One of the major changes in healthcare delivery has been the successful implementation of retail clinics.  They obviously have had an impact on the physician community as evidenced by this pushback they are getting from the AMA as described in a recent Forbes blog.  This has been fueled by the recent announcement that Walgreens is going to expand their services beyond the simple ear aches and other minor acute care offerings.  Yes, they are going right at the core of medical practice, the treatment of chronic care conditions such as hypertension and diabetes. With the impending flood of newly insured patients coming into the market in 2014 this could be a significant market changer.

Think about the market dynamics that are going on here.  Pharmacies have taken over significant control in the drug area through their intense work switching patients from brand name products to generics.  They constantly manipulate the switch from more expensive to less expensive drugs.  They already control in so many ways continuity of care through their refill callback systems.  They are already taking charge of the patient and the long-term care of their chronic conditions.  When was the last time you got a call from your primary care physician saying it is time to come in for a visit.  Dentists and eye doctors do it all the time and drug stores constantly call to remind you when refills are due, but doctors don’t really seem to care.  Pharmacies already have taken over a significant share of the vaccine business, an area totally controlled by physicians a decade or so ago.  They also do much of the education on how to prepare for a colonoscopy, how to read a pregnancy test, how to take insulin and many other things, which some would say should have been done by the physician or others in their offices.  The retail clinics have already been accepted as places to get quick and easy medical care, so why not move into more complex areas of medicine?

The real issue here is that physicians have ignored their core business and this has allowed retail clinics to fill the gap.  Physicians have given up going to hospitals which has eliminated their central role in caring for the patients.  They have allowed specialists to take much more control over their patients which also has lessened their role.  They never have walk-in hours which makes scheduling burdensome and not worth the effort if there is a clinic a block away.  They try to limit their hours and don’t push for follow up visits like they did in the past.  They religiously follow formularies and treatment protocols, which might be good for payers but in so many ways eliminates the use of their clinical skills.  If everything is done “cook book” fashion than there is no need for the master chef, right?  Note that part of the AMA rules for these retail clinics calls for following protocols.  Why go through the hassle of going to a physician when everyone is following the same set of guidelines and you can get the exact same care a block away at any time?

There are a lot of lessons here for the pharmaceutical marketing community.  First, there is an obvious mega-trend taking place and this begs the question as to whether you and your company have embraced the retail clinic world?  How many are there in the country?  Do you know who works which clinics?  Do you have any idea how much care and for which disorders is being delivered in each clinic?  Do you have specific marketing plans for this segment?  Oh wait, I know the limitations involved here.  The reps are not central here, right?  The data is not readily available, right?  There are corporate rules that limit your marketing options.  Has your response been to try to fight through these barriers and figure out how to work with these providers or have you just thrown up your hands and given up on these markets, like you have with Medicaid and other difficult to win markets?  You see the lesson from the physicians is that the more you give up the less relevant your role will be in healthcare.  Begin to compete for all the business, all the time as if your future depends on it.