Mall Medicine

Mall Medicine

  • This article contains a brief description and brief outline of the history of retail medicine as well as future trends of retail medicine in the US and the UK, including both recent success and failures.
  • The article then goes on to describe how the concept could be quite lucrative in the GCC and what are the milestones needed to bring retail medicine to the Gulf. 

There is an interesting new trend sweeping the western world; healthcare is moving away from hospitals and setting up shop in malls and other large retail outlets.

I was first introduced to the concept of retail medicine at the 2007 World Innovation Forum in New York City. Seen by many medical doctors as the scourge of traditional primary care, retail medicine has revolutionized the delivery of medicine through its own unique interpretation of disruptive innovation.

It all started on a wintry weekend in 1999, when American entrepreneur Rick Krieger took his sick son to an urgent care center in Minneapolis, Minnesota. Rick knew his son needed his throat tested and soon enough, after a two-hour wait, a strep throat test was finally done.

Like many parents before him, Rick believed that there had to be a quicker, more convenient way for experienced parents and patients to get quick healthcare diagnoses, so he teamed up with a physician and a nurse to put the limits of traditional medicine to the test.

Started as QuickMedx (and soon rebranded as the Minute Clinic), Krieger’s convenience care concept was simple – treat the 20% of disease that cause 80% of the visits to primary health centers (an essential extension of Paraeto’s 80/20 principle).

To keep costs down, Krieger and his team decided to staff these ‘mini clinics’ with resident nurses instead of physicians (pushing the boundaries of clinical practice) and locate the clinics within large retailers (thereby forgoing much of the costs such as building and servicing of restrooms).

Today, with over 500 clinics and close to 2 million mostly walk in, cash paying customers with a 99% satisfaction rate, the Minute Clinic (through its partnership with CVS Caremark Corporation) has opened up the US market to a whole new age of medicine. Even traditional medical power players such as the Mayo Clinic, have extended their brands into the retail medicine space, in this case via the Mayo Express Clinic.

More significant is box retailer Wal-Mart efforts, which started with a pilot program in 2005 for 75 clinics in 12 US states and and has since expanded to include plans for 6,600 medical clinics by 2012 through a partnership with various retail medicine companies such as RediClinic. Across the Atlantic, British supermarket giant J Sainsbury will also be adding government-paid doctors to some of its stores, where shopping patient will be alerted by a pager when their appointment arrives.

The ability now exists to put your next medical checkup on your grocery list.

The popularity of retail medicine lies in the trend of patient convenience. People want to have flexible visiting times. This is the millennium of multitasking and retail medicine is moving fast up the healthcare continuum as a complement to larger primary care clinics and hospitals.

In the UK, employees spend around 3.5 million working days a year traveling to and from doctors, costing the British economy close to $2 billion (estimated by the Confederation of British Industry). In the US, insurers have also advocated for increased healthcare options through retail medicine as evident by CIGNA Healthcare members in Dallas, Texas being offered convenience through the insurer’s addition of MedBasics Family Health Centers to its network.

However, the success of retail medicine is not without its share of skepticism. Many people and institutions (American Medical Association, American Academy of Pediatrics,) are concerned about quality of care, hygiene issues and the limited scope of the clinicians running these ad hoc facilities. These issues, coupled with an inability to maintain the salaries of healthcare professionals, have forced retail medicine corporations such as CheckUps and Take Care Health Systems to shut down multiple walk-in clinics in both Wal-Mart and RiteAid respectively.

Industry experts estimate that a company can consume $300,000 to $600,000 to finance and maintain a retail clinic, breaking-even at about 25 to 30 patients a day. This should be no problem for retailers within the GCC, where the desert heat pushes the average consumer to frequent the mall over 70 times per year (according to Dubai based market researcher GRMC).

The GCC retail industry is an extremely attractive sector globally, according to At Kearnery’s 10th annual Global Retail Development Index (GRDI) which ranks seven countries from the MENA region make it into the top 20 in the 2011 index of top ranked emerging markets for global retail expansion, including Kuwait (5th place internationally), Saudi Arabia (ranked 7th) and the UAE (ranked 9th).

With over five million square meters of retail space currently available in the GCC (worth over $100 billion and expected to treble in the next nine years according to Retail International), proprietors of retail medicine should have no problem carving out a niche for themselves with the right strategy and scope.

Developing a retail medicine concept specifically for the GCC would require significant investment and expertise. A number of detailed assessments need to be taken into account, starting with scope of service where the individual retail clinics must have a well-defined and limited scope of clinical services that falls within the local government regulations and is catered to local cultural norms. Also, an evidence-based medicine approach to clinical services and treatment must be implemented and quality improvement-oriented, in addition to the selection of the highly specialized staff.

Once the scope and staffing have been completed, an international partnership may be necessary to bring international best practices to the GCC.

The operations of the facility must be also carefully considered, with a team-based approach encouraged. Even retail walk in clinics should have a formal connection with physician practices in the local community, preferably with family physicians, to provide continuity of care. Other health professionals, such as nurse practitioners, should only operate in accordance with local regulations, as part of a team-based approach to health care and under responsible supervision of a practicing, licensed physician.

Most importantly, a steady referral stream also needs to be established where the clinic must have a referral system to physician practices or to other entities appropriate to the patient’s symptoms beyond the clinic’s scope of work. The clinic should encourage all patients to have a “medical home.”

Finally, it is also essential to have electronic health records set up to gather and communicate the patient’s information with the local healthcare providers.

The article is written by Dr. Mussaad Al Razouki for Arab Business Review

To read more thought-leadership stuff by leaders from Arab Region, please visit Arab Business Review

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