Keep Walmart Out of Your Healthcare!

  • by: Kim Jackson MD
  • recipient: Walmart CEO Doug McMillon and Executive Vice President, Consumables and Health and Wellness and U.S. Manufacturing Lead, Walmart U.S. Michelle Gloeckler

KEEP WALMART OUT OF YOUR HEALTHCARE!

A few years ago, Walmart failed at a foray into acute care due to poor management; instead of scaling back, the megastore has regrouped and in partnership with Quad Med, is attempting to replace your Primary Care Physician (i.e. your Family Doctor, Pediatrician, and Gynecologist etc.) with questionable practices. Yes, Walmart is rolling out clinics in its stores, and your health will likely suffer. Here’s why.

• WHAT’S THE FOCUS? The goal of a medical clinic should be total patient care NOT money. Walmart has long faced allegations of human rights violations, global and domestic, including sweat shops, underpaying workers, and anti-union practices all in the name of the bottom line. According to Rachel Abrams in the article, “In Ambitious Bid Walmart Seeks Foothold in Primary Care Services,” like its competitors, Walmart is looking to grab a bigger share of the billions of health care dollars and benefit from the changes that have resulted from the Affordable Care Act. At the same time, it has shifted to hiring temporary workers in order to avoid providing workers health care. Furthermore, the indirect revenue that comes from incidental purchases while in store has not gone unconsidered by Wal-Mart because you may as well get milk and bananas while you’re getting checked for the flu or better yet why not get your meds from THEIR pharmacy.

• CONVENIENCE OVER QUALITY? Care clinics are staffed by nurse practitioners. The difference between Nurse Practitioners and Primary Care Physicians may not seem great to some, but according to Dr. Davis Liu in the article, “Why Nurse Practitioners Should not Do Primary Care without Physician Oversight,” besides the radical difference in training and practice hours, it is the “listening, examining, and diagnostic skills of the primary care provider that makes the difference between ordering the right tests, the right treatments, and if needed, the right referrals or ordering too many unnecessary tests, prescribing inappropriate treatments, or generating extra referrals.” In the same vein, Dr. Robert L. Wergin, president of the American Academy of Family Physicians, states that retail clinics have no place in taking care of chronic, ongoing problems like diabetes which can result in complications that are not easy to manage. Primary care is complex. Things can get missed."


• FRAGMENTED CARE. A great portion of the efficacy of a primary care physician is based on relationship. In the article “The Case Against Drugstore Clinics,” Dr. Richard Gunderman asserts that the quick and episodic character of many retail clinic visits tends not to foster the kind of long-term, personal relationships to which many primary care physician visits contribute, the kind of relationship that allows the doctor better insight into a patient’s symptoms.

• COMPLIANCE. As well, compliance and conflict of interest issues make Walmart’s venture especially sticky. What referrals will these in-store practitioners use? If a practitioner’s spouse is a nephrologist, would it not be pretty likely that a patient is referred to that clinician? Are they compliant with state regulations? For instance, some insurances require patients to see doctors from 1st and intermittent visits, how can this be done if doctors aren’t in clinical roles on site? How can Walmart be in compliance with anti-kickback laws when it has in-store pharmacies, over-the-counter meds, and additional therapies on its many aisles that the practitioner can direct the patients to purchase?

• PATIENT PRIVACY. Walmart clinics employ an open air format, which brings to concern privacy and confidentiality issues. When patients are going to doctor’s offices, everyone present is there to receive health services so a certain decorum and expectation of privacy is in place. It would be extremely awkward to go home and hear your spouse say, “Yeah, Joe told me he saw you at the Walmart clinic; I thought you were just going to pick up a few things.” This increases the risk of patients not following up or not being as truthful, both of which hinder excellent health care. Even worse, if a person reports to Walmart clinic with the flu or some unidentified contagious disease, gets seen, and continues on to grab eggs and milk, the spread of that disease would be exponential. This business model reflects Walmart’s irresponsibility as well as disrespect and lack of understanding of community health in the first place.

• THE WAL-MART EFFECT. Historically, the expansion of a Walmart store leads to corresponding local businesses going out of business. The sheer size of Walmart, its ability to undercut competitor’s prices and wages, squeezes out competition. This means that when you need your local physician, she or he just may not be there.

We appeal to you, CEO Doug McMillon: new leadership means new direction. Just say no to primary care clinics. Dr. Gunderman boils the sentiment down perfectly with this statement: Do we want to be treated as healthcare consumers or patients? If Walmart is allowed to strong arm its way into health care, the Hippocratic Oath may as well be edited from, “First, do no harm,” to “First, lose no cash.” Call 1-800-WALMART (925-6278), and let them know to stay out of our healthcare.

The medical community understands that better access to medical care is clearly needed. Physicians Working Together with other non physician medical providers as a team in the appropriate medical setting is the best way to do this and we totally support that model!  

Tweet @Walmart #ceasecareclinics #saynotowalmartcareclinics

REFERENCES

Abrams, R. “In Ambitious Bid, Walmart Seeks Foothold in Primary Care Services.” The New York Times. 7 August, 2014. Retrieved from www.nytimes.com.
Gunderman, R. “The Case Against Drugstore Clinics.” The Atlantic. 11 October, 2014. Retrieved from www.theatlantic.com.
Liu, D. “Why Nurse Practitioners Should not do Primary Care Without Physician Oversight.” Retrieved from http://www.davisliumd.com/nurse-practitioners- primary-care-without-physician-oversight/.
http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/326- medicare-update
https://www.caremark.com/portal/asset/Anti_Kickback.pdf
“AMA Calls for Investigation of Retail Clinics”- http://www.medicalnewstoday.com/articles/75308.php
Petition Authors: Kim Jackson, MD; Addie Kitchens, Eric Funches

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