The medical department store

By now you know that things in the medical commerce world are rapidly changing:

1. Patients are now referred to as customers and health professionals, much to their dismay, are now providers. Next they will be called sick care retailers.
2. Online medicine is growing much like online commerce
3. The retail apocalypse continues, and hospitals are consolidating or closing
4. Sick care sales and marketing is evolving to engage and educate patient customers and sickcare retailers are learning how to sell to them
5. The buying experience and convenience has taken precedence over quality as a differentiator for medical facilities and clinicians. For patient customers, conveniencecare trumps value based care. That's why there is a doctor-patient values gap.
6. Price transparency is growing
7. Online communities of patients with similar medical problems are everpresent
8. The digital ecosystem economy is evolving towards creating a whole product solution. Maybe some day you will be able to get your health records from an ATM.
9. Financial technologies are making it easier and more convenient to pay for sickcare products and services
10. Healthcare professionals are being trained and held accountable for patient customer service
11. The Consumer Electronics Show and the JP Morgan conference now gets more press coverage than most medical meetings
12. Amedzon, Walmart and media companies are the new new sick care things

??Medical malls, a new type of care delivery location is gaining traction. They?can be a pure medical center or a mix of health care services and leased retail space. There are about 30 in the United States.?They have the potential to enable hospital-based systems to deliver care more effectively, efficiently, and flexibly and to help address health care inequities and constantly evolving public health needs while promoting local economic development.

The Marketplace Mall in Rochester, N.Y., has a food court, arcade games and plenty of fashion boutiques. Soon, it will perform hip replacements and rotator cuff surgeries, too.

A closed?Sears?department store and an adjacent wing of the mall are being reborn as a roughly 350,000-square-foot orthopedic healthcare campus. It will include operating rooms, outpatient facilities and medical and administrative offices.

The University of Rochester Medical Center’s $227 million project is part of the recent boom in mall-to-medical conversions. Malls have long been home to urgent-care facilities or doctor’s offices. But in recent years more property owners have started turning entire sections over to hospitals or clusters of medical tenants.

As hospital-based systems rethink and redesign their care and business models, medical malls can be part of that evolution. Potential opportunities include but are not limited to:

• Emphasizing care that is continuous rather than episodic and more coordinated and integrated when mall tenants use the same electronic health record system
• Positioning the medical mall as a hub of care delivery?— with telehealth, in-home care, and the hospital itself as “spokes”
• Deriving revenue from clinical and nonclinical services beyond the walls of the hospital?— and from tenants’ rents, if the mall facility is owned by a hospital or health system
• Expediting a shift to efficiency-based payment incentives given the service-delivery efficiencies that medical malls can offer
• Mitigating payers’ increasing resistance to reimbursing the costs of hospital overhead when hospital-level care is unnecessary

Consequently, don't be surprised when you see a medical department store move into that empty mall down the road from your house. The department store transformed America. Now some of the very forces that fueled its rise have been turned against it. The only way out may be for it to recapture something of its past.-making it an experience for a community.

What used to be you local pharmacy is morphing into the medical department store. Livongo, Hinge Health, and a handful of other digital health companies will join CVS Health’s platform for PBM clients. CVS announced it would add five companies to its Point Solutions Management Service, a service it launched last year to make it easier for CVS Caremark clients to contract with third-party apps and monitor their performance.

In the case of Walmart, what old is new. There are many aspects of Walmart’s approach to healthcare that were new:

• a direct payment model that bypassed the entrenched healthcare reimbursement system;
• multi-disciplinary practices so that patients could go to one spot to get everything they need (diagnosis, treatment, testing and medications);
• a focus on consumer conveniences

However, any historian will tell you that this concept of a one-stop shop for healthcare is a throwback to the pioneer days where local apothecaries were the one place townsfolk would go to get the care and medications they needed.

“Welcome to the 1400s, maybe even earlier, where the pharmacist, the apothecary was the doctor, was the medicine man, and was the nurse, and the birther, and everything else for that community. We’re just getting back to that. The only reason why that changed was because managed care started putting constraints and laws started coming into place, and it basically minimized the role of the pharmacist.”

Medical department stores will offer many different departments:

1. Wearables and other consumer medical electronics
2. Clothing with sensors
3. Telemedicine appliances and medical devices and other durable medical equipment
4. Patient and care circle education centers
5. A service department
6. A medical geek squad
7. DIY medicine departments with kiosks
8. Patient and care navigators to help you connect to social service agencies to address the social determinants of heath outcomes
9. Data navigators to help you make sense of all that data you are generating every day
10. Health, data and insurance IQ literacy resource centers
11. Smart home furnishings, appliances and bathroon accessories, including our nextgen smart toilet
12. Healthy food delivery services, kitchen appliances and cooking classes
13. Discount travel agencies to arrange medical travel
14. Primary care centers with an adjacent digital device, digital therapeutics and pharmappcy, where you get that app your doctor prescribed downloaded and explained.

1. Retail dental clinics
2. Mass vaccination centers

Here is a glimpse at the future of retail pharmacy.

CBD dispensing robots are coming to select stores in Colorado.

You can even check into our adjoining surgitel to recover from your procedure at our day surgery center.

If you are worried by now about how you are going to compete with Applecare, Walgreeds and WalMed, here are some tips on how to practice retail medicine.

Unlike some startups of the past — think Warby Parker and Casper — a new generation of startups is blooming that isn't looking for big investments from venture capitalists. Instead, these founders are saying goodbye direct-to-consumer (DTC) and hello, big box retailers. The shift comes in part due to the struggle many entrepreneurs faced during the pandemic amid a drop in consumer demand and supply chain issues, writes Fast Company. Beauty brand Megababe, for example, ditched DTC and kept investments in-house. What happened next? After reaching stores like Ulta and Target, their growth rate hit 70% year over year. The same will happen to digital health apps and prescription digital therapeutics.

Another benefit of all this one-stop shopping is the food court (think Harrods) with a healthy food farmacy and several bars where you can join your friends to avoid social isolation and loneliness. Fill out the form on our app to receive sales promotions and coupons and check out our low, low prices if you missed Black Friday. We are at Walmart.com

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Twitter@SoPEOfficial and Co-editor of Digital Health Entrepreneurship