Is this doctor prescribed or a symptom of a bigger problem?

Walk into any chain drug store today, or even a grocery store or big-box pharmacy, and you’ll quickly be inundated with bold, bright displays, hanging signs and banners that tell you to take advantage of a host of on-site health services. Everything from shingles shots, blood pressure tests, Covid-19 boosters to even skin treatments for sunburns or rashes caused by poisonous plants are available.

If you shop at the pharmacy, conscientious cashiers will offer even more services. Instead of fries and a Coke, you might be offered a cholesterol test, a diabetes screening, or even a pneumococcal vaccination. You may even see the prices of these services posted or readily available, giving you a ready impression of the value of the care being offered to you.

Indeed, primary care services, for some time only available through a doctor’s office, are increasingly and readily available from retailers, grocers, spas, and even luxury hotels. In some hotels, one can receive stem cell therapies or even use MRI machines and CT scanners for preventive diagnostic sessions. Yes, the road to better health can follow you on vacation.

What you are witnessing is the development of innovation over decades, away from a very broken, impersonal and separate model of health care delivery that is in desperate need of reform. Healthcare comes to you again, saving you the trouble of seeking care yourself.

The existing paradigm is full of inefficiencies. We’ve all tried to schedule appointments for essential services only to find seats many weeks or months later. We’ve all been put on hold for simple billing questions or forced to call an office during a narrow range of business hours only to hang up in frustration. At various times we were expected to have tests or blood work done at a completely different facility, thus adding another inconvenient layer of time and expense.

What makes the rise of retail health so compelling is that the leading for-profit players are successfully implementing go-to-market approaches, delivering what consumers want and bypassing the obstacles placed in front of consumers by traditional care models. CVS and Walgreens have been in the space for years, gradually bringing services once exclusive to the aging model. In doing so, they shed light on the inefficiencies and lack of sophistication in traditional healthcare delivery to more demanding and evolving consumer orientations.

These legacy systems were largely aloof from change and very slow to respond, which opened up huge opportunities for disruptors to become more nimble, more customer-responsive and value-conscious. Commercial healthcare and retail are doing all the things that many in the world of traditional healthcare delivery have failed to do. They answer phone calls, often have same-day-same-time visit options. They are much more amenable to a working person’s schedule, eliminating the need to take a “sick day” for trivial uncomplicated issues. They respond to both customer inquiries and customer feedback, and the range of services they offer continues to grow. Comparison shopping prices are also often readily available. It’s tempting to ask why go to the doctor at all? For routine maintenance types, many users clearly prefer this.

By 2030, the value of the healthcare retail sector is expected to reach almost $11 billion, so there is plenty to do here. The big players bring together providers, some urgent care, lab, optical, hearing and dental services under one roof, creating an obviously attractive and convenient option.

Many of these providers in the space are already accomplished retailers. The transition to healthcare delivery is a natural process designed to provide consumers with what they want. Amazon Care promises, within its existing service areas, access to a licensed clinician 24 hours a day, 7 days a week, 365 days a year, with no waiting rooms and no travel time due to their innovations in telehealth and remote services. Customers can even schedule home visits.

CVS Health does much the same, as well as providing a robust telehealth program for mental and behavioral health. Clear pricing and the convenience factor are common themes among these non-traditional providers.

When it comes to prescriptions, Amazon’s Pill Pack is an item that allows patients to avoid the pharmacy altogether. No more searching for refills or waiting in lines to get prescriptions delivered expeditiously to your door instead. Similarly, Mark Cuban Cost Plus Drug Company promises the lowest prices on the most commonly used generic drugs, which are also delivered to the patient’s door.

Sure, retail healthcare can’t do things like treat a broken bone or do much in the way of emergency medicine, but there’s nothing stopping such developments in the future. And he’s certainly unlikely to take on major surgery or treatment for a serious, complex illness. But there is likely to be an impact on patient/user expectations about the context in which these services are provided.

Despite all this attention the obvious question arises; does any of this make us healthy? We seem to be bathed in opportunities to receive both medical care and clinical advice. In stores and on television, we see ads for supplements, drugs, and public campaigns to get vaccinated or tested for this or that disease. It seems that one would have to work very hard to avoid important health lessons that the world has conspired to provide us with. But are we better off amid this flood?

They are marginally very likely, but overall death rates, even with Covid-19, remain stubbornly high. Life expectancy continues to decline. Heart disease and cancer are still the number one and number two causes of death, respectively. Deaths from despair, such as addiction and suicide, are also on the rise. What gives?

The missing element here is a holistic approach. Retail health arose to enhance the standard delivery model, but it cannot replace it entirely. Its development is one step away from the focus on iintegrated first aid. This contributes to further fragmenting the delivery system rather than unifying it. This contributes to a mix of unconnected and disconnected care in a way that continues to promote poorer outcomes, as national statistics sadly illustrate.

The road signs to better health are clear, but what is needed is a focus on a continuum of care that is tailored to meet the patient’s complete health needs. This is difficult to achieve in a number of unrelated but largely competent suppliers. A unified approach is the right one, but achieving it, at least in this environment, seems far off.

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