MinuteClinic's hour may be at hand

Mark Perry draws an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a .

Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics.  Especially when consumers are spending their own out-of-pocket money for health care and they have a choice, they prefer market-driven, consumer-driven options like affordable, convenient retail clinics over conventional physician offices.

I think Perry is on to something. It's hard to get people out of their established habits. They have a relationship with their own doctor, they accept the long wait for appointments and even treat it as a proxy for high quality (if my doc is so busy he must be great), and just suck it up when it comes to co-pay's and deductibles. They want access to high tech exams and the latest drugs.But all these things change over time. MinuteClinic and its ilk are well-positioned to take advantage of these trends in the long run. To take them in turn:

• Relationships aren't what they once were. Your doctor may or may not remember you. If you have something routine (or even if not) you may be shunted off to see a "physician extender, " such as a nurse practitioner. At least when you go to MinuteClinic that's who you expect to see
• Wait times for appointment can be lengthy. Under health reform they are likely to get worse, especially since open access scheduling is slow to catch on
• We've now reached the breaking point for co-pay's and deductibles. Even insured people are nervous about going in for treatment and want to save money. They realize it's only going to get worse
• High tech exams (like MRIs) and drugs have lost some of their allure. Cost is part of it, but the continued news stories of safety problems with drugs are taking a toll, too. I think Americans are finally realizing that when it comes to health care less is often more

Finally, especially for routine issues, MinuteClinics do as well or better for quality. The reason is pretty simple: nurse practitioners are more likely to follow protocols than doctors, and the standardized MinuteClinic model represents a more disciplined approach to operations than the typical physician office.It will be interesting to see if the substitution of MinuteClinic for the physician office is a trend that holds up over time.