Trick question.
CVS operates about 550 in store clinics under the the Minute Clinic brand umbrella.
More broadly, there are about 1,200 total in-store clinics … run by CVS, Walgreen, Wal-Mart, Kroger and Target.
Ken’s Take: These are great providers of routine health care … I’d like to see them spread like wild fire … and, I’d be all for government run “free clinics” in under-served urban and rural area.
TakeAway: A disruptive innovator in the French Telecom industry is growing market share and inadvertently challenging Apple’s IPhone business model.
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Excerpt from Forbes: “Apple’s Business Model Vulnerability, Exposed by a French Upstart”
Free Mobile is up-ending Apple’s prospects in France. Analysts are blaming the firm for driving down iPhone sales by 10% in the past quarter alone.
Free is offering unlimited domestic calls and texts, free calls to many international countries, 3 GB of data, and no contract commitment — all for $25 a month. In exchange, subscribers give up benefits associated with traditional mobile carriers. Free barely advertises, does not invest in proprietary applications; and doesn’t subsidize handsets at all.
Free has won nearly 3 million subscribers in its first three months, and the incumbents are facing intense price pressure.
This is a major problem for Apple. People who have to pay the full price for a handset flock to the less expensive, and technically quite solid, Android and Windows offerings.
The iPhone has always been expensive, reliant upon big subsidies from carriers trying to stand out from their competitors.
Edited by ARK
In AMS, we’ve being reading about Clayton Christensen’s theories on disruptive innovation.
For background, see last weeks post disruptive innovation.
This week, Business Week has a feature article on Christensen — focusing on his life values — but also summarizing his research work, including some criticism.
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Criticism of Disruptive Innovation
If there has been one knock against Christensen’s theories, it’s that they are better as analysis than as a course of action.
It’s something Christensen and an impressive network of co-authors and collaborators have worked hard to dispel.
“The theory is more descriptive than prescriptive,” says Larry Keeley, the co-founder of Doblin, a strategic consulting firm in Chicago, who considers Christensen a peer and a friend.
“There are very few robust intellectuals working on innovation, and I don’t mean to take anything away from Clay’s accomplishment when I say this, but …
[the disruption theory] strikes me as an incomplete idea.”
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Christensen on life values:
“To understand a company’s strategy, look at what they actually do rather than what they say they do”
The same logic applies to one’s life. For example, ambitious people will reliably tell you that family, or being a mother or father, is the most important thing in their lives.
Yet when pressed to choose between racing home to deal with a chaotic pre-bedtime scene and staying another hour at the office to solve a problem, they will usually keep working.
It’s these small, everyday decisions that reveal if you’re following a path to being the best possible spouse and parent.
“If your family matters most to you, when you think about all the choices you’ve made with your time in a week, does your family come out on top?”
That’s a question I often ask.
Everybody knows that some people use ERs in place of a primary care physician or an urgent care clinic.
That’s costly to the healthcare system since an average ER bill is around $1,000 while an average bill at a Minute Clinic or one of Walmart’s ProCare clinics is about around $50.
Currently, Federal law requires ER physicians to look at everyone who comes to the ER and treat those who have life-threatening illnesses or injuries.
So, the “system” has pay a $950 premium and seriously hurt or ill patients get to wait in long queues to get treated.
Bad deal all around..
A hospital in Odessa Texas is trying to attack the problem buy requiring patients to post a $250 deposit if they want to be treated in the ER minor ailments
According to OAOA.com…
When someone comes into the Medical Center Hospital ER, they’re assessed to determine the severity of their ailments.
Based on the examination a doctor decides whether or not the person’s injury or illness requires a stay in the ER.
If the injury or illness is determined to be minor, they’ll be directed to a local clinic rather than be treated in the ER.
People with chest pains, abdominal pains or high risk conditions like tuberculosis are the types of patients who would not be redirected to a clinic.
In addition, children younger than 10 years-old and adults older than 65 years old will not be redirected either.
But if that person chooses to remain in the ER and have their minor ailment treated there, they will have to pay a $250 deposit,
The new measure is part of an effort to redirect those without serious issues to more appropriate places for treatment and streamline the ER.
Sounds like a step in the right direction, but I still gotta ask: Why aren’t there Minute Clinics next to every ER?
Have a stern triage nurse out front directing folks to turn right into the ER or turn left into the clinic.
Everybody gets appropriate treatment and we actually save some healthcare costs … rather than just shuffling around who pays for what.
Punch line: Clayton Christensen – the guru of disruptive innovation – says that the US healthcare system needs some seriously disruption … to improve quality and cut costs.
Here’s a summary of his prescription.
Excerpted from MIT Sloan Review: Good Days for Disruptors – An Interview with Clayton Christensen Spring 2009
Every disruption has three components to it: a technological enabler, a business model innovation and a new commercial ecosystem.
In health care, the enabling technology is the ability to diagnose diseases precisely.
Now, through molecular diagnostics, enabled by our understanding of the genome, and through imaging technology that allows people to look inside the body with remarkable clarity, we are acquiring the ability to precisely diagnose more diseases by their cause, not by their symptoms.
That ability then enables us to develop rules-based treatment and a predictably effective therapy.
Our hospitals are, like mainframe computer companies, hopelessly complicated and very expensive.
To ever expect today’s hospitals to become cheap is a pipe dream.
Instead, we need to bring technology, in the form of precise diagnostics and predictably effective therapy, to outpatient clinics so you can do more and more and more of the things there that in the past required a hospital.
And then we need to bring better diagnostic technology to doctors’ offices, so you can do more and more things there that previously required a clinic.
And to nurse practitioners, so they can take on more and more of the things that in the past required a doctor.
Yes, I’m a big fan of MinuteClinics — walk-in clinics that inexpensively treat common disorders such as strep throat and bladder infections.
The hospital is really not a viable business model because, in general, its costs are driven by overhead, which is driven by complexity.
In a large general hospital, much of the cost is overhead cost that’s not expended in the direct care of a patient.
While cost is driven by complexity, quality is driven by integration. It’s when we don’t integrate things correctly that problems fall through the cracks.
Specialized health care institutions, whether they are focused hospitals or focused diagnostics clinics, can integrate correctly, and because of their focus, they have much lower overhead costs.
You get better quality and lower cost.
The Homa Files 