It was a sore neck that introduced Janine Charles to the world of Wal-medicine.Her search for a local doctor's office gave her an address that turned out to be a Super Wal-Mart in Orlando, Florida.She thought about giving up and trying another address, but she instead went inside the store and wandered around.Inside, she found that space formerly used to house a small video arcade had been transformed into a medical clinic. She ended up paying $90 for an examination and a shot of muscle relaxants. Had she gone to a traditional doctor's office, the same treatment would have cost her $200. In most emergency rooms, the treatment would have cost over $500. Even better, this clinic accepted Ms. Charles' insurance. If you also factor in the fact that Ms. Charles could do her grocery shopping in that store while she waited for the pharmacy to fill a prescription for her, you suddenly have a very convenient trip (Rowland).While Ms. Charles visited a clinic that was staffed by a doctor, most of the clinics inside Wal-Mart, Target, and other big-box retailers feature nurse practitioners, who can write prescriptions in most states. The retailers do not enter the world of medical care as part of their own corporate activities, but simply lease the space to clinics. It's not just the big-box retailers who are looking into clinics, either. Because of the losses due to mail-order pharmacies and big-box retail sales, drugstore chains are also opening clinics. Rite Aid Corp., Brooks Eckerd Pharmacy, and Osco Drugs are all entering partnerships to open clinics, and Walgreen Co., the pharmacy chain with the most sales volume in the United States, is also negotiating a deal to have Take Care Health Systems LLC operate clinics in some of their retail locations. The retailers who are leasing space to these clinics hope to make profit not just from the leases themselves, but from the ancillary shopping that will go on while people wait for their prescriptions to be filled, or wait for their appointment to be called. It is similar logic to those grocery stores and big-box retailers who have leased space to banks, hair salons, postal service kiosks, and fast-food restaurants (Moewe).
Doctors' associations, as one might expect, have raised objections about the possible problems with this type of medical care. While nurse practitioners can treat a number of simple illnesses, the American Medical Association notes that simple symptoms can be indicative of any number of serious illnesses. The primary concern of many customers, however, is a combination of convenience and cost. Doctors' offices are often seen as insensitive when it comes to a patient's time, often making customers wait significant amounts of time past their scheduled appointments. Also, the simple cost, especially for the uninsured, of an ordinary visit to the doctor's office can easily exceed $200 - and since these clinics charge rates starting at $25, depending on what the customer needs, it is easy to see that these clinics will draw many customers away from their physicians (Spencer).
What factors should companies use when considering whether or not to enter the doc-in-a-box game Tedlow's three-stage model of marketing, whereby marketers move from fragmentation to mass marketing to segmentation, can be instructive here (Ellickson).
Market fragmentation can be defined as "the emergence of new market segments with distinct needs and requirements out of previously homogenous segments. These new segments limit the usefulness of mass marketing and erode brand loyalty" (Dictionary of Marketing Terms). The doc-in-a-box concept still seems to be either in the latter stages of this fragmentation stage or the initial stages of the mass marketing stage.
Traditionally, the relationship between patient and doctor has given the doctor a considerable