Can Walmart Urgent Care Compete With Existing Clinics?

This podcast is brought to you by the Wharton School at the University of Pennsylvania. Was the healthcare sector continues to develop with things like telehealth and more? The retail side of medicine is also in focus with how companies like Walmart and others will impact that industry. In fact, the expectation of some experts is that Walmart may able to do very well in segments of healthcare due to what the consumer or the patient is actually looking for.

这档播客由宾夕法尼亚大学沃顿商学院为您呈现。随着远程医疗等发展，医疗行业不断进步。医疗领域的零售也备受关注，像沃尔玛等公司对该行业的影响如何。事实上，一些专家预计沃尔玛可能在医疗某些领域表现出色，因为它能够提供消费者或患者真正需要的内容。

Mark Pauli, Professor Emeritus of Healthcare Management at the Wharton School joins us with more on that. Mark, great to talk to you again. How have you been? I've been fine Dan. Thanks. Thank you.

马克·保利，沃顿商学院卫生管理名誉教授，我们很高兴邀请您加入我们的讨论。马克，很高兴再次与您交流。您最近过得如何？丹，我一切都很好。谢谢你。非常感谢。

All right. So Walmart and Amazon are obviously making- I visited Walmart last week to do some research for this. So I'm all set. Well, exactly. So give us what you found out because I think a lot of people are truly trying to figure out the role that a company like Walmart is going to have in healthcare moving forward and why they may have an advantage.

好的。所以沃尔玛和亚马逊显然正在做一些事情-上周我去了沃尔玛做了一些研究。所以我已经准备好了。真正的问题是，告诉我们你发现了什么，因为我认为很多人确实在试图弄清楚像沃尔玛这样的公司在未来的医疗保健中扮演的角色，以及为什么他们可能有优势。

Yeah. Well, so it's tempting, right? Because healthcare is 18% of GDP. Healthcare spending is actually not growing as rapidly as a lot of other things in these inflationary times, but as I personally know, the population is aging. So it looks like a growth industry and to a lot of big companies, Amazon as well as Walmart. This looks like a low hanging fruit that they could take part in. So that's I think what's going on.

是的。嗯，这很有吸引力，对吧？因为医疗保健占国内生产总值的18%。尽管在通货膨胀时期，医疗保健支出并没有像许多其他方面那样快速增长，但正如我个人所知，人口正在老龄化。因此，它看起来像是一个具有增长潜力的行业，对于亚马逊和沃尔玛等许多大公司来说，这看起来是一个他们可以参与的低风险机会。所以我认为这就是正在发生的事情。

And also Walmart has had success in moving away from its original focus on low priced clothing and things like that to becoming the number one retailer of groceries in the US. So, you know, if you can do it for potato chips, why can't you do it for knee replacements? Seems to be the question. As usual, of course, there are some issues about the value creation here, but that seems to be the philosophy that this is a big chunk of the economy. It has not been reformed or reorganized in any serious way for the last 50 years, at least. So, you know, why not give it a shot? And that's what Walmart is doing.

而且沃尔玛已经成功地从最初以低价服装等为重点向成为美国第一大食品零售商转型。所以，你知道，如果你能把这做到薯片上，为什么不能做到膝关节置换手术上呢？这似乎是个问题。当然，这里还存在一些关于价值创造的问题，但这似乎是一项庞大的经济领域的理念。至少在过去的50年里，它并没有进行任何重大的改革或重组。所以，你知道，为什么不试一试呢？这就是沃尔玛正在做的事情。

From an operational perspective, what are the challenges that Walmart is going to be dealing with on a daily basis? Because certainly from a regulatory standpoint, you would think there's probably more potential headaches in healthcare than there might be in some of the other operations that Walmart's involved with.

从运营角度来看，沃尔玛每天将面临哪些挑战？从监管角度来看，可以想象在医疗保健领域，沃尔玛可能面临的潜在问题可能比其它业务更多。

Yeah. Well, certainly there's regulation that's going to make it life more complicated than selling potato chips. And there's also insurance coverage. Imagine if you had the file and insurance claim for your six pack of Coke that would make life more complicated for the seller too. So, it's definitely more complicated. They seem to imagine, and here I'll probably be a little bit snarky, that, you know, you go out on a Saturday to buy some socks and you decide to stop by maybe for a shingles vaccine or probably not for a colonoscopy, but that seems to be the idea that this would be a convenience sort of thing. And that seems to be what they're setting up. They're setting up something which is very similar to the urgent care centers or retail clinics that are already pretty well blank at the U.S. and, of course, make use of those abandoned gas stations where they set up these clinics. Walmart apparently intends to move into that market for sort of episodic primary care.

是的。嗯，当然有各种规定，这会使得销售薯片等简单的生活变得更加复杂。而且还有保险覆盖的问题。想象一下，如果你买了一瓶可乐，然后要提出保险理赔，这对卖家来说也会变得更加复杂。所以，这绝对更加复杂了。他们似乎想象着，你一个星期六出去买一些袜子，然后顺便去打一针带状疱疹疫苗，或者做一个结肠镜检查，虽然可能不太可能，但这似乎是他们的设想，就是这将成为一种便利的事情。而他们正在建立的东西与美国已经相当成功的紧急护理中心或零售诊所非常相似，当然，他们还利用了那些废弃的加油站来设立这些诊所。沃尔玛显然打算进入这种临时初级医疗市场。

It seems so, I guess, the skepticism comes from thinking of two things. One is the big money in healthcare is not in primary care. The big money is in things like knee replacements, but Walmart's not going to do that or, you know, care for heart disease or for that matter, diabetes care. Maybe there's something they could do there, but that seems to be a little bit trickier because they're not, you know, they're not really set up for continuity of care. It seems they appear to be more interested in displacing the place where, you know, in your neighborhood where you will go if you've got a splinter that you can't get out or you've got a rash that doesn't seem to be going away, things like that.

看起来是这样，我猜测这种怀疑主要源于两点。一是在医疗行业中大部分利润并非来自基础医疗服务。大部分利润来自于像膝盖置换这样的项目，但是沃尔玛并不会做这些，或者说，他们不会为心脏病或糖尿病等提供治疗。或许他们在这方面有一些可行的举措，但是这似乎相对复杂些，因为他们并没有为连续的医疗服务做好准备。他们似乎更感兴趣的是替代你所在的社区中，那个你因为无法取出木屑或者因为皮疹一直未愈而需要就医的地方。

So, yeah, so that's a pleasure. If you kind of alluded to kind of the low-hanging fruit of the medical profession, correct?

嗯，是的，那真是一种乐趣。如果你有点暗指医学行业中那些容易达到的目标，对吗？

Yeah, well, there's a lot of money hanging out there, so that's, I think, the temptation, but it's not so easy to grab a hold of because, as you mentioned, the regulation, the insurance-induced complexity and the fact that people with who spend have a lot of money spent on them, are not going for episodic care. They're going for chronic care, and that's a lot harder to put in place in a setting that's adjacent to the local Walmart. Amazon tried it. You mentioned that and basically failed, so, but maybe Walmart can make a success of it, I don't know.

是的，好吧，有很多钱在那里等着，所以我认为这是个诱惑，但要抓住它并不容易，因为正如你所提到的，监管、由保险引起的复杂性以及那些有大量花费的人并不寻求片段性医疗。他们需要慢性病的治疗，而在与沃尔玛附近的地方建立这种系统是更加困难的。亚马逊曾试过，你提到过，但基本上失败了，所以，但也许沃尔玛能够成功，我不知道。

You mentioned before about kind of the changes that Walmart has made as a brand. They've kind of upped the level of perception of what a Walmart is. And so, I guess, to a degree that believe that that's a benefit for them as they make this foray further into healthcare is that they already had a strong relationship with a lot of consumers when they were kind of considered to be a lower-end retail option. They've kind of built on that, and now they've kind of continued to establish that relationship with so many millions of Americans. Yeah, yeah.

你之前提到了沃尔玛作为一个品牌所做的一些改变。他们在沃尔玛这个品牌的认知上提升了一定水平。所以，我想，在进一步涉足医疗行业时，他们相信这对他们是有利的，因为他们已经与许多消费者保持了牢固的关系，即使在被认为是低端零售选项的时候。他们在此基础上继续发展，并且现在已经与数百万美国人建立起了这种关系。是的，没错。

So they certainly went into eyeglasses, and for all I know, they could make a big presence in Botox, but the real money in healthcare is not in things like that, although it's probably enough to cover a fair amount of profit. The real money is in things like care of chronically ill or surgical procedures, even some diagnostic procedures like a colonoscopy, which you're unlikely to have at your local Walmart just on the spur of the moment. So there may be a model that can, I guess, sort of my advice, my two cents worth would be they need to somehow integrate this more convenient setting with what everybody thinks is needed in healthcare, but nobody's been able to pull off, which is real coordinated care that identifies individuals as individuals and links them to particular providers, physicians, and so forth. So it's a little bit hard to see how it will work in a mass production setting like Walmart, but maybe they could do it.

所以他们肯定进入了眼镜行业，我猜他们也可能在肉毒杆菌注射方面有重要影响力，但在医疗保健领域，真正赚钱的并不是这些，尽管它可能足以覆盖相当大一部分盈利。真正赚钱的是像对慢性病患者的护理或手术等方面，甚至包括类似结肠镜检查这样的诊疗程序，你不可能随时在当地的沃尔玛完成。所以也许有一种模式能够，我猜，总结我的建议就是，他们需要以某种方式将这种更便捷的环境与每个人都认为医疗保健需求的整合起来，但迄今为止没人能够实现，那就是真正有序的医疗护理，将个人作为个体予以辨认，并与特定的提供者、医生等联系起来。所以在像沃尔玛这样的大规模生产环境中如何使其发挥作用有些难以想象，但也许他们可以做到。

There's a lot of discussion around these days about staffing issues in the healthcare sector. Doesn't Walmart have to be very concerned about that as a problem in trying to build that up as well? Well, sure. The ability to cut costs, which appears to be what led to their success for groceries, is probably much more limited in healthcare just because it's, for one thing, labor-intensive and for another thing, the kind of labor it uses, for the most part, is specialized professional labor, which, as you mentioned, is in short supply and it doesn't come cheap. So yeah, cost-cutting strategy by hiring lower paid workers doesn't seem to plausible.

最近有很多关于医疗保健行业人员问题的讨论。沃尔玛在努力发展这个领域时，肯定也会对此表示担忧吧？嗯，当然会。降低成本能力是他们在食品杂货领域成功的原因，但在医疗保健领域，这种能力可能受到更大限制，首先是因为这个行业劳动密集，另外，它所使用的劳动力大部分都是专业技术人员，而这些人员目前供应不足且价格不菲。所以，通过雇佣薪酬较低的员工来降低成本的策略似乎不太可行。

So as Walmart moves forward here, what kind of a role do you think that they will play and will they potentially drive out some of those urgent care facilities that have kind of dotted the landscape over the last decade? Yeah, that's kind of what I see as most likely, that that seems to be what their product would be. Their other service would be this is going to be a service for the most part. And those in pre-standing, not always independent, they're chains of them, of course, but they may be relatively easy pickings for Walmart just because of the greater convenience and perhaps some economies of scale associated with it, which is going to be a good thing for the episodic need for medical care, it's a lot more convenient just to drop by than it is to try to make an appointment over the phone and I'm going to learn Spanish so I can make those appointments more efficiently, but it's very complicated to make appointments with your regular health care system, which is not set up very well to deal with episodic care. So that may be the niche that they target and that could be a useful edge on to auto repair and other kinds of things that Walmart is good for.

当沃尔玛在这方面取得进展的时候，你认为他们将扮演何种角色，他们可能会淘汰一些在过去十年里遍布山水之间的急诊护理设施吗？是的，我认为这是最有可能的情况，这似乎是他们的产品。他们的另一种服务主要是服务性的。那些单独存在的急诊护理设施，虽然并非总是独立的，它们有时是连锁的，但由于更大的便利性和一些规模经济的关联，它们可能相对容易被沃尔玛取代。对于临时就医的需求来说，这将是一件好事，只需路过就可，比起电话预约要方便得多，我将学习西班牙语，以提高电话预约的效率，但与常规医疗系统预约相比，这非常复杂，因为它们并没有很好地为临时护理做准备。所以这可能是他们定位的细分市场，这对于汽车维修和其他沃尔玛擅长的事情也可能是一个有用的优势。

All right, Mark, great to talk to you as always. Thank you very much. You get your oil changed and your fluids changed at the same time. Exactly right. Oh, man. All right, Mark, thanks for joining us all the best. You got to Mark Paul, yeah, Professor Emeritus of Health Care Management here at the Wharton School.

没问题，马克，和你交谈总是很愉快。非常感谢你。你需要同时更换机油和液体。完全正确。哦，天啊。好的，马克，谢谢你的加入，祝一切顺利。你已经听到了马克·保罗，沃顿商学院卫生管理名誉教授。

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