Save Us, Sam.

I had this whole snarky bit written out about this piece of news, then it occurred to me that despite my aversion to mixing food and communicable diseases, this may be an answer to our over-crowded emergency rooms. WalMart is already most people’s one stop shopping destination. Where else can you have your car serviced, film developed, eyes examined, eat lunch, then do your Xmas shopping before loading up on household supplies and groceries? So, ok, add to that the convenience of getting your kid’s school shots done at a discount, and that is Walmart’s new strategy. I was a bit puzzled by this sentence:

“It has said the clinics are expected to boost the health of its shoppers and should also help sales by drawing consumers into its stores.”

I’m pretty sure that the demographic that will use the Walmart based clinics already know to follow the bouncing yellow happy face around the store as it slashes prices even lower! Is this move really likely to “draw” more people into Walmart? Are there people out in Suburbia that noticed these 200,000 square foot behemoths but haven’t wandered in for a peek? I loathe Walmart for a hundred different reasons, yet I shop there, at least some of the time. I hold my nose and dive in for two reasons; time and money. It does help me that I can get my oil changed and film developed and shop for groceries and poster-board and get this all done in a hour, and, I have a list of things that we use a lot of and the price makes it unwise to purchase anywhere else. (I’m a bit of an old woman when it comes to shopping for groceries. I don’t do coupons (wish I had the patience) but I literally have a list of things I buy from Walmart, and a list for Kroger.) And I have noticed a trend that has Walmart dressing up it’s exterior to better blend in to local communities. Inside, though, it’s the same. Stacked deep, sold cheap. And why is it always the same sad sack of a kid I see being cooed at and propped up to have his picture made?

Where was I? Right. Emergency rooms. Any nurse paying attention will tell you that the bulk of the wait time at your local E.R. isn’t caused by Illegal Aliens or by Ginger dragging George Clooney into a closet and away from patients. No, its those people who either have no insurance and know that they cannot be turned away, or, worse, people who run to the E.R for every headache, rash, scrape or overly loud fart. The fact that the “E” stands for emergency concerns them not in the least. Something is not right in their world, and by God, they are going to see a doctor. Once inside, the attending physician now has to run every test in his arsenal or risk missing something and being sued. This ties up time and resources, and we all pay.

Maybe, just maybe, having an affordable clinic located at Walmart is part of an answer at least. These days, I’m willing to work with the devil a little if it means we take a step forward, or a step back, anything to break the inertia.

28 Comments

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28 responses to “Save Us, Sam.

  1. I’m a bit of an old woman when it comes to shopping for groceries.

    (snicker)

    or by Ginger dragging George Clooney into a closet

    That tart. She should at least share with her girlfriends.

    OK, but seriously, I think you’ve hit on something here, so I’m agreeing, with one stipulation – IF they are going to be open thru after school hours/early to mid-evenings.

    I worked in my hometown ER and in a certain South Nashville ER. I *hated* working days, because once school hours were coming to an end – and also once people’s working hours were coming to an end – we would get so overrun with people. And while there would be the occasional emergency or near-emergency, most of them were not – sore throats, vomiting, whatever. And most of those folks were coming to us because their doctor’s office had already closed for the day or couldn’t get them in.

    Things got a little better when the various minor medical centers starting cropping up, but (A) when I was working in Nashville, I think there was only one, at least in that part of town, and there were some insurance coverage issues for a lot of people; and (B) in most small towns, there’s no such thing anyway. But most of them have a Wal-Mart!

    Every ER has the same problems. Certainly the gunshot wounds and massive car wreck injuries and heart attacks and such get put in the first of the line. But depending on symptoms, a lot of times people with classifiable emergencies (appendix, for example, and many others) are gonna get stuck waiting in the same pool with the strep throats and projectile vomiters that are, maybe but most likely not, emergent. You just don’t know until you can get them back in the examining room, and unfortunately if you have ten rooms and eight of them are filled up with car crash victims, gunshot and stab wounds, heart attacks and drug overdoses, the 30-40 people waiting in the waiting room can’t all fit in the other two rooms at the same time.

    So yeah, the Wal-Mart thing might be a good solution, or at least help. Again, though, only as long as they will be open past usual medical office hours, though.

    I was so happy when I finally got moved to almost-all graveyard shift and most everyone really was an emergency.

  2. And hey, maybe Wal-Mart employees will have access to healthcare…

  3. I’m a bit of an old woman when it comes to shopping for groceries.

    I’m just gonna start calling you “grumpy old man” from now on for a myriad of reasons. ;)

    That tart. She should at least share with her girlfriends.

    Lynnster! lol! I take great pride in my tartness, and so would George if he’d only give me a call. hee!

    …a certain South Nashville ER

    Does it rhyme with “Southern Kills”? They literally almost killed me one time. A frightening place indeed.

    I think it is a really good thing that Wal-Mart is planning, but I’m afraid it will turn into the same zoo that the store is.

    One of the things that convinced my ex to study to be a Nurse Practitioner is that with so many in-store clinics sprouting up all over (i.e., Minute Clinic, etc.), the demand for NPs is predicted to skyrocket.

    I wonder out loud, though, if so many nursing students decide to go that route, how it is going to affect the overall nursing shortage in this country? (i.e, for hospital RNs)

  4. nm

    Rachel, they’ll have access to health care, but they’ll have to wear their jackets while they’re waiting to see someone, and if customers wander by and ask them questions they’ll have to go help and lose their places in line. Plus they’ll have to clock out first.

  5. I don’t reckon that I’m old, but I DO have the “seperate list”thing.

    And as far as ER waits go, I seldom have one. “Kidney Stone” is like “Heart Attack” in that it gets you past triage pretty quickly.

    ERs will always be overstocked with drug-seekers, though. I’ve heard people in there begging for morphine for a sore throat. Those folks will NEVER go to a minute-clinic.

  6. nm, are you serious?

  7. My interviews with the local Health Clinic Director were pretty eye-opening. The Immigrants are used to paying a small amount for basic services, and therefore are not a financial drain to the County Health Clinics. I think Lynnster is right, alot will hinge on their hours of operation. When the clinics close, the E.R’s get flooded.

  8. Rachel, you tickle me.

  9. nm

    Rachel, no — or rather, only in a sarcastic way. Isn’t it Walmart that makes employees clock out in the back of the store but keep their uniforms on as they walk to the front to leave, and requires them to wait on customers without being paid for it as they do so?

  10. I definitely wouldn’t have been surprised.

  11. Isn’t it Walmart that makes employees clock out in the back of the store but keep their uniforms on as they walk to the front to leave, and requires them to wait on customers without being paid for it as they do so?

    Can’t speak for Wal-Mart, but that was the policy when I worked at Sam’s Club.

  12. How much better to have such a happy crew that they would elect to do this on their own, and be happy about it?

    Like I said, from the damage it does to local economies, to it’s horrible record on Women’s rights, I hate WalMart. But I fear we are stuck with them. That said, if I’m right about the future of this country, Walmart may actually save us all.

  13. Does it rhyme with “Southern Kills”? They literally almost killed me one time. A frightening place indeed.

    Mm hmm. It was pretty decent when I was there, but that was now 20+ years ago.

    Can’t speak for Wal-Mart, but that was the policy when I worked at Sam’s Club.

    I have a friend who has had a lot of job difficulties in recent years and as a last resort, went to work at Sam’s, but pretty quickly quit. Man, I was totally shocked about a lot of their staff policies and procedures – it sounded like it operated more like a cult than a business! I don’t know if Wal-Mart follows the same type stuff, but yuck if they do. That was a real eye opener for me.

  14. nm

    Walmart is notorious for screwing their employees in every way they can, a number of them bordering on illegal. For instance, Rachel’s remark above is based on their deliberately cutting workers’ hours so they won’t be eligible for benefits, and claiming to be providing health care assistance by suggesting to workers that they go on Medicare or TennCare. I will never shop at Wal-Mart. I would rather go without something altogether (as I have had to do from time to time) than know that I can afford it because it has been wrung out of other people’s sweat that way.

  15. I’ve gone on about my issues with Sam’s/Wal-Mart before.

    Man, I was totally shocked about a lot of their staff policies and procedures – it sounded like it operated more like a cult than a business!

    That’s a lot of the way they dominate things. It IS very much cult-ish.

    The thing I think more people should be concerned about is just how BAD Wal-Mart is for our oil economy. Most people think we’re in Iraw for oil. We may or may not be. But there would be lower gas prices if you didn’t shop at Wal-Mart, and here’s why.

    Our cost of oil is affected strongly by supply and demand. One of the reasons Oil has become so expensive is because there is much more global demand–especially from China. Many of the companies who supply goods to Wal-Mart have had to take their production overseas in order to manufacture the goods cheaply enough to meet Wal-Mart’s demand.

    This production is mostly centered in China. China does not have the same environmental laws we have in the states, so many of the factories are not fitted for fuel efficiency. They burn oil and coal like crazy.

    Then they ship the product back to the States on Oil-guzzling tankers. It would take far less oil to make paper plates here in the U.S., but because of our environmental laws and wage laws we cannot do it as cheaply.

    Anyway, you shop at Wal-Mart to get cheap things, but you pay more in gas to get to the Wal-Mart. There is a PERCEPTION of savings which benefits the Wal-Mart economy, but there isn’t really a NET savings to the consumer at all.

  16. Well, yes, part of that rings true. However, Kat, I wouldn’t trade environmental laws for more manufacturing, necessarily. The other thing that comes to mind is that a dwindling supply of oil will cause prices to spike upward, and quickly, and our economy could likely collapse at around the 200 dollar a barrel mark. I believe we will see that, and right soon. In the event of a total breakdown, I’m hoping that WalMart’s distribution and warehousing network might just be a lifeline for those communities cut off from production points. We’ll pay more, sure, but they may be the only company that can actually deliver goods at that point. But thats a whole other post, I think.

    NM, I hear ya. In our area, we have few choices, and with small kids, and a demanding schedule, conveinance is important. I think WalMart will be forced to change, and there has been progress made. Minute, to be sure, but like I said, any move breaks the inertia.

  17. Another thing I thought about… With all of these McClinics popping up in Wal-Marts, I wonder about the calibre of clinicians they will be able to attract into those jobs. What will the pay be? If they have a bunch of fresh-out-of-school pratitioners, will the care be sub-standard? It would be interesting to see if there is a difference of pay-rate for a Pharmacist in a Wal-Mart/Sams as compared to one at, say, a Walgreens, and if so, would that same difference parallel into the world of McHealthcare? It does concern me…substandard care and all…of course, there is always the public health department.

  18. A good friend of mine is a Walmart eye doctor. He makes around 200k a year. Bear in mind that it is local hospitals that will be opening the clinics, so they will determine pay. Personally, I think it’s a good idea for young doctors to work in these clinics as a way to pay off student loan debt.

    Walmart only leases the space.

  19. 200K…dang.

    Yeah, I didn’t catch that the clinics would be run by local hospitals. I don’t think that is the case with clinics like the Minute Clinics that are in the CVS Pharmacy stores.

    That’s good to know.

    Sorry, just the thought of waiting to see a doctor/NP at a Wal-Mart makes me shiver.

  20. I’m waiting for Wal-Mart to get into the realty business, and cars too, for that matter. I mean, they sale everything else, even souls.

  21. I wouldn’t trade environmental laws for more manufacturing, necessarily.

    I don’t know that I would either. But I do bristle at things such as Kyoto where we are penalised but places like China are allowed to pollute unchecked. I’ll never favour a global environmental treaty that doesn’t treat all comers equally. Because anything else is cronyist hypocrisy.

    that WalMart’s distribution and warehousing network might just be a lifeline for those communities cut off from production points.

    Wal-Mart’s DCs are some of the most backward and oil-dependent things we’ve got. They can’t exist in an economy bereft of oil.

    I think it’s a good idea for young doctors to work in these clinics as a way to pay off student loan debt.

    Yes, but…still the substandard care argument exists. One of my few visits to a minute clinic involved my “doctor” reading through a My Little Golden Book of Diagnosis, only to have me (the chronic patient) tell him my probable diagnosis, my differential diagnosis and the standard tests and treatments for both.

    After he confirmed my information with the Flip Book Of Basic Disease I was treated according to my own instructions.

  22. Mack, as far as a distribution lifeline in the middle of a collapse, we’ve already seen it. There were few entities that were able to persevere in the aftermath of Katrina: for instance, my company has a, er “branch” in New Orleans, and they were able to keep “customers” alive and evacuated, and even helped the government-owned “competition” down the street, because of our sheer bigness as a company, and the fact that we have a much better command and control/distribution system than almost anyone out there.

    I mention this because my company (I think you know who it is; I’m trusting you not to mention the name) is even more hated than Walmart in some circles (mostly because they would like to see what we”sell” socialised). But our very private-ness gave us the nimbleness that other entities did not have, and lives were saved.

    Take our nimble distribution, multiply it by a factor of 100, and you have WalMart. Save us, Sam, indeed.

  23. Slarti, yes. The fact that they have so many warehouses and a huge fleet of trucks could insure that provisions get to the masses, in a catstrophic event. Even if it is caused by a sudden depletion of the world’s oil reserves, the infrastructure is there.

  24. a huge fleet of trucks

    ???

    a sudden depletion of the world’s oil reserves

    ^^^^^??????

  25. Anyway, you shop at Wal-Mart to get cheap things, but you pay more in gas to get to the Wal-Mart.

    I manage to stay away anyway. There isn’t one anywhere convenient at all to me. Then again there isn’t anything else very convenient either – the closest (and only) is a Target and it’s still a good piece away.

  26. …and it’s still a good piece away.

    oh, Lynnster…
    You just gave me a tiny flashback to my daddy. He used to say that as a measure of distance, too…

    “aw, that’s a good piece away from here”

    You just kinda made my day. :)
    (Sometimes it doesn’t take much, but sometimes it’s the littlest things that are the sweetest.)

  27. I think “good piece” and “fair amount” are pretty interchangeable with me, but maybe I settled on that one this time thanks to some unseen forces JUST to give you a smile today. :)

  28. Infrastructure, Kat. Key word. A smaller, less organized entity could not insure timely delivery of provisions. I’m not talking about on a for profit basis. I am saying that, if tasked, and provided fuel, they could deliver to almost anywhere, and their warehouses are strategically located. Plus, they have amazing software to aid in that endevour. My spelling sucks, but I’m too tired to care…

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