Increased competition in primary care services
How to play nice in the sandbox with pharmacies joining the primary care game
With the rise of accountable care and wellness marketing, primary care has taken center stage in the world of healthcare. The role of the primary care practice has changed, from treating the sick to managing the health of their communities. They are now charged with empowering their patients to take control of their personal health and managing chronic conditions to decrease hospital admissions and preventable procedures.
In theory, primary care practices will serve as the gatekeepers of specialty care, referring patients within their network to ensure they will stay updated on their progress through electronic health records. However, this theory has not yet been put into action, unless patients see physicians within an accountable care organization. But even then, they have the option to see specialists out-of-network.
This leaves patients with a lot of choices.
Patients don’t just have the choice of which practice to visit, but whether they want to visit a primary care office at all. Local pharmacies are now offering primary and urgent care services for the same cost as a co-pay. They also operate extended hours for busy patients on-the-go who need to squeeze in a visit before their 8 a.m. meeting or take their feverish child for a strep test at 6:30 p.m.
The services available at pharmacies extend to immunizations, wellness educational programs and improving medical adherence. Some even offer optical. Patients are able to be seen by a PA for an ear infection, walk to the next counter to fill a prescription and go pick up a few things for dinner while they wait, all under the same roof. It truly has become one-stop shopping.
So what does this mean for primary care offices? Well, there are pros and cons:
Pros
- Pharmacies joining the primary care game increase access points to care. Members of the community, especially in rural areas, can be seen more quickly to prevent conditions from worsening. This helps the community to avoid hospital admissions with preventive care.
- Many studies have shown that a surplus of access to primary care results in improved population wellness, a decrease in patient readmissions and emergency room visits, a decrease in unmet care needs and a decrease in care costs.
- There are millions of newly-insured Americans under the Affordable Care Act and we have an aging population with increasing healthcare needs. Pharmacies can help shoulder this work load.
- Longer hours offer convenient appointment times for individuals who cannot miss work or take their children out of school.
Cons
- Patients who choose to seek primary care at a pharmacy will most likely not see a physician. They are often staffed with PAs, nurse practitioners and of course, pharmacists.
- Because patients will be seen out of network, there will most likely be miscommunication among the pharmacy, the primary care physician and specialists. They will not be hooked into an electronic health record system and faxes may get lost, so it will be hard to keep everyone in the loop when medications are adjusted or tests are ordered.
- This miscommunication can lead to fragmented care. An inconsistency in who a patient sees and differing medical opinions could result in duplicative testing, patients not following their prescribed medications, treatments or therapies and missing warning signs of a larger problem. This all can be prevented with consistent care and physicians who know their patients’ histories.
- While an increase in primary care access points can help patients, it can be a challenge for primary care practices because of the increased competition. Below are three ways primary care practices can be proactive in protecting their marketshare.
Be proactive
- It’s imperative for primary care practices to differentiate themselves in the marketplace. Why should a patient choose to see a physician at your office over seeking care where they shop? Figure it out and communicate it in your marketing messages. Also, if you’re a hospital or health system, refocus your marketing strategy to attract patients at the primary level instead of promoting specialty services.
- To fight back against fragmented care, work with the pharmacies to develop a communication system and mutually beneficial relationship. For example, Walgreens has affiliated themselves with larger hospital systems in different markets so they can refer patients to specialists. These affiliations help keep the physicians and pharmacists on the same page to prevent inconsistent care.
- Instead of seeing the pharmacies as strictly competition, form a strategic partnership that will benefit your community. Think of it as extending access to your current patients and a platform to meet prospective patients by offering clinics, educational sessions and screenings at the pharmacy.