20 Surprising Ways Wal-Mart Clinics Will Affect Healthcare

By Jessica Hupp

Originally published on Wednesday February 27th , 2008 on RNCentral.com

And originally titled:
20 Surprising Ways Wal-Mart Clinics Will Affect US Healthcare

Re-posted here with permission


Big-box behemoth Wal-Mart has ventured into the healthcare realm, offering low-cost, walk-in clinics in more and more of its stores every day. Although Wal-Mart medicine may not sound like a great idea at first, these clinics can bring good changes to the health care industry, like insurance-free care, eased emergency rooms, and more widespread treatments. Of course, the plan is not without its drawbacks, creating a "Wal-Mart effect" on small practitioners, as well as a race to the bottom. Here, we'll take a good look at some of the implications you might not have thought about.

1. More immunizations: With immunizations available at Wal-Mart, they're much more convenient for those that may not have time to go to the doctor. As a result, more people will be immunized, and the risk of contagious disease will be lowered.

2. Flat fee visits: Most Wal-Marts charge a flat $45 for a "Get Well" visit, which is painstakingly simple when compared with health care's typical insurance, co-pay, and deductible scheme. As Wal-Mart clinics become more popular, other health practitioners may be forced to adopt a similar pay structure in order to compete.

3. Faster care: Wal-Mart offers walk-in visits, offering a refreshing alternative to appointment-based health care. As Wal-Mart's clinics and others like them become more popular, we'll see patients getting care right when they need it.

4. Automated health: At Wal-Mart clinics, practitioners check out patients with the aid of a proprietary computer program that diagnoses illnesses. This sort of automation can help make diagnosis more accurate and efficient, while still allowing for human expert guidance when needed.

5. No insurance necessary: Perhaps the biggest thing to come out of Wal-Mart clinics is that they don't require insurance. Paired with flat-fee service, this simple pricing structure is likely to bring in patients that otherwise would just go without medical care.

6. Race to the bottom: Wal-Mart tends to have this effect on local businesses, creating a situation where quality must be sacrificed for price. In the healthcare world, cheaper isn't always better, and competing with Wal-Mart clinics could result in decreased quality of care.

7. One-stop shopping: Retail clinics like Wal-Mart's open up an opportunity for a place to take care of basic medical needs, combining the clinic with optometry, pharmacy, and over the counter supplies.

8. Primary care providers can narrow their focus: As Wal-Mart takes on all of the sniffles and scratches, doctors can spend more time working with patients who need more professional help. They'll be able to use their time more effectively and appropriately.

9. Automated health care could be problematic: Although automation increases efficiency and reduces human error, that doesn't mean that a computer program is the best way to diagnose a patient. Critics are worried that this type of diagnosis will cause important intricacies to be missed.

10. Eased emergency room crunches: As health care becomes more accessible, the patients that generally clog up emergency rooms unnecessarily will be able to take care of problems before they become worse. Additionally, clinics like Wal-Mart's can take care of ailments that for some without insurance would require a trip to the hospital.

11. More retail pricing information: To compete with Wal-Mart, physicians will start sharing information about how much specific visits and procedures will cost. This can make health care more competitive and consumer-friendly.

12. Better rural medical access: In many rural areas, the nearest health care practitioner isn't so near. However, you can often find a Wal-Mart even in remote parts of the country. This would make it much more convenient for rural citizens to get hassle-free care.

13. Increased medical awareness: With health care right where people shop, it's a lot harder to ignore aches and pains. Plus, as stores run campaigns for prevention services and screening, they'll be able to catch and stop ailments earlier than before.

14. Increased office hours: Wal-Mart's clinics offer evening and weekend hours, while many primary care physicians do not. To compete, these doctors will need to offer extended hours to patients.

15. Mall health clinics: Wal-Mart isn't the only one in the neighborhood clinic game. As their clinics become more successful, we can expect to see this sort of health care facility popping up in more places, like malls and strip centers.

16. Traditional medical offices will feel the crunch: As Wal-Mart's clinics tackle the easy patients, regular health practitioners will be left with more complicated patients that take more time and money. These patients are generally less profitable, and could cause monetary problems for these offices.

17. More referrals: Primary care physicans and specialists will see more referrals as Wal-Mart and others like it determine that some cases are too difficult to be handled by the clinic. This would include finding doctors and sharing medical records.

18. Increased utilization of nurse practitioners: For the most part, Wal-Mart clinics are and will be staffed by nurse practitioners. This is part of a growing trend to use highly skilled and trained nurses instead of doctors.

19. Less red tape for known illnesses: For patients who have recurring or easily-diagnosed illnesses, Wal-Mart clinics will make getting treatment easier. This will help patients avoid the high cost of taking the time to visit a primary care physician.

20. Decreased continuity of care: With traditional doctors, patients have charts and medical records, but at in-store clinics, diagnosis is a one-off deal. Problems that could be caught over multiple visits and diagnosis could go unearthed unless the patient works to inform practitioners.

VON Canada selected as Regional Management Centre for the SMILE program (Seniors Managing Independent Living Easily)

February 26, 2008 (Ottawa, ON) – VON Canada - Ontario (Victorian Order of Nurses), through its local sites in Kingston and Trenton, has been selected, by the South East Local Health Integration Network (LHIN), as the Regional Management Centre for the SMILE program (Seniors Managing Independent Living Easily). The SMILE program will empower seniors and their caregivers in the South East to access home support services that are individualized to their specific needs.

According to VON President, Dr. Judith Shamian, this program is a collaborative initiative that focuses on empowering seniors by giving them new options to remain in their homes for as long as possible.

VON is responsible for ensuring equitable access to seniors across the region for selected traditional and non-traditional support services and resources (i.e. those that may come from a neighbour or friend, as well as established agencies), for developing and supporting the access portals, for providing service coordination, and for accountability for the performance of the SMILE program to the South East LHIN.

VON will administer the $9.7M program (over three years) in the region. The South East LHIN Board of Directors also approved the Victorian Order of Nurses as the program administrator. “We are very fortunate in the South East to have a network of terrific home-support care agencies and services.

VON will work with the community at large, its partner provider agencies, such as the South East Community Care Access Centre, and other agencies serving seniors to:
· Implement the SMILE functional program plan;
· Administer a system that allows an individualized service and delivery plan
for each senior on the SMILE program, and for accommodating the senior’s
choice in the level of assistance with service navigation;
· Establish service contracts with providers that include performance targets,
and for funding allocations; and,
· Manage or assist users in handling the transactions needed to pay for aging
at home services.

As the regional focal point for the program, the Regional Management Centre will play an integral role in facilitating the provision of comprehensive and standardized information related to the SMILE program and will work collaboratively with existing health service providers, associations and community groups to share information about health services already available in each community.