Retail healthcare

MARY REICHARD, HOST: It’s Thursday the 3rd of March, 2022.

Glad to have you along for today’s edition of The World and Everything in It. Good morning, I’m Mary Reichard.

MYRNA BROWN, HOST: And I’m Myrna Brown. First up: docs in the box. Delivering healthcare in a retail setting.

Physicians are in short supply. The Association of American Medical Colleges estimates that in just 12 years, this country will have 42,000 fewer primary care doctors than it needs.

REICHARD: But several major retailers are trying to help fill that void. WORLD’s Josh Schumacher reports.

COMMERCIAL: This is where prescriptive care meets preventative…

JOSH SCHUMACHER, REPORTER: Last year, big-box pharmacy chain CVS announced plans to turn some of its stores into doctor’s offices. The company already operates some health clinics. But its new three-year plan includes putting about 350 more doctors in stores across the country.

COMMERCIAL: This is CVS HealthHub. We aren’t just reimagining our stores. We’re reimagining our roles. Creating healthcare that’s more accessible, more personal, better connected, and more comprehensive.

And CVS is not alone. Walgreens and Walmart have similar strategies for moving into healthcare.

So why are these traditional retailers making such a radical change? Like all successful businesses, they see a need and are moving to fill it. In this case, it’s a shortage of primary care physicians like Dr. Omar Hamada.

HAMADA: Primary care means basically, the first physician that a patient will see when they have a medical problem.

The field of primary care includes pediatricians, family and internal medicine doctors, and OBGYNs.

And Americans’ ability to access that sort of care is diminishing. The Association of American Medical Colleges estimates the United States could be short up to 42,000 primary care physicians by the mid 2030s.

Dr. Jeffrey Singer is a physician and a senior fellow at the Cato Institute.

SINGER: The point is, there's no question anybody who's tried to get appointments lately, including myself, with a physician, particularly a primary care doctor, is oftentimes has to wait a while.

And the need for doctor visits is likely to grow.

The Census Bureau estimates that about 10,000 people turn 65 every day in the United States. That means a lot more people are going to need extra care, especially from primary care physicians. At the same time, the average physician is 55 years old—or older—and getting close to the end of their careers.

Meanwhile, doctor wait times have risen as well. Sixty percent of patients have to wait two weeks or more to see a primary care physician. In some areas, wait times are closer to four weeks.

And Dr. Omar Hamada says, the shortage is only going to get worse, for two main reasons.

HAMADA: One, the older docs are retiring, and many of them are now retiring earlier, especially because of what's been happening over these past couple of years with the pandemic.

Hamada says this retirement wave is partially due to physicians just feeling overwhelmed. Part of it is irritation about increasing regulations. And part of it is just a lack of morale.

HAMADA: The other thing is that more and more physicians are avoiding primary care and going into the sub specialties.

That’s mostly because primary care physicians make less money than other doctors. Hamada says primary care physicians often begin their practice in six-figure debt. After all, they’ve gone through four years of college, four years of medical school, and three years of residency. But once they get into the workforce, they’re making five-figure salaries and working 70 to 80 hours a week.

HAMADA: So somebody has to really want to be a primary care physician to go into these days.

But patients still need primary care. Dr. Jeffrey Singer says some outside-the-box solutions could help fill that gap.

SINGER: There's a lot of opportunity to increase the healthcare workforce.

One of those opportunities involves nurse practitioners.

SINGER: Some states, for example, a state in which I practice Arizona, allows nurse practitioners to practice independently of physicians as primary care providers. And the evidence is they do an excellent job providing primary care, but other states require them to work for or under the supervision of a licensed medical doctor.

Another way to get more primary care physicians? Allowing international medical graduates and immigrant doctors to start practicing medicine in the United States. Singer says stringent immigration and licensing requirements limit the opportunities doctors from other countries have to practice medicine here. Loosening those could provide an influx of physicians into the U.S. primary care system.

And then, of course, there’s the new supermarket-like primary care model offered by retailers like CVS, Walgreens, and Walmart.

NARRATOR: We’re expanding our products and services.
SHOPPER: Huh, they do a lot here…

But not everyone thinks that’s a good solution. Dr. Sterling Ransone is a primary care doctor, and the president of the American Academy of Family Physicians.

RANSONE: I think that, you know, the basis of primary care is building a durable relationship with the patient over time. And I think people get better care when they've got a trusted physician that they know and who's known them for years.

Dr. Ransone believes consumers likely aren’t going to get that sort of personalized care at a local pharmacy whose primary focus is turning a profit.

But others aren’t as skeptical. Joe Antos is a senior fellow at the American Enterprise Institute. He welcomes the creative solutions from the likes of CVS, and the loosened nurse practitioner restrictions in places like Arizona, as well as technological advances like telemedicine visits.

ANTOS: The fact is that the U.S. healthcare system, even though it can be very slow and stodgy to adapt to changing circumstances, the fact is that we have seen major changes exactly because technology has made it possible.

And Antos says this might actually turn out to be better for consumers.

ANTOS: I think the average patient should also become more aware that they stand to not only get as good care, but also lower cost to them more conveniently. More, more patients need to recognize that there's a lot in this for them.

Reporting for WORLD, I’m Josh Schumacher.

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