Wal-Clinic and the Nature of Primary Care

Struggling to find new sales avenues as the big-box model is in decline, Wal-Mart is building an express-care network.

The author makes some interesting points about the nature of primary care in our busy lives.  Scheduling, no-shows, and overbooks are some of the biggest headaches in primary care practice.  It is very difficult to plan the demand for care when the supplier is a specific primary-care provider for some patients only.

Does it really matter anymore which primary care provider you will see?  The author makes the sad-but-true remark that most of them have no idea who their patients are.  This got me thinking that in an age of ever-increasing specialization, this makes sense.  

When medicine was at a point where the village doc could be an all-in-one OB, pediatrician, etc., it would follow that his relations with the patient would be much closer.  But as the nooks and crannies of medical research have expanded, the primary care physician in itself takes on a less powerful role.  

The idea of having a centralized decision-maker in the medical process, guiding the patient through the health care maze, may still be a good one. But this is likely best done by a specialist or surgeon, depending on the circumstances.

It remains to be seen what Wal-Mart can deliver in this channel that rivals like CVS and Walgreens haven’t done years ago.  But when the  world’s largest retailer moves, it’s usually signalling something.  The increased acceptance and reliance on the express-care rather than the traditional primary care model is this story’s lesson.