Wednesday, February 26, 2014

High Deductibles Help Retailers Compete with Primary Care Doctors

Data! Data! Data!  How dangerous it is to reason with insufficient data.

Yes, I have a turn both for observation and for deduction. The theories which I have expressed there, and which appear to you to be so chimerical are really extremely practical—so practical that I depend upon them for my bread and cheese.

It’s elementary,  My  Dear Watson!

Sir Arthur Conan Doyle, MD (1859-1930),  creator of Sherlock Holmes

Sir Arthur Conan Doyle  was a physician.   He created Sherlock Holmes, the master of observation, reasoning, and logical deductions, and his sidekick,  Dr. John Watson.   If Doctor Doyle were alive today,  he might well accept the logic that retailers will be formidable competitors of primary care physicians.

I have just finished reading John Commins two part series in Health Leaders Media: One, “Retail Medicine Syncs with High Deductible Health Plans" (February25) ; and Two, "Behind Retailers Health Care Strategy"( February 26).    

Both pieces feature an interview with Vaughn Kauffman and Ceci Connolly of PriceWaterHouseCoopers’ Health Advisory Service on how retail services plan to carve out larger roles for themselves from traditional  primary care doctors.

What retailers have to say and what they plan to do,  I think Sir Arthur Conan Doyle and his fictional characters would agree is logical .

One, high deductibles, in essence, switch risk to  health consumers for routine health problems and certain routine treatments for chronic disease.

Two, high deductibles make competitive prices important for consumers, and prices for retailers tend to be lower than prices found in primary care settings.

Three,  high deductibles make price transparency important, and health consumes want to know in advance what they are paying for.

Four,  high deductibles make convenience in shopping more important.

Five ,  high deductibles renders important  familiarity with the provider, be it a primary care physician, a nurse practitioner, a physician assistant,  or a store where one shops and for whom one has established brand name recognition.

Six ,   high deductibles gives chain grocers, big pharmas,  and big box retail story advantages with their  marketing strategies, data, and the ability to reach thousands of customers at the click of a mouse.

Seven ,   high deductibles have one great failing – they lack the expertise,  equipment, and knowledge needed to deal with serious disease and catastrophic care.

Look at it this way.   The average consumer may visit a  retail outlet (national pharmacy chain, grocer, or big box retailer)  60 or 70 times a year,  a pharmacist 30 times, and a primary care doctor 3 times.  Familiarity breeds comfort and convenience, and higher volumes breed lower prices. These are formidable advantages in a consumer-driven stagnant economy in which consumers have little time and little cash to spare. 

What can primary care doctors do to combat these trends?   

One, they can hook up with retail outlets as back-ups for problems requiring greater knowledge.    

Two, they can offer high level services in concierge-type or direct cash practices with a higher level of personal attention.   

Three, they can consolidate services with hospitals and other physicians with one-stop shopping for medical services.

In summary,

Retailer  health services are here to stay.

Deductibles up retailer appeal right away.

Trouble is they can’t deal with catastrophe,

They don’t have sufficient mentality.

For real  problems answers aren’t  in big boxes,

Real  solutions reside in minds of real docs.

Tweet:   Retailers, using knowledge and data on consumers,  are carving out health care services to compete with primary care physicians.

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