by Tony Chen

Can we stop talking about retail clinics as an "emerging" trend? These clinics are here to stay. Plus, there's already 1,000 of them (as we predicted almost 2 years ago), and probably thousands more on the way.

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Yes, there have been hiccups. Physician-staffed clinics have not done well for obvious cost/business model reasons. A few NP-staffed clinics haven't done well because of over expansion -- most notably, CheckUps (which had clinics in WalMart locations) closed 23 clinics. They had just grown too fast. Too many acquisitions too quickly = no cash flow. Other NP-staffed clinics have done very well, and why wouldn't they? A couple patients an hour, and boom, it's a profitable business.

Now that retail clinics are part of the healthcare reality, the real question is this: how far upstream will they try to expand their scope?

We have at least 2 indications that they're just getting started:

- Walgreens has recently drastically shifted strategies. They aren't focused on opening more stores anymore (like they have been for the last 10 years). Nope, they're focused on leveraging their growing portfolio of health care service access points. Besides adding new services to their retail clinics, they've also recently acquired hundreds of worksite clinics. They've created a "health and wellness" division and are aiming to have 10,000 healthcare access points in 4 years. Get ready, hospitals and physician offices, Walgreens is creating a healthcare system of care right where people work and live.

- A recent article from AAFP also concludes that future retail clinics will also provide chronic disease management, injections, weight loss counseling, and more. The money quote from Mary Kate Scott, now the key guru on the topic:

This has happened in just about every industry. By providing just a small set of services and doing it again and again, you actually can bring down the cost and increase the quality. Take Jiffy Lube and Midas. Jiffy Lube said, "All we're going to do is change oil," and Midas said, "All we're going to do is brakes." And someone came along and said, "We won't charge you what a mechanic charges, because we're going to use a technician, not a mechanic." And slowly they've expanded their services.

And I gotta tell ya. I love Jiffy Lube - their "EMR" on my car is better than the one I have at my dealer. Just wait until Walgreens puts in place those auto-alerts that Jiffy Lube mechanics use so well ("did you know you're due for your 30,000 mile...").

UPDATE: WalMart is also getting into the telemedicine biz.