change of plans

[Smallsteps]

https://journaltimes.com/news/nation...354f3d1c6.html

So I came across this article after i had read on threads here about various store opening health clinics. According to this article Walgreens wants to replace 40% of their clinics with other options.
I am not sure if that will be a trend that this idea of medical options is not really working or it is more about the profit/ foot traffic they assumed would come in.

[disneysteve]

Interesting. I can't say that I'm surprised that their walk-in clinics don't create much income for them. And there is a ton of competition. The article mentions telemedicine services. That's a small piece of it but I think urgent care clinics are a much bigger issue. And even in that realm, there is a bunch of competition. My thought is that the urgent cares that are part of a larger healthcare network are better positioned to benefit than those that are independent. Putting a clinic in a pharmacy might attract some customers but probably not in any meaningful way. I wouldn't suddenly start buying all of my pharmacy needs at Walgreens just because that's where I happened to get my flu shot this year.

With the healthcare system-owned UC though, it's different. If my family doctor is with XYZ Health and so is my cardiologist or GI doc or my wife's GYN or my daughter's orthopedist and we need an UC for something, there is a big advantage to going to the XYZ Heatlh UC clinic because they have all of our medical records and each of our regular doctors and specialists will then also have access to anything that happens at the UC visit. I frequently have patients tell me that they will only come to our UC for just that reason.

And it works in reverse, too. If I see a patient who needs follow up after my visit, I can refer her to someone in our system, thus generating additional and ongoing income for the system. The UC serves as a way to recruit new patients not just for the UC but for the entire healthcare system it is a part of. Walgreens has no such network. All they can hope is that the next time you need some antacid or a bottle of Advil, you'll go there to get it but that's probably not the case.

[kork13]

Similar to what Steve said, I think that Walgreens/CVS simply face too much competition in the space (not to mention their idiotic tit-for-tat placing a CVS on the opposite corner of every Walgreens & vice versa). I personally think that dedicated pharmacies are going to struggle moving forward in general, because there are so many other places that offer the same (or more expansive) services in more convenient locations. Target/Walmart/grocers/etc. are the big players, and they offer not only pharmacy services, but the full gamut of grocery & household items. I think Walgreens/CVS will eventually get squeezed out of the mini-clinic space by urgent care clinics, as well as Walmart's forthcoming offering...but eventually I think they'll get bought up and be completely consumed by the large supermarkets like Target/Walmart. It's already started -- hasn't CVS been moving into Target locations? Or is that Walgreens? (I can literally never remember the difference between Walgreens/CVS -- they're the same in my mind).

[disneysteve]

Yes, CVS took over Target's pharmacy operations a couple of years ago.

I don't think free-standing pharmacies like CVS and Walgreens are suffering at all though. They are doing gangbuster business, which is why they keep building them on every corner. What they have been steadily pushing out is the small independent pharmacies who do little more than fill prescriptions, because that's not where the money is. It's also why CVS and Walgreens locations are far bigger than they used to be and sell lots more than medications: candy, beer and wine where that's allowed, groceries, school supplies, holiday decorations, etc. Some CVS stores today are nearly the size that supermarkets used to be when I was young. I don't see them fading away anytime soon.

[Smallsteps]

Yes, CVS took over Target's pharmacy operations a couple of years ago.

I don't think free-standing pharmacies like CVS and Walgreens are suffering at all though. They are doing gangbuster business, which is why they keep building them on every corner. What they have been steadily pushing out is the small independent pharmacies who do little more than fill prescriptions, because that's not where the money is. It's also why CVS and Walgreens locations are far bigger than they used to be and sell lots more than medications: candy, beer and wine where that's allowed, groceries, school supplies, holiday decorations, etc. Some CVS stores today are nearly the size that supermarkets used to be when I was young. I don't see them fading away anytime soon.

In many cases i wonder how these free standing places stay open in my area. We have been over saturated by urgent care clinics for YEARS here yet even local drug stores have had these mini clinics in them. I think in my lifetime i set foot in these places maybe a dozen times.

Maybe i am a unusual, if i BELIEVED the pharmacy commercials every person in America has at least a half dozen prescriptions.... I have none.
Perhaps that is a bigger issue if the gangbuster business is on medications.....people are way over medicated.

Most other items i ever saw in these stores like candy / and other items are marked up too much. I never understood why there are so many of these around. they never look busy enough to pay staff.

[kork13]

. I never understood why there are so many of these around. they never look busy enough to pay staff.

This is largely what I was going after..... I don't see how they have enough business.

[Smallsteps]

This is largely what I was going after..... I don't see how they have enough business.

There has to be some reason they throw money into making a clinic then scrapping 40% of them.
Now talking about adding diet centers their must have been some cost involved in creating rooms for a mini clinic and then signage/ advertising etc..... then nope we are going a different direction.
It seems like money wasted..... like painting your living room every 6 months.

If the money is all in prescription drugs............. we as a country should really examine why? Is there REALLY a pill for everything? or perhaps we follow the money.
If there is a pill..... it never cures..... it just becomes an.... addiction.
After years of taking some pill and no real progress... we are told to switch to the "new and improved" pill that simply means something that still has a patent to keep the price up.

The "studies" change to lower the level that was once considered AVERAGE.... for example cholesterol.
So after that whole group is on a statin we need to lower the level to increase the potential customer base.
We have people convinced nothing else will work you must take this pill forever...

[disneysteve]

If the money is all in prescription drugs

Nope. That's not where the money is. As I said above, that's why the pharmacies like CVS and Walgreens have grown in size over the years and the independent pharmacies have slowly died out. Filling prescriptions is not where they make their money. They make their money with all of the other merchandise and other services they can provide. CVS stopped selling tobacco but I think Walgreens still does. Candy, grocery items, ice cream, wine and beer, cosmetics, hair care products, personal care products like feminine items and diapers, toys, greeting cards, seasonal things like holiday decorations or barbecue supplies, and medical supplies like vaporizers, reading glasses, canes, glucose testing monitors, etc. That's where the money is.

I had a friend for years who owned an independent pharmacy. He would often tell me stories of filling prescriptions on which he actually lost money because the meds cost him more than the insurance company paid him. Or maybe he made a small profit but still had to account for the bottle, the label, the computer system, the staff, the rent and utilities, the licenses, and any other overhead.

As for your point about a "new and improved" pill, you're not wrong about that, but most doctors are wise to that ruse. Nationwide, in 2018, 90% of prescriptions were for generic medications. That's up from 60% in 2005. Those "new and improved" drugs get very little action. Most of us prescribe almost entirely generic drugs that have been around for years and are much cheaper and have better insurance coverage.

If there is a pill..... it never cures..... it just becomes an.... addiction.

Regarding this comment specifically, most chronic health conditions don't have cures. That's why they are chronic conditions. High blood pressure, high cholesterol, diabetes, arthritis, whatever. We have various ways of treating them and controlling them and slowing progression but we can't fix them for good. If you have to take a blood pressure pill for the rest of your life, that's hardly an addiction. It's a treatment. Those are two wildly different things. Would you say a diabetic is addicted to insulin?

[Smallsteps]

[QUOTE=disneysteve;n703593]

Nope. That's not where the money is. As I said above, that's why the pharmacies like CVS and Walgreens have grown in size over the years and the independent pharmacies have slowly died out. Filling prescriptions is not where they make their money. They make their money with all of the other merchandise and other services they can provide. CVS stopped selling tobacco but I think Walgreens still does. Candy, grocery items, ice cream, wine and beer, cosmetics, hair care products, personal care products like feminine items and diapers, toys, greeting cards, seasonal things like holiday decorations or barbecue supplies, and medical supplies like vaporizers, reading glasses, canes, glucose testing monitors, etc. That's where the money is.

Maybe in your area this is true.
I was curious so asked an employee at a nearby store that honestly i saw only one other person in and i purposely stayed over an hour. the volume just is not here but they somehow stay open. there literally are 6 similar other outlets in a 4 sq mile area. The amount that the employee told me was average (she only had data from the store side not pharmacy section accounted separately) did not add up to cover rent lights etc let alone the employees unless they are running in the red.

As for the other comment yes some are needed and are just helping a condition...... but as i am surrounded by an elderly group near where i live i had coffee with some ladies.
One had all her meds looked at by a new doctor and simply put she did not need a few of them. but the previous office kept on authorizing the refilling ..........................she alerted the group to ASK and check and most ladies had at least one or more meds discontinued.
Some of these ladies should have not been on them but bought the idea that if no longer needed someone would quit refilling ..... but somehow that didn't happen.

HBP and high cholesterol both can be treated with lifestyle change etc but STATINS are a well known big revenue $$$$$$ to pharmaceutical companies.

[disneysteve]

HBP and high cholesterol both can be treated with lifestyle change

Lifestyle change should absolutely be PART of the treatment, but it is very rarely adequate to get those conditions under control. Diet, exercise, quitting smoking, reducing salt intake, limiting alcohol intake, cutting back on caffeine, etc. are all great things to do but if you have high blood pressure or high lipids (or both), odds are extremely high that you will still need medication to manage them and minimize your chances of long term complications. Both diseases have a genetic basis that you can't fix by losing a few pounds or spending more time on the treadmill.

To your point about folks having meds they may not need, I agree with that. You should get in the habit of periodically asking your doctor if you still need everything you are taking.

One huge problem in my opinion is the auto-refill programs at the pharmacies. They will keep filling a prescription month after month whether the patient still needs it or not (or the doctor ordered it or not) so the patient just assumes they're supposed to keep taking it. I hate those programs and it is frustratingly difficult to get them to stop doing it.

[TexasHusker]

There is not enough profit in primary care clinics to make much money over and above what the doctors make. Stand alone ERs are quite another story, although many markets are saturated with those, too.

Hospitals and big pharma is where all of the insane profits are.