🍩 Groceries, a GP visit & Generic drugs... On Demand?! 🏥
Woolies announced their telehealth play, and we have some thoughts... on everyone else's thoughts
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ICYMI - Woolies recently announced they’re entering the telehealth game (yes, “the fresh food people”). 🍏
Prompting more debate than… well… most things I’ve seen in healthcare in Aus. It kicked off. And I don’t know about you, but the mixed reactions and many opinions - left me fascinated.
So what is it exactly are Woolworths doing, you ask?
*LAZY INSERTS SCREENSHOTS*
I guess like with any big change, especially those affecting long-standing power dynamics, there is always going to be resistance. Stemming from a mix of good reasons, along with fear, misunderstanding, self-interest, and a multitude of endless others.
Either way, the one thing that is for sure…
Change is happening. And will continue to.
Whether we like it and agree, or not.
So today we’ll take a look at a few of the underlying issues.
💡 Some thoughts…
(🫖 Brought to you after wasting far too much time wading through endless comments and some epic discussions with our WTH private community crew)
In today’s episode of “Let’s State the Obvious”…
We’re in a primary healthcare crisis. And have been for good a while.
There’s a GP shortage. It’s getting worse.
It’s a stupidly complex issue. That’s been in the making for decades with no quick fix in sight.
Despite what news.com.au article’s blatant BS and clickbait headline said (though let’s give it to them, it 💯 did the job and got the attention they wanted) - Woolies does not have a fix for the GP crisis. Nor do they actually claim to.
Whilst Woolies’ may not “solve Aus’s GP problem”, I for one think their new foray further into health is interesting, and inevitable, presenting some intriguing opportunities for consumers, patients, and potentially even professionals.
And look… at least something is being done.
Also, does this mean I can get rewards points for GP visits?!?! 👀 🎫
A few points upfront
No one is saying this solves any systemic problems (except news.com.au lol), but if it starts to help with accessibility - that’s great!
Like anything - there are clear use cases it could be great for, and others, terrible for. So there is a need to be discerning, have clear education and communication, and see what comes next
This will not fix the GP crisis - but it might help with the distribution problem. And maybe even present some more flexible career options for clinicians?
Something I do find puzzling though, was how so many seemed to think that this… wasn’t possible?
Anyway - apparently this was a wake-up call.
But what’s been particularly fun is the seriously strong opinions going on in the comments sections…
On privilege and all-or-nothing thinking
There’s a very valid argument and concern about the “lack of continuous care” — meaning due to minor one-off visits many things can be missed and often result in subpar or dangerous medical care.
That’s all very true. But what this fails to consider, is currently many people don’t even have a regular GP. Data shows millennials and younger generations often are more nomadic or just don’t want one. Many can’t afford it. Not to mention… current wait times have blown out to weeks to months.
Sometimes, care is better than no care.
Another fascinating thing I find in healthcare, which is mostly shades of grey - is the tendency for black-and-white, or all-or-nothing thinking.
After endless convos and trawling discussions - there’s a clear “good” vs “bad” mentality in a decent chunk of the views. Things in life are almost NEVER that simple. Especially in healthcare. It’s all about specific context and use cases.
In the case of woolies…
Is this good for doctor certificates? Basic regular script renewals? ~ Probably
General Health Checkup? ~ No
Also, what many seem to forget is that “Reality” and “The Gold Standard of Care” or “What should be”… Are actually worlds apart.
In practice - the gold standard rarely ever occurs. It’s a “should”. And due to system strain, it almost never happens anymore. And, that gap is only getting bigger.
We can talk all we like about what “should” be happening - but without any practical resources, actions, or a plan to support that, then it’s really nothing more than a dream we’re idolising. Don’t get me wrong, we need something to aim for. But there’s a big difference between striving for greatness, with at least a plan to try to make it happen, and delusional daydreaming.
Hell, the fact we can even spend our time hashing out this stuff goes to show our privilege. We know enough to consider its implications, know how the healthcare system works, argue over it, and very likely, have options and access to regular care if we need it.
When reality is - there are millions out there who don’t. And might kill for something like this. Or might have an opinion. But we’re probably leaving them out of the conversation… as usual.
Relevance, Branding & Capitalism
Whether we like it or not - we live in a capitalist society. Which is embracing technology at a rapid pace.
Every industry, and organisation, is in a race to stay relevant. And valuable. Healthcare has somewhat been immune given the public structure. Which is great - it should be a universal right.
But as costs continue to increase, and resources decrease - margins and making “the business” of healthcare practices work, are becoming harder than ever. The economics of healthcare have not made sense for a very long time.
So naturally - I reckon this can go one of two ways…
1) The gov steps in to subsidise and fund things properly publically
2) Increased privatisation + Bulk service options
What many seemed to miss, is that option 2) has actually been happening slowly for years. In the form of super clinics and chains. PE groups. Private Hospital chains and private health spreading their wings. It just hasn’t been as “obvious” or stepping outside of our neat little boxes like Woolies is making this move.
But, woolies kind of makes sense from a business standpoint. They have a brand, trust and distribution. They have such big balance sheets that they can afford to run off low margins or even at a loss while they get things rolling.
It is already happening, pretty much everywhere but Aus
We’ve already seen this model take hold in the US (CVS, Walmart, Amazon's ever-increasing health plays), and in the UK. Surely we weren’t naive enough to actually think it could never breach our shores?
The argument (in my limited understanding) for why this type of thing was blocked was due to “quality of care”, “protecting conflicting interests” and our “public health system” being able to provide it. Well, now it clearly cannot provide. Leaving the public desperate. And without the government updating regulations, the old laws of supply and demand, come back into play.
And, if you look into the crystal ball which beholds our future, it kind of looks a hell of a lot like the NHS.
There is a growing lack of trust in the health system
Woolworths is THE most trusted brand in the country. At least according to Roy Morgans's consumer sentiment survey of >22,000 Aussies, and has been for 5 consecutive quarters. Beating out Aldi, and Apple.
Although unpopular amongst some, this puts them in an very interesting position. Especially given the continued loss of trust in healthcare providers and professionals.
Consumers have been taking things into their hands and searching for solutions. And one of the nations, biggest, most trusted brands just served one up
Kind of ironic given they are reportedly the single biggest owner of pokies machines in the country. Guess that was overlooked?
Sure, this one divides the crowd - but given their market share they don’t exactly need everyone to be on board to still have a sizeable business.
GP has a branding, incentivisation and structural problem
I started Med school ten years ago (*shudders* - eww I’m old).
Naturally, as naive, confident young idiots - we discussed specialisations and ambitions. Even then, there was a very real stigma to becoming a GP. They were under-resourced, increasingly becoming glorified admin monkeys, forced to do more with less, and with that less medicine and patient care which many are drawn to medicine for. And (often) paid peanuts compared to other specialisations. The main “reason” you did GP, was for “lifestyle”(ie - not a million years of training and unpredictable placements and night shifts). There was little to no incentivisation.
It was often said - you don’t go through the hell that is medical training to “just become a GP” (no disrespect here to all the INCREDIBLE GPs, just quoting many many conversations).
Unsurprisingly, the problem has gotten worse.
And they reckon we’re going to be short 10,000 GPs in the next 7 years.
Something has to change here…
Time to Spitball Some Pros & Cons Baby
✅ Potential Pros
The rural argument - increased healthcare accessibility - Regional & remote areas are in trouble. Increasingly struggling to attract the health workforce they need. Waiting weeks or needing to travel crazy distances. This could help with that
One of use case help - For things like scripts, doctors’ certificates, or even referrals, this same-day affordable service could help a hell of a lot of Aussies
It might make people value “real” healthcare - Sometimes, you have to try other options to appreciate what you have or understand what quality is. This “one off” shop might not be for everyone and see “proper” care providers come out on top
Reducing some of the admin burden - GP and health clinics are riddled with the endless admin. If this can be taken off the hands of clinicians, clinic owners & patients or streamlined, that could be a big win and free up resources
Redistribution - Services like this could potentially help with getting basic services to where they are most needed. Helping vulnerable demographics, remote and rural individuals and those too ill to leave home access care
Streamlining services - Healthcare is pretty darn inefficient. If you can get things in one place, and delivered - that’s going to save a lot of people time, money and stress. *If executed well
Providing (potentially) more stable and flexible employment options for clinicians - The flexibility and stability component of being a doctor can be challenging. If this works, it could help with that
Might it actually get the gov into gear? - I know it’s optimistic, but maybe, just maybe this will government sit up, pay attention and act to help put in stopgaps. But - even then, I’m not sure how long it will take to save this Titanic.
❌ Some things that are a wee bit concerning
Lack of continuity of care & Medical Context - Pretty obvious. Without context, and continued medical care, we miss the chance for proper comprehensive healthcare, monitoring of conditions and treatment, and general checkups. Which can be pretty dangerous
Opportunities for abuse - It’s easy to emit information when you’re meeting a doctor for the first time. And could lead to the wrong medications, prescriptions and other things which fall through the cracks
The devaluing of doctors’ time and expertise - This isn’t isolated to this particular play, but the inherent value of anything is always what someone is willing to pay. And people in Aus have grown accustomed to not paying (or much) for healthcare. This does potentiate that trend
Use of data and privacy - This one, is probably the most intriguing and complex conundrum in this case. Given Woolies and its many brands collect endless data points which are then used for targeted advertising, how and where will they draw the line?
Potential conflict of interest and predatory behaviour
”With great power, comes great responsibility” ~ Master Yoda
But in all seriousness, with things like people’s health in their hands and lots of competing commercial interests (*cough* pokies, groceries, retail, pharmacy) it’s not hard to see how this could cross the line
And, it’s probably why the gov has prohibited big supermarkets from selling prescription drugs…
Anyway, to round off this rant
It’s easy to cast judgement, throw rocks, and point out problems. And look, I’m a littttle worried about the potential ethics. But, what are our other solutions?
Overall - I’m sticking to my OG comments. I sit in neither the “this is the only way” nor “this is terrible camp”. But instead, trying to look at it from a lens of practicality - where we live in a capitalistic and consumer-led society, with a crumbling public health system that no longer meets the needs of our country.
Also, I’m beyond curious about the domino effect it will no doubt have on other businesses, the government, and maybe even the industry at large.
After all - someone has to do something…
And if we wait for “perfect” action, we’ll all be waiting a bloody long time. And it will be far too late.
What do you think? Agree? Disagree? Very curious about your take on this!
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Thats all folks
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