Just in the NY Times:

Attention Shoppers: Low Prices on Shots in Clinic

Everyday low prices on strep-throat exams.

That is the basic idea behind a retail approach to routine medical care now catching on among consumers and entrepreneurs. At Wal-Mart, CVS
and other chain stores, walk-in health clinics are springing up as an
antidote to the expense and inconvenience of full-service doctors'
offices or the high-cost and impersonal last resort of emergency rooms.

For a $30 flu
shot, a $45 treatment for an ear infection or other routine services
from a posted price list, patients can visit nurse practitioners in
independently operated clinics set up within the stores — whose own
pharmacies can fill prescriptions.

"It was a lot easier to
know you can just drive up the block to a clinic, rather than spend
time in the pediatrician's waiting room," said Liz Lyons, who recently
took her 9-year-old son to have a sore throat swabbed in a clinic at a
CVS drugstore in Bethesda, Md.

She made a $10 co-payment, with her husband's insurance picking up the rest of the $59 tab.
 

 The rest of this article can be found here

 I can think of lots of clever marketing campaigns, such as:

1. A smiley face wearing a stethoscope (go to Sam's club and you can get the whole family seen at once)
2. Shots-R-Us franchises
3. Starbucks offering ADD therapy ("I'll take a double Ritalin espresso")
4. Back injury clinic at the Home Depot (also can re-attach fingers, arms, etc).
5. Big Lots offering expired meds for cheap prices
6. Krispy Kreme weight loss clinics
7. McDonalds includes Lipitor in a "Super Healthy Value Meal"
8. Motor Vehicles office with anger management and blood pressure clinics
9. Victoria's Secret STD clinic
10. Marital Counselor at Hooters

But seriously...

You have to understand, this scares us physicians to death.  Yes, I can raise all of the objections I want against this (the most important of which is that these patients don't get longitudinal care, just episodic care), but the market is speaking and so how are we going to respond?  The fact is, we make more money off of the quick sick visits that these clinics cater to than we do from the scheduled office visit (not because we charge a lot, but because we can see more of them in the same time it takes to see a scheduled appointment).  If we lose these visits, we will lose a lot of revenue.

Physicians have allowed this to happen.  We have not found a system that is suited to the needs of our patient - to be seen in a timely manner and to contain cost, so one is coming up without us.  Patients would gladly come to our office instead of an ER, but office appointments have been hard to come by and offices are not open late or early. 

I really believe that we can offer a better alternative in the private physician's office, but to do so we need to adopt what is good about these walk-in clinics and combine them with what is good about the primary care office setting.  We need to find a way to improve the incremental cost to the patient, increase convenience, while maintaining high quality.  Can this be done?  I am not sure.  Insurance company reimbursement is a big problem, in that we tend to charge what the highest bidder will pay and write off the difference for those who do not pay.  A better approach needs to be devised.  Otherwise, the already-fragile financial state of our practices could be threatened even more. 

Any ideas?