punctuative! by Matt Winn

Health Services Coming to a Location Near You

RVK Architects, from detnews.com

Gone are the days when healthcare was siloed in hospitals and doctors offices. I’ve written before about the “retail” model that’s taken nurse practitioners into big box retailers such as Target and CVS. In recent weeks, we’ve seen further movement in the space with Duane Reade’s (”DR”) announcement that LabCorp will offer clinical testing services within DR’s premises and Toyota’s annoucement of a $9 million health clinic in its San Antonio, TX facility.

Anyone who’s had their blood drawn from Quest or Lab Corp knows that they’ve got good geographic coverage (relatively convenient), but often terrible customer service. I’m surprised that Duane Reade is willing to take the PR “association risk” but encouraged by the move to consolidate self-maintenance under one roof. Duane Reade has been innovative before with their pharmacy kiosks. I do wonder if we’re going to reach the point in the not too distant future when folks choose to buy certain blood tests on a routine basis - HDL/LDL cholesterol, for instance - without seeing a primary care practitioner. That scenario is much more likely if the blood draw takes place at a convenience store.

Toyota’s decision to in-source clinical care of its San Antonio workers deserves particular attention. There are privacy concerns, of course. The disease mgmt guys will tell you that employees are loathe to take health risk assessments even in the face of monetary incentives because they’re worried about “big brother” - i.e. if my employer knows I’m at high risk of a heart attack, why would they promote me? And there are care concerns - who’s to say that Toyota will have the best interests of its employees at heart (think about medical care on the sidelines of a football game)? But there’s also a profound statement about our healthcare system. Toyota, whose core competency is building, marketing, and selling cars, believes it can offer health services more cheaply, and provide better quality care than the traditional system. I’m looking forward to seeing how this “experiment” turns out; will we see “rent-a-doc” outsourced business services providers at smaller companies?