Wednesday, February 13, 2008

Unintended Consequences

Patients are finding it increasingly difficult to find a PCP (primary care provider). There are many reasons but most revolve around economics.

PCP reimbursements are so low that many cannot cover their overhead.

PCP's earn less than any other physician. At the other end of the scale are anesthesiologists, neurosurgeons and radiologists.

Recent med school grads are shunning primary care in favor of a specialty.

A small percentage of existing PCP's are moving to a cash only basis or establishing concierge practices.

All of this is occurring while demand for PCP services is increasing.

This is especially true in states where health insurance mandates are being rolled out.

States such as Massachusetts.

According to the Massachusetts Medical Society, nearly half of all internists aren’t accepting new patients. For Bay Staters who are lucky enough to have a doctor, the average wait for an appointment is now over seven weeks. As the state moves hundreds of thousands of the uninsured into the health care system, retail clinics can reduce demand on over-burdened providers.

Seven week wait time.

Hundreds of thousands of uninsured's moving in to the demand side of the market.

Mandated coverage + the promise of free or heavily subsidized coverage is pushing demand for PCP's.

That is the bad news.

The good news is this creates a market for the walk in clinics.

Approximately 55 percent of customers who seek care at Wal-Mart’s clinics are uninsured, with 10 percent to 15 percent reporting that they would have otherwise used the emergency room.

We have been proponents of the walk in clinics for a long time for many reasons. They are convenient, affordable and deliver a high level of care within certain parameters.

Retail clinics show how the lure of profits creates opportunities for competition and quality care at an affordable price.

We don't see clinics totally replacing the need for a fully staffed PCP but their business model seems to be a hit.
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