Will consumers fix healthcare?

All the rage of late in the medical business world is about retail medical clinics (or more aptly named, "convenience health clinics").  For Wall Street Journal readers, you know what I'm talking about.  You may also know that the American Medical Association has declared war on these clinics.  You may read their declaration here.

So far, customer satisfaction for this clinics has been high, around 97%.  Its not surprise then, that this business model is taking off, with clinics popping up in Walgreen's and Wal-Marts all over the country.  It is obvious that the AMA's opposition to these clinics is simply a turf battle and not legitimately about patient care quality.  It reminds me of physician's opposition to direct access to physical therapists, and the battle over referral for profit arrangements; both battles also fought under the guise of physician's altruism.

The all-seeing Seth Godin, had a nice post a while back on "Stuck Systems."  Here is a quote from that post:

"So, the marketer faces a challenge similar to the disruption challenge that most marketers face--how do you take a system filled with an inefficient, annoying, time-consuming, wasteful and yes, even stupid task and make it better in a way that serves all sides? 

If it were me, I'd focus on being cheap and fast and viral. And the more you break the system, the better your upside."

Healthcare is a stuck system.  I don't think it can stay that way for long.  In the end, consumer choice of convenient services will rule the day.  It could be an incredibly ironic moment in the upcoming presidential election, where health policy is expected to play such a large role, that consumers have already chosen their "fix" for healthcare in the marketplace.

Physical Therapists must acknowledge they are part of a stuck system!  Third-party payment, regulatory woes, and limited access characterize our jobs.  The convenience model needs greater attention.  We are continually growing the research evidence base to support this model for physical therapist practice.  We might think about acting quickly, it could be embarrassing for a physical therapist to get beat in a race by a nurse practitioner!

ERIC

Comments

[Taylor]

Maybe we should be making more allies with NPs?! From my observations nursing has a lot of influence on the healthcare market these days, and are responsible for steering patients more than most people think. ~T

[Jason Silvernail]

I would agree with Taylor, and I find NPs are some of my biggest supporters and referring providers - they aren't afraid to admit they don't have the answers for everything and are quick to bring in the expertise of others.
I've had many good experiences with them.

Remember the Kaiser model? A PT and an NP doing triage...

[John Ware]

I'm not worried about NPs either, but I am worried about ATCs, personal trainers, massage therapists and, to a lesser degree, chiros.

Physicians seem to be stuck in the 19th century in terms of treating medical conditions: desperately seeking the etiological agent for disease. They don't seem to get it that most people with "disease" today have just that dis-ease. They aren't going to die from it; rather, it's literally a pain in the ass that won't go away, and they want relief ASAP.

They don't want to wait in a doctors office for half the afternoon to be given a prescription of something that is really going to make them sick, either.

They don't want to have to call their insurance company for prior authorization or listen to some customer "no" service representative tell them the condition is not covered under their benefits.

They don't want to have to become an expert in human anatomy and physiology in order to find the right provider for their pain in the ass or have to search WebMD every time they get a pain in the ass.

Yeah, our system is stuck alright, and I know where (see above). But I don't think the consumer is going to be able to fix it. They'll find a "fix," but it'll be trial and error, and they'll be a lot of errors- and a lot of lawyers, too. This is a problem that all players- providers, consumers, 3rd party payers and government-must work together to fix. Anything less will be just another pain in the- well, you get it.
John

[Ken Mailly, PT]

"It is obvious that the AMA's opposition to these clinics is simply a turf battle and not legitimately about patient care quality."

Eric,

My only comment is that the issues associated with ownership and operation of these "clinics", (or PT services, for that matter) is not about quality; it's about accountability & control.

As has been said by many others on this blog, we are so far from being able to define "quality", that is is almost laughable to even introduce it into our conversations.

Ownership is neither about "autonomy" nor quality; it is about accountability and control. If we think otherwise, with all due respect, we are kidding ourselves.

PT is either a profession or it is not. Businesses can be owned by anyone; professional services cannot. If we fail to grasp this simple reality, we will never actually BE a profession, let alone realize a "Vision" for that profession.