than relying on traditional doctors and hospitals alone. And from the pure business perspective, why not treat patients on the spot where they also happen to be consumers of related medications, OTC, HBC, and health care products?
This could be a great way to get a second opinion, among other things. And providing competition for established healthcare operations will benefit everyone. Kudos to Walgreens for putting a stake in the ground.
I think it will be all over the first time a misdiagnosis results in a death and, shortly thereafter, a lawsuit.
Serious questions need to be addressed before I’d endorse this idea.
Who, for example, will carry the malpractice burden for these offers? How will drug chains indemnify themselves? What are the long-term implications for this offer once we understand how the ACA pans out? If it works, how will the customer demand cycle work? One can’t have a “waiting room” full of patients standing around a store and there is a danger to limited time exams.
And, most compellingly, how will drug chains compete with physicians’ offices replete with a dazzling assortment of digital technologies? Medicine is — for better or worse — coming down to access to diagnostic technologies.
My CVS can’t keep the POS system in the pharmacy working for more than three days at a time. Good luck with the EKG machine!!
Given the reported looming shortage of doctors, anything that expands the availability of quality health care is a good idea. The underlying issue here is whether a PA is able to provide an accurate diagnosis. I doubt that Walgreens would run the risk associated with a misdiagnosis if they didn’t believe their clinics could handle it properly.
This is not a substitute for a family doctor, as Walgreens cannot write a prescription for anything without a doctor’s consent, so I am curious to see how this works out. Do you think the doctors are going to like seeing their practices threatened by these clinics? Obamacare has more pitfalls every day, and this solution has to be a win win for the pharmacy and the doctors as well for it to work.
I see this as a way to push people into a system that is overburdened to start with, and it could get tougher and tougher to find the rural family doctors to move out to these areas in the first place.
In my area the in-store clinics are poorly run and understaffed. The “walk-in” component is completely misleading as they are getting more traffic than they can handle. If you walk in without making an appointment ahead, you’d better be prepared to wait a few hours to see someone.
I can’t imagine them taking on additional responsibilities like this. The execution does not live up to the press release, in my opinion.
I think a lot of the potential success or lack of will depend on how we define chronic illness and what the pharmacy clinics will be able to treat. I question what scrips they can or should be allowed to write without a physician, and the liability factor that surely will cast a big shadow.
Duly noting Ryan’s comments about liability—I think this situation will play out in one of two ways.
We could find out that the reverence with which we have come to regard physicians is overblown (a la the purported pain of the Sequester) and the healthcare system emperor will be found to have no clothes —at least the General Practitioner that most of us call our “primary care” physician.
Or, we (and the affected retailers) will find out that mixing real healthcare with retailing just isn’t a very good idea. Either because it provides inadequate healthcare, or it distracts retailers from their primary job.
This one really could go either way.
I occasionally visited Walgreens when I needed something I didn’t expect to find in the grocery store. I was generally underwhelmed with their merchandising and price points. Then I switched drug plans and Walgreens is the only preferred provider in my area so I visit more often. I don’t know if the plan to treat chronic disease and to be the preferred provider for certain drug plans is part of a larger marketing strategy, but maybe it explains the lack of competitiveness in the other areas.
When I first read about the chronic disease plan I thought it made a lot of sense. If one of your primary revenue streams depends on prescriptions and the number of general practitioners available to issue prescriptions is rapidly declining, then what better way to protect your revenue stream than to begin issuing prescriptions yourself? This seems to be the strategy for Walgreens and it makes sense for the patient who has been on a stabilized treatment regimen for many years.
The challenge I see with all these options is that they create a very confused environment for patients. My personal experience was a recent sports injury playing tennis. I fell going after a lob and my glasses cut my eyebrow. It was a weekday afternoon so I called my regular doctor, he doesn’t do stitches. I waited overnight and went to an urgent care center the next morning. They would not address anything over 12 hours old. I went to the emergency room (which was what I was trying to avoid all along) but they don’t do anything on the face. They did however have a plastic surgeon on call who came in and stitched my eyebrow. If there had been no urgent care center I would have simply gone to the emergency room as my only option.
For all the reasons mentioned in the article, healthcare delivery is going to change over the next ten years. It is smart for Walgreens to be flexible and try to address the opportunities.
With the Affordable Care Act passage (Obamacare), and the Supreme Court’s tacit approval in 2012, Walgreens, and others will have to fill the void that will be created with fewer physicians. Socialized medicine, unfortunately, is likely to grow. My comment there is not political, but an economic view. Localized, trustworthy retailers like Walgreens will fill that void.
Walgreens’ challenge will be to find the appropriate number of qualified healthcare professionals to provide the service. They have worked diligently to meet that need among pharmacists. It will be a larger challenge in filling needs with nurse practitioners, D.O.s, and others that they may seek.
The long slog “forward” will have numerous side-steps, but having private enterprise entering to support it, will put a comfort floor in place. Unfortunately, these retailers will have to expand their legal departments, as well as the health care teams — the sharks will be circliing over the next 10 years.
Nurse practitioners and physician assistants writing prescriptions under a doctor’s protocol is well established. As long as they stick to easily diagnosed chronic conditions like diabetes, hypertension and high cholesterol, it should work out just fine.
Execution still needs work for sure, but this is simple math; Obamacare + demographics + chronic disease trends.
And by the way, this is only one of the healthcare related opportunities for retailers. Watch also for big advances around new consumer devices (i.e. spit on a dongle attached to your smartphone and find out if you have the flu).
Smart move by retailers to focus here.
Retail pharmacies can reach health consumers where they “live, work, play and pray” as the Surgeon General says. Health is lived largely outside of the doctor’s office, and pharmacists are highly trusted members in people’s health ecosystems. So Walgreens and Take Care have the opportunity to become key members of the primary care team. This will work optimally if patient data generated through the encounter at Walgreens’ clinics can transfer into the patient’s electronic health record at the PCP’s medical home.
But in the interim, pharmacies can expand the limited primary care supply in many communities where newly-insured and under-insured people lack access to PCPs. For more on this phenomenon, see my paper written for the California HealthCare Foundation, “Primary Care Everywhere.“
I have a hard time seeing this actually working: aside from all the liability issues mentioned, there’s an inherent conflict-of-interest in having someone who makes their money from selling drugs—i.e. “treating” and also being the diagnostician.