Sticking a head in the competitive sand

I speak to groups often about the new competitive threats traditional healthcare providers are facing in today’s market, and my audiences – usually marketers and strategists – usually get the picture. But it’s amazing to me how so many others in healthcare, often administrators or physicians, don’t believe the threats are real. Take, for example, mini-clinics, which are now rolling across the country, popping up in Target, CVS and other huge retailers. Last year, we heard a physician say, “If they’re going to MinuteClinic, they must not really be sick.” Yikes.

But I thought most of that kind of “head in the sand” attitude was behind us, until I came across a blog from Kenneth Peelle, MD, president of the Massachusetts Medical Society. Titled “Mini-Clinics: Not So Fast!”, Dr. Peelle laments the announcement by CVS of 20 to 30 planned mini-clinics in Massachusetts. He makes three main points in his argument:

“Concern #1: Safety. We’re worried that medical care will be delivered without the knowledge of the patient’s primary care physician and without the knowledge or availability of a patient’s medical history.” Fair enough – hard to argue with patient safety. The majority of services offered by mini-clinics are fairly standard, however, making quality standards easy enough to develop. But isn’t this really a question of continuity of care? The same would hold true for an urgent care visit, assuming they were made outside the system of the primary care doctor.

“Concern #2: They could kill our fragile primary care system.” If the success of primary care clinics hinges on strep tests and immunizations, there’s a deeper issue going on. Doomsday scenarios abound here: “Allowing mini-clinics to skim the easy, less complex patients might be the death knell of primary care, and our community health centers, too.” Wow, that’s kind of a stretch, it seems.

“Concern #3: Conflict of interest. It’s an inherent ethical conflict when a pharmacy is located at the same site as a primary care clinic, owned by the same company.” Really? You mean like the primary care clinics, urgent care clinics and pharmacies, all owned by the same health system, all in the same building? What about MRI machines owned by orthopods, GIs ordering scopes down the hall, or cardiologists ordering echocardiograms for their own machines? Our healthcare system is rife with these conflicts, and they raise legitimate issues. But this is very much the pot calling the kettle black.

In the end, it’s not so much that Dr. Peelle and others don’t make valid points. It’s the idea of fighting the inevitable: new competitive entrants that can provide elements of healthcare better and for less money. Those that understand changing market forces will figure out how to identify the true value they provide to patients and consumers, and will capitalize on that. If healthcare is truly a market-driven system, competition is good, not bad, even for the competitors…