Blog | Thursday, December 22, 2011

Wal-Mart and the daily special on primary care?


NPR and the Wall Street Journal ran stories this week on Wal-Mart's attempt to re-shape delivery and provision of primary medical care in the U.S. The company is soliciting proposals from vendors that offer products and services designed to deliver efficient and inexpensive primary care to the market place.

Then, in an "Oops" moment, the company's VP for health and wellness issued a statement the next day clarifying his intent: "We are not building a national, integrated, low-cost primary care health care platform." A company spokeswoman said that the request for proposals was "overwritten and incorrect."

Huh?

Let's start with basics: Wal-Mart is the world's largest retailer. It employs around 2 million people, far more than any other private sector company in the world. It has combined annual sales of over $400 billion.

Wal-Mart's success is in large part due to its massive supply chain and innovative inventory logistics. It knows what its customers want, it negotiates strongly on price, and then stocks the items in huge quantities, passing on the savings to customers.

This strategy has fueled unprecedented growth and changed many communities in which the corporation operates.

This is not without controversy. Wal-Mart pays its employees lower than average hourly wages, and does not offer health insurance to a significant portion of its workforce. The company is said to be responsible for 10% of the total exports of China; one website reports that 80% of Wal-Mart's suppliers are in China.

What's any of that got to do with health care? I find it an interesting question, one that begets further ones:
1) Could Wal-Mart use its strategic and logistical excellence to build a robust and cost-effective primary care network?
2) Would doing any of this improve the company's corporate image? Imagine Wal-Mart working in service to our national goal of "bending the cost curve" on health care spending, and while doing so providing basic health care services not only to its currently neglected employees, but to the population at large.
3) Is 'straightforward' primary care amenable to widget-ization? Certainly most doctors would argue "NO!"

I will be eager to follow the travails of Wal-Mart as they pursue this enterprise. It may be courageous, outlandish, innovative, and special, or it may become Wal-Mart's Waterloo.

I just hope that whatever happens with health care, they do a better job than they did with this Chanukah display that's circulating the Internet.

This post by John H. Schumann, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.