Timothy Hoff, Professor of Management, Healthcare Systems, and Health Policy recently gave an invited talk in January in the United Kingdom at the Health Services Research Center, University of Manchester Business School entitled, “Just Amazon It: The Good, Bad, and Ugly of Ongoing Disruption in U.S. Primary Care Delivery.” Attendees included University of Manchester faculty, doctoral and masters degree students, and interested members of the community.
Disruptive forces have descended on the U.S. primary care delivery system in the past decade, transforming not only the way we think about health care services but also how and where those services get delivered. Retail thinking rooted in creating more efficient and accessible forms of care delivery that focus on using work redesign, lower-skilled labor, and technology to increase service volume and lower prices is making its way into U.S. primary care led by non-health care companies such as Amazon and Apple that have used similar tactics in their other business lines. Some see this primary care disruption as “fast-food”, i.e. a cheapened form of care that lowers relational excellence and overall quality in the health system. Others view it as a needed correction to the physician- and hospital-controlled service provision typified by high costs, poor access, and lower care quality. A wave of mergers within the American health care industry between pharmacy chains and insurance companies, designed to provide one-stop health care shopping for large groups of patients is also part of the disruptive trend. The seminar analyzed these developments and their implications for patient care and the health care workforce.