Concierge medical practice vs. retail medicine clinic: which one competes more successfully?

In the showdown at the commercial coral between concierge medical practices and retail medicine, which one will trump? With these two behemoths taking such a chunk out of traditional medical practices, I’m reminded of Godzilla v. Mothra.

GodzillaThe plot is irrelevant – just think of these two mythical beasts taking each other on.

Concierge medicine and retail boutiques both try to draw the patient out of the traditional medical office setting and into a space where convenience and ease of access make good selling points.

In retail medicine, the focus is on non-severe, routine conditions such as sore throats, ear infections, sinus infections, bladder infections, and pinkeye. In concierge medicine, the focus has been on executive / VIP care, as well as greater access to personalized care by the physician.

Think of your Beverly Hills doctor providing you a suite of medical services and 24/7 access for a mixed monthly membership (concierge medicine) vs. seeing the nurse practitioner in Walmart (retail medicine).

Both concierge medicine and retail clinics raise legal and regulatory questions about corporate practice of medicine, fee-splitting, HIPAA, insurance coverage, and practice of medicine outside traditional boundaries.

A recent Medscape article asks whether concierge medicine doctors really can successfully compete with retail medicine.

The article suggests that both concierge medicine and retail medicine are “stripped-down, lower-cost versions of urgent care centers. Rather than using doctors, they usually employ nurse practitioners (NPs), who adhere very closely to evidence-based guidelines.”

Because of the current shortage of primary care doctors, both models of medical care are gaining in popularity — and, patients like to avoid waiting times and to receive care on demand (as they can anyway via telemedicine). This is a “convenience revolution” and physicians are now jumping aboard.

According to the article, it’s “difficult–maybe impossible” for concierge medical and direct primary care (DPC) physicians to match the price structure of retail clinics. Among other things, retail clinics can price their care services lower, because these services lead patients into the store to buy prescription drugs. Retail clinics also can afford extended hours.

The Direct Primary Care Journal quotes Ellie Campbell, DO as to why this model of care is thriving:

“We have trained patients to request a drug for every bug and a pill for every ill, and that if they want it they should be able to get it NOW. We have irrevocably devalued the education, expertise, and experience of primary care physicians, and permanently diluted the relationship that patients used to have with their family doctor. This is evident in the growth of some of the urgent/family care centers and “minute clinics” that are sprouting up everywhere.””

The Journal also notes Walgreens’ competitive entry:

Walgreens turned hospital executives’ heads in April 2013 when it announced that its clinics would begin diagnosing and treating chronic conditions such as diabetes and hypertension. The chief medical officer of the company’s renamed Healthcare Clinic says it wasn’t a declaration of war against hospitals. Walgreens isn’t acquiring physician practices, doesn’t offer imaging and has no space for inpatient beds. Rather, the retail giant wants to be the American health system’s primary care front door, and a key piece of the population health puzzle.

As financial pressures increase on smaller health systems and community hospital systems, and the primary care shortage accelerates, the convenience market for health care services will continue to grow.

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