Kiwi Polemicist

December 5, 2008

Wal-Mart: food, lawn mowers…and health care

Yes, you can go to one of the famous (and infamous) Wal-Mart shops to get your food for the week, get a lawn mower, and get your earache seen to.

Before I get to the health care a little background information is needed because the size and reach of Wal-Mart is almost incomprehensible for New Zealanders. In the US it has 4,100 shops and 1.4 million employees¹. 53% of the US population lives within 5 mi/8 km of a shop, 90% live within 15 mi/24 km, and 97% lives with 25 mi/40 km².

Wal-Mart has long had pharmacies in their shops, and hundreds also have medical clinics. Basically Wal-Mart leases clinic space to a variety of companies, one of them being RediClinic. This health care model is unknown in New Zealand, so let’s have a look at the RediClinic service.

  • the  clinics are normally near the front of the shop, offering a range of fixed-prices services. The price board is clearly displayed and health insurance isn’t necessary (getting medical care without health insurance is a problem in the US): the services are cheap by US standards. The clinics are open seven days a week and you just walk in. RediClinic says that you should be done in about 15 minutes, but if there’s a queue they’ll give you a pager so you can shop while you wait
  • the clinics don’t have doctors, they have “clinicians” or nurse practitioners. If something is outside their scope of practice they’ll boot you towards a doctor
  • the clinics will only treat people aged two or older, presumably because small children can get very sick very quickly and more skill is needed for an accurate diagnosis
  • they will only treat a limited range of conditions. Apart from screenings, health checks and immunisations, they will treat things like colds, sinus infections, earaches, minor skin problems, minor eye problems, tummy troubles and urinary infections. They can’t treat chronic conditions; this service is for minor and transient illnesses
  • Wal-Mart requires all the clinics to use decision-support software. The functionality varies, but this type of software may suggest diagnostic questions, offer a list of possible diagnoses, and assist with prescribing. It’s designed to reduce the risk of misdiagnosis and provides some medicolegal cover
  • the nurses can prescribe for the conditions that they treat, and you can get your medicine at the pharmacy which is also within Wal-Mart

This wouldn’t be my cup of tea because I prefer the continuity of care that a family doctor provides, but there clearly is a demand for it. I can see that it would be very handy for busy mums, travellers and those who don’t have health insurance.

The clinics are an excellent example of the free market identifying a demand and providing the desired service: can you imagine a government department putting health clinics into the uber-capitalist Wal-Mart shops?

What do you think about these clinics? Would you use them?

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This is what happens when you go shopping at Wal-Mart

cartoon-nurse-says-left-or-right

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Interesting reactions from the medical community can be found here and here.

Wal-Mart also has about 3,000 optometry clinics in its shops. Click here for more information.

1. walmartstores.com

2. Charles Fishman, The Wal-Mart Effect, p213

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3 Comments »

  1. wow. walmart is providing any and everything these days. If only they could provide safety on Black Friday.

    http://athleticpedia.wordpress.com/

    Comment by K.C. — December 5, 2008 @ 2:18 pm

    • K.C: Their crowd control does seem to be lacking, but if everyone behaved decently there would be no need for crowd control.

      Comment by kiwipolemicist — December 5, 2008 @ 2:40 pm

  2. Certainly a service I would appreciate if it was available here.

    Comment by Mum of Eight — December 5, 2008 @ 7:02 pm


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