Last week, our online editor, Loren Bonner, wrote a story about big retailers, like CVS and Walgreens, that are trying to take on health care.

I said to Loren in the hall that hospital executives must be fidgeting in their seats about this. Sure enough, the current issue of Hospital and Health Networks that landed on my desk late last week featured the cover story on this very subject.

I had to compliment Loren on being ahead of the curve.
Those of you living in small town America must notice that small town main street is being shuttered by big box stores. If this happens in health care, as appears to be the case, I expect big changes on the horizon. Retail clinics and urgent care clinics are expected to double their presence by 2015, especially as more Americans gain coverage under the Affordable Care Act and seek out primary care.

If more people rely on big box stores as the place they go for primary care, will it make it harder for hospitals to deal with emergencies and more complicated procedures? Will it drive prices up? Will it fragment care? It's true that patients don't have the same relationship with their primary care doctor like they did when I was growing up, but I'm afraid the disconnect will be even more pronounced if health care is run even more like a business. For these big box stores, I believe it's all about the money.

Furthermore, if hospitals don't have primary care revenue and only more expensive revenue streams, then their costs will likely go up. This means our insurance premiums will go up too.

It's an interesting shift to ponder and it seems like many of you have your opinions about convenience clinics, based on the comments Loren received on her story. I hope to keep the dialogue going, so please share your thoughts here too.

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