1) Merrill Goozner notes that when it comes to wellness programs, employees respond better to the carrot than the stick.
My take: The same goes for physicians. Instead of cutting reimbursements, why not reward them instead? P4P is a step in this direction, but the carrot is not nearly big enough.
2) The NEJM recently ran a left-pandering op-ed by the American Prospect’s Robert Kuttner.
My take: The NEJM is the premier medical journal today, with unquestioned influence and authority. With great power comes great responsibility I would prefer the Journal to stay out of politics, or at least present a balanced viewpoint to counter Kuttner’s article.
Pimping out its name to one side just cheapened the NEJM brand in my eyes.
3) Retail health clinics are a threat to primary care.
My take: Perhaps. The standard argument is that these clinics skim off the “straightforward” cases, leaving the time-consuming, complex patients to the PCP. As it stands, we have a severe primary care shortage, with appointments at a premium. PCPs are in no position to complain, as very few would be able to accommodate the retail health population anyways.
There is also opportunity. The growth of retail clinics has identified a subset of patients who value access and quick visits that are on time. PCPs would be smart to capitalize on this population. Open your own walk-in clinic to preempt those from retailers. Implement a “walk-in” urgent care program in your practice.
Retail clinics have little interest in practicing primary care, so a PCP should partner with existing clinics to provide a base of potential patients.
There is no reason why PCPs can’t also benefit from the retail clinic phenomenon.
Related posts:
- Retail clinics
- Are retail clinics living up to expectations?
- Retail clinics are not for patients with chronic disease
- Should primary care doctors embrace retail clinics?
- The retail clinic era is over, and why pharmacy-based clinics are doomed to fail
- Retail clinics and disruptive innovation
- Retail clinics and cherry-picking
{ 5 comments }
1. Carrots are definitely better than sticks…at least for most humans. For physicians, the carrot’s got to be substantial to be meaningful. The Bridges to Excellence and P4P programs provide carrots that are too small to be meaningful. Even more patronizing are the Medicare Advantage PPO/FFS plans that garnish so much of the additional premium dollars for themselves. That carrot better be pretty damn tasty…but then again if I’m starving….
2. Despite my prior comments in an earlier post, I do agree that an unbiased journal should not take a political stance. But then again, the NEJM has neither been premier nor unbiased for quite some time. There’s a lot of crap that gets published, and they’ve lost my respect for a long time. (By the way, who reads print anymore?)
3. Retail clinics are easy pickings if primary care physicians want to play. When patients pay cash, a lot of the costs we allocate to providing a particular service for insured patients no longer apply–the referral coordination, the claims submission, the lost time value of money all go away. We cover our costs and then some by charging cash-paying patients the same rate as Medicare. The pricing is almost exactly the same as what the retail clinics charge.
All it takes is being able to present the services, pricing structure, and delivery properly. If the price and access are the same, wouldn’t the logical consumer pick the better trained provider?
I’m sorry. Our pratice opened a retail clinic. We could only get paid the contracted rate from insurers for office visits even for after hours care. We were open late, Sats and Suns. So we kept lots of folks out of ER’s but still I made < $95K seeing my office patients 3 days a week and covering the Urgent care 12 hours one day a week and every 6th weekend…And we had an EMR(big investment) and tried to promote continuity, but people chose convenience. So, the fiscal plan is not consistent with the known model for optimal care….Can be a burn out….
Kevin wrote “pimping” Soooo offensive
THe NEJM and the Lancet, used to be God’s Word from on High when I was a student.
They are pathetic shadows of their former selves with fake data and ferocius deceitful propaganda beginning to fill their pages.
Ed Sodaro MD
haven’t some of these retail clinics gone broke? i wonder what their cost structure is? do they get subsidized rent from the store? as an earlier poster noted, if they have insurance, we may not be able to collect cash from them, even if we don’t bill the insurance.
will you not see established patients in favor of these new cash paying patients? what about your existing overhead?
i wonder if you could save just as much money by focusing on cost cutting in the traditional practice.
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