Primary-care Physicians Might Soon Be Competing, Partnering With Walmart

November 11, 2011
Aubrey Westgate

Walmart is exploring the possibility of offering "complex" primary-care services within its stores.

Patients are already stepping into Walmart for flu shots. Soon they could be frequenting the retail giant for asthma treatment, depression, diabetes monitoring, and physical exams.

In October, Walmart issued a request for information seeking partners to help it build “a national, integrated, low-cost primary-care healthcare platform that will provide preventative and chronic care services that are currently out of reach for millions of Americans.”

It’s important to note that John Agwunobi, president of Walmart U.S. Health & Wellness services, issued a statement November 9 that the RFI is “overwritten.” But he did not specify exactly what that means, and Walmart could not be reached for comment.

Regardless, it’s clear the retailer is at least exploring the possibility of expanding its primary-care services within its stores.

Family physician Glen Stream, president of the American Academy of Family Physicians (AAFP), told Physicians Practice it appears Walmart is attempting to fill a growing demand for primary-care services in the healthcare system.

“Perhaps they see this as an effort to fill an area of need,” he said. “With that said - and I’m very much trying to give them the benefit of the doubt - I would say that I would find serious concerns with how they would propose doing that in their retail store environment.”

As written, Walmart’s RFI states that its main objectives are to “lower the cost of healthcare while maintaining or improving outcomes and expand access to high-quality health services by becoming the largest provider of primary-healthcare services in the nation.”

Stream takes issue with both objectives. The first, that it seeks to reduce the cost of primary-care, is unreasonable, he said.

“A glaring misconception in their concept, in my opinion, is that the excess cost in our healthcare system is not in primary care,” Stream said. “It’s in specialty services, procedures, imaging studies, hospital care, emergency care … the whole concept of squeezing out cost is just, sorry, it’s absurd.”

As far as the second objective goes, to become the largest provider of primary-healthcare services in the country, it’s the range and scope of services Walmart seeks to provide that worries Stream. The retailer may be underestimating just how “complex” primary care is, he said.

The RFI asks interested parties to spell out their expertise in a wide variety of complex primary-care services, including managing and monitoring patients with health conditions such as asthma, HIV, arthritis, depression, and sleep apnea.

“Primary care doesn’t operate in isolation, it operates as an important hub of a patient-centered system,” Stream said. “If at one store you get this treatment, at another store you get that treatment, and your regular family doctor doesn’t have any idea what’s going on, nobody’s looking at the full picture.”

Paul Howard, a senior fellow with the Manhattan Institute for Policy Research, told NPR Health that if Walmart’s initiative does move forward, physicians could be partnering up with it in the future. For instance, accountable care organization (ACO) participants could link up with Walmart to help monitor and manage their patient populations.

In addition, the providers offering these additional primary-care services within Walmart would, hopefully, be physicians. You could be courted to join it.

Let us know your thoughts. Is it a good idea for Walmart to offer expanded primary-care services?