Health care is changing, just not in the District of Columbia...

Although the stores are primarily in the suburbs, I wrote a couple blog entries in October about the plans of DC area pharmacy chains adding quick service healthcare clinics to some of their stores. (See CVS Health Clinics in the Maryland suburbs -- what does this mean for DC hospital planning and More about store-based health care services.)

The Memphis Commercial-Appeal has a story about Kroger's (the nation's largest grocery chain) adding clinics to a store in Tennessee. From "Kroger to open medical clinic. Grocer hopes to boost pharmacy sales":

In just a few weeks, Kroger Co. will open its first in-store minor medical clinic in Memphis, adding a diagnosis or work physical to the list of things you can get at the grocery store. The first clinic will open at the store at 3830 Hickory Hill Road by early February. It will accept major insurances and TennCare. "Often our pharmacists end up being the only health care provider some of our customers see," said Eddie Garcia, head of Kroger's pharmacy merchandising in the Delta region. "We decided we wanted someone who could diagnose their illnesses."

I am not suggesting that instead of contracting with Howard University, that the city look to Harris-Teeter, Safeway, and Giant Supermarkets for delivering health care services, after all we know that many Safeway and Giant stores aren't all that great and we know that Wards 7 and 8 are under-stored in supermarkets

Still, it's a compelling idea to think about delivering day-in day-out minor and preventative health care services in more settings more easily accessible, throughout the city, rather than putting all our efforts into another hospital.

DC already has plenty of hospitals, hospital beds, and highly rated trauma and specialized services. Despite the plethora of hospital-based health care services, the city continues to suffer from persistent negative health care outcomes associated with diseases traditionally linked to poverty and other issues around serving low-income populations.

As the Marc Fisher column points out ("New Hospital's Likely Prognosis: Taxpayer Bailout"), many of the visits to DC-area emergency rooms aren't for emergencies, but are health care visits made to the hospital because many peoople don't have primary care physicians. The cost of hospital-based services for such care in terms of opportunity cost and the real cost of providing health care services in that venue is exorbitant.

I bring this up again because it speaks directly to what is being discussed in terms of the health care delivery "paradigm" as it relates to hospital care vs. health care.

To my way of thinking, it seems as if the various simultaneous planning efforts going on throughout the city, with schools, the comprehensive plan, health care, libraries, and parks, aren't really looking to improve things all that much. Innovation and creativity are missing from the process. There are few challenges to dominant paradigms.

And that is something that concerns me about the efforts to create a DC Planning Commission. I suppose we need one, but it's not like the Zoning Commission and the Board of Zoning Adjustment are at the forefront of pushing for quality urban design.

The same Edifice Complex oriented people will be the ones making the appointments to the DC Planning Commission, and are likely to be the kinds of people appointed to the Commission. (Meaning, not people like Ann Hargrove or Richard Layman--although maybe, just maybe, a staff job would be possible for someone to tell truth to power, but don't count on it.)

The presentation about why a DC Planning Commission is needed is Thursday night.

Index Keywords: health-care-planning