Now that CVS and Aetna are merging, what happens next? Ignoring the obvious dangers of creating such a large vertical monopoly in the delivery system for now, will everyone who has Aetna insurance have to get care through CVS minute clinics? From a non-CVS provider's standpoint, that sounds scary, but from a patient perspective, it may not seem so bad. Many patients have grown tired of waiting on hold to make appointments just to deal with endless waits in the waiting room to see their physician. They are used to being treated by another provider working for their doctor.
New urgent care clinics continue to open and many patients like being able to walk right in, no appointment necessary, and get treated right away. For basic concerns, the convenience is worth the additional co-pay.
So, now Aetna and CVS take convenience one step further. Patients get to be treated without an extra co-pay, like at urgent care, and get one-stop care and pharmaceutical shopping, while Aetna gets to pay the lower-level providers at the CVS clinic less. Everyone wins, right?
Not really. As Medical Economics pointed out in its recent article, CVS-Aetna deal could be costly for independent physician practices, this merger is certainly not in the best interest of independent physicians or even those in larger groups. And it's really not in the best interest of high-need patients who are often juggling multiple health issues and need the lifestyle support and coaching of a trusted physician who actually knows them.
So how can independent physicians or private groups compete with convenience? The key for physicians is to differentiate themselves from the ever-growing competition that lower-level providers and quick "minute" care offer.
As any patient who's ever found themselves in a vulnerable position knows—there is no substitute for a doctor who truly knows you. When you don't feel well and you're pretty sure it's pneumonia because you've had it before and you know the signs, will the provider, not necessarily a doctor, at the minute clinic who's boss is also paying your bill believe you, even though from her perspective (rightly), she thinks you just have a cold?
The doctor who knows you and your health history will take you seriously. That doctor knows you rarely come in complaining of a cold, and they remember that last bout of pneumonia you had. They know you are prone and they give you an X-ray immediately. For senior patients—this kind of personal care can be vitally important.
What is convenience if it's not accompanied by quality? Patients should beware—cheap is a false economy. Private physicians need to compete by delivering value to patients—convenience plus quality. Concierge medicine does just that. It offers all of the convenience that patients get at urgent care and minute clinics, but combines it with the quality care that only the doctor who truly knows them can provide. It's a way for physicians to show patients they hear them and respect their need for convenience and efficiency, while also standing firm against the depersonalization of medicine that goes against the way they were trained to practice.
Reports show compliance with treatment regimens is greatest when patients report a close relationship with their doctor. For a pre-diabetic patient, being accountable each time they visit their trusted doctor is just the motivation they need to stick with nutritional guidelines and fitness plans that are not just life-saving, but also cost effective by reducing greater medical expenses down the line. Will these patients feel as accountable to the clerk at the pharmacy window who may or may not ask them to step on a scale?
We recognize that the healthcare marketplace is diverse and requires an array of options. A minute clinic can be a great option for young and healthy patient who need a quick flu shot or screening.
But for many, membership medicine is exactly what the doctor ordered. Some physicians are uncomfortable with models that force patients to pay membership fees, but there are several models that allow for much greater flexibility. A doctor can treat fixed-income patients, Medicaid patients, traditional patients and concierge patients. What is key is that they offer a good alternative to the convenience factor that is working hard to lure away their loyal patients.