The COVID-19 pandemic caused the perfect storm for retail health clinics to become a mainstay in primary care. People are getting sicker and there are fewer primary care providers to treat them, so heading into the new year and beyond, retail clinics may be top of mind, according to Forrester Research’s Natalie Schibell.
“We saw this tremendous rise of consumerism where people wanted in their healthcare experiences what they’re experiencing in retail: everything at their fingertips here and now in their moment of need,” Schibell, a VP and research director for Forrester, said in a call about the healthcare landscape come 2023.
Traditional healthcare is not equipped to handle this, she added. For decades, the medical industry has been known to be behind the times in terms of technology adoption and use, and it’s consequently been slow to catch up to the demands of consumerism.
The COVID-19 pandemic made everything more difficult by making people sicker, putting patients behind in their primary and preventive care services, and exhausting the healthcare workforce.
Retail health clinics stand poised to fill in those gaps by fusing their expertise in consumer behavior with their existing models for episodic care. But challenges might also stand in their way.
Traditional healthcare has been behind on consumerism for a reason: primary care is very difficult, Schibell said. Amid calls to support a longitudinal patient journey, retail health companies will need to make major adjustments to shift from their previous episodic care models to adapt to the primary care setting.
COVID-19 MADE THE POPULATION SICKER, CLINICIANS BURNT OUT
Primary care is beleaguered right now simply because people are sicker and they need more from their clinicians. Most Americans have a chronic disease, with around six in 10 having one chronic illness and four in 10 having two or more, Schibell said.
The pandemic certainly didn’t help that situation. Patients didn’t access primary and preventive care during the earliest aughts of the pandemic, leaving more folks with undetected illnesses or advanced stages of cancer that demand medical attention right now. That’s not to mention long COVID, which mystifies healthcare providers who are struggling to predict, diagnose, and treat it.
That’s amid a backdrop of an aging US population; by 2030, about a fifth of the population will be over age 65 and potentially need more medical attention.
That exacerbates another key pandemic consequence: clinicians are seriously burnt out and exhausted.
“One in five healthcare workers have left the industry since March of 2020 from stress, burnout, PTSD from the COVID-19 pandemic that continues to loom,” Schibell said. “And they can’t simply hire enough individuals. There’s lots of turnover and they can’t even man the educational institutions with enough lecturers. And because of that, they can’t bring in more students.”
And the students that are enrolling in medical school don’t want to go into primary care, Schibell added.
“They want to be specialists,” she stated. “Why? Because when they graduate medical school, they don’t want to come out with these exorbitant loans that they can’t pay for. If they become a specialist, they know they’ll make more money, and they’ll have less debt.”
On top of that, primary care is simply difficult. The administrative burden is enormous, pushing some providers to retire early and some budding medical professionals to pick another specialty.
That clinician shortage is particularly damaging because patient healthcare needs are evolving, Schibell added. Patients are more activated than ever, and after getting a taste of more consumerism medical benefits at the hands of the pandemic, they want more.
“Healthcare has been failing to do that for many, many years,” she explained. “We’re seeing that primary care is broken today. There’s been a lack of empathy. There’s been a lack of access to care due to individuals going through long wait times to get not only primary care appointments but specialty care appointments.”
Patients don’t want to wait an average of 26 days to get a medical appointment; they want their healthcare when they need it, personalized to their preferences and delivered in a seamless way.
Traditional primary care isn’t equipped to do that, at least not yet.
But retail health clinics might be.
RETAIL HEALTH CLINICS SATIATE THE APPETITE FOR CONSUMERISM
Retail clinics have a leg up on the healthcare consumerism trend because they are managed by companies that are also in the retail space. CVS, Walgreens, Walmart, and more are experts in understanding consumer behavior, and they can apply these principles to their medical offshoots.
That’s important because that is where patients want to be; they want the experiences they have in other services sectors in their healthcare interactions, too.
“Right now, people are going online,” Schibell said. “They can order everything from eyeglasses to mattresses. They don’t have to wait. They can get it within 24 hours or so, or even same day via Amazon, via courier services, Instacart.”
The pandemic accelerated this by putting telehealth and other direct-to-consumer healthcare companies at the forefront. Some of these retail-focused companies even paired up with healthcare companies—Schibell mentioned the partnership between Gopuff and telehealth company Wheel Health.
“People got used to that, and it’s now become a business imperative to increase the personalization of experiences,” Schibell noted.
“People certainly do not want to wait 20 days for an appointment. They don’t want to have to call somebody up on the phone. They want it to be seamless,” she continued. “And a lot of retail organizations came up with online appointment scheduling so that you would go to the store, you’d get what you needed, or it could possibly be delivered in the home environment. And so patients wanted that, they crave that, and now they demand it.”
But retail health clinics can’t just flip a switch to primary care mode. Retail clinics were designed for episodic care, which is counter to the patient-centered care that’s important in primary care settings. As retail health clinics explore their potential to shake up primary care, Schibell said they’ll have to contend with some unique challenges as well as the ones that have plagued traditional primary care for years.
LONGITUDINAL CARE JOURNEY, DATA MAY STYMIE RETAIL HEALTH
Schibell predicted that retail clinics will have trouble with adapting to the longitudinal care journey that primary care promises. About three-quarters of people have a usual source of care, normally a primary care provider, and many see that same PCP for years out of their lives. Primary care is known to be fulfilling because clinicians can forge long and deep relationships with patients and have a fuller understanding of their medical histories.
“That is the number one challenge of this major paradigm shift that retail health is undergoing into primary care,” Schibell said. “Traditionally, retail health focused on acute and episodic kinds of care. Someone came in there with a cold or possibly strep throat. It’s episodic, and you might not see that patient again.”
Retail health clinics were usually frequented by people ages 20 and 42 and women with kids—people who want to address an acute issue quickly, maybe get a prescription, Schibell noted. It was in the primary care office that people got nudges to access preventive care and screenings and guidance about their holistic health and well-being.
Making that pivot is going to be hard, Schibell pointed out.
Moreover, retail clinics are going to need the information to get a longitudinal view of the patient. Even traditional primary care clinics have trouble with that right now, with health IT interoperability limiting the information PCPs can view from specialists or other providers or even direct-to-consumer types of care like Ro Health or Hims & Hers.
“And that’s the biggest challenge, in addition to the staffing issues of primary care, is healthcare interoperability,” Schibell noted. “Now, there’s this huge risk of duplicative and disruptive care and retail health is supposed to drive down the costs, make it nice and efficient. However, if you’re not getting a holistic view of the patient, this can go very wrong.”
“With great transformation and with great digital innovation comes great responsibility,” Schibell concluded. “And the biggest responsibility, as I see it, is the need for a flow of health information on these patients.”
Source: PatientEngagement Hit