Blurred Lines

It was the allure of convenience and discount pricing that first reshaped consumers’ buying habits more than 50 years ago and created a new landscape of product and service delivery. What began with the discount retail chain Woolco in 1962 has evolved into a national phenomenon of monolithic superstores promising one-stop shopping. Everything from apparel and tires to eggs and gasoline could be found under one roof at lower prices. In this half century, local corner stores ceded ground to department stores and supermarkets, then to suburban shopping malls, then to discount chains and big-box retailers. Today, Woolco is gone, but the retail landscape continues its undulating shift as consumers alter how they make their purchasing decisions and new business strategies emerge to keep pace. Fresh food is no longer the sole domain of supermarkets but can be found in pharmacies, convenience stories, and warehouse clubs. Retailers are battling over consumer dollars with manufacturers such as Apple, Nike, and other consumer product players as they sell directly to consumers.

But it’s not just retail that is experiencing this upheaval. All markets are feeling the pressure of consumers’ demand for convenience and price. Consider the explosion of urgent-care centers. Tucked between a Starbucks and Trader Joe’s at local shopping malls, storefront centers such as Doctors Express offer the convenience of walk-in care and are open nights and weekends. An estimated 3 million patients visit these facilities each week for treatment of common injuries and illnesses. And a visit to an urgent-care center is much less expensive than a trip to the local emergency room, saving billions in healthcare costs. Of course, the cost-saving phenomenon has not gone unnoticed. Many insurance companies have added urgent-care centers to their provider networks, and 4 years ago the insurance company Humana bought Concentra, a nationwide urgent-care provider. Not to be outdone, Dignity Health, the nation’s fifth-largest hospital system, purchased US HealthWorks, the second-largest urgent-care chain. Further blurring the lines of medical care, walk-in retail clinics have popped up in Target, Walgreens, Walmart, and CVS and accounted for 7% of US medical visits, according to a 2011 study in the American Journal of Managed Care.

Dentistry is not immune. The American Dental Association conducted a study last year that found 2.1 million patients had visited emergency departments seeking dental care. Between 2008 and 2010, more than 4 million consumers turned to emergency departments for help with dental conditions at a cost of $2.7 billion. The billions being expended have garnered considerable attention from dental-service organizations, insurance companies, and manufacturers.

As consumers’ perceived value of the independent healthcare professional diminishes, the question becomes: Will the Dr. Welby’s of the world disappear from medicine and will private-practice dentistry follow in their footsteps?

Pam Johnson
Editor-in-Chief
pjohnson@aegiscomm.com