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In Less Than a Year

Stanley Feld M.D.,FACP,MACE

On May 28, 2006, I wrote that the Steve Case and Rick Scott’s In Store Clinics would fail in the pharmacies and Targets and Wal-Marts.

In less than 1 year Rite Aid is closing their In Store Clinics in Portland Oregon.

In response to an email about this article I replied;

“Creation of free standing “DOC in the Boxes” is one of the complicated mistakes that business people are making.” Their thought is to make money. Their public relations people say their aim is to provide inexpensive and rapid access to healthcare care. I said, “The effective result is to distort the problems in the healthcare systems even further.”

“Both Steve Case and Rick Scott are very smart guys, when it comes to picking the cherries off the trees, and making money. I am sure they will make some money at this venture. They will also bale out just before it crashes.”

“I think Wal-Mart and CVS are indeed putting their reputation and good will on the line and are going to get a nose bleed. “

These are again today’s solution to yesterday’s problems which in turn will become tomorrow’s problems.”

The business plan is to give patients’ easy access to care delivered by Nurse Practitioners. I saw two problems. First, if you do the arithmetic the business can not make money without the clinic receiving reimbursement for medical procedures. Second, when you are sick, you want to have access to a physician. By taking flu shots away from the Family Practitioner, you simply make it harder for him to stay in business.

The correct business to start is one that helps the Family Practitioner increase the efficiency and quality of his practice. This would help rebuild an environment of trust between the primary stakeholders, the patient and the physician.

“For a $30 flu shot, a $45 treatment for an ear infection or other routine services
from a posted price list, patients can visit nurse practitioners in
independently operated clinics set up within the stores whose own
pharmacies can fill prescriptions.

“It was a lot easier to know you can just drive up the block to a
clinic, rather than spend time in the pediatrician’s waiting room,” said
Liz Lyons, who recently took her 9-year-old son to have a check up.”

Again, these In Store Clinics do not answer the real problems facing the healthcare system. The true problems are access to care for the uninsured, affordable and cost efficient delivery of care, and increasing the quality of care for people with chronic disease.

Yesterday, Rite Aid Corp announced they were closing 10 in store clinics in Portland Oregon.
“Rite Aid Corp.’s first experiment offering health clinics inside its stores ended when the clinic operator decided it could not turn a profit.”

Take Care Health Systems LLC is the vendor for the Rite Aid Clinics. “The concept works, we know that, we just have to be in the right place,” said Hal F. Rosenbluth, the chairman and co-founder of Conshohocken-based Take Care.

However, a Rite Aid representative stated “Take Care’s executives helped pick the market after looking at demographic studies and making site visits”.

“In the meantime, Take Care is operating clinics in Walgreen and Eckerd stores in the Kansas City area, St. Louis and Pittsburgh. It plans to open clinics in Walgreen stores in Chicago in November,” Rosenblatt said.

All I can say is, “I told you so”. Watch out Walgreen, Eckerd, CVS, Target and Wal-Mart! You are next. It is not the vendor, it is the business model!

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