Is Amazon a Threat to Chiropractic?

Technology continues to rapidly change how health care is delivered. A 2020 article discussed how Google parent Alphabet has been investing in health care artificial intelligence and pharmaceutical products since 2009. Other big-hitter tech companies are making similar investments in an effort to get their slice of the very lucrative health care pie.¹

Giving Patients What They Think They Need

In 2020, Amazon launched Amazon Pharmacy, which began offering discounted prescriptions through the mail. In early 2023, this was extended to include Amazon’s RxPass. This $5-per-month service offers Amazon Prime members the ability to reduce their medication costs by 68%. In addition, the subscription fee includes over 50 generic drugs for common conditions like high blood pressure.

The service is not currently available to people on Medicare or Medicaid, and can’t be used with health savings accounts or flexible spending accounts (HSAs or FSAs). But the price is right and will likely gain a considerable number of subscribers quickly.

And That’s Only Part of the Plan...

The above works nicely with another recent development: the Amazon Clinic. This online clinic network brags it offers health care service with response times of an hour or less depending on the ailment. According to the website, patients can just “answer some questions, get a treatment plan from a licensed clinician. No video visit or live chat required.” Unlike many concierge clinics, patients don’t even see their provider online.

After reviewing a patient’s questionnaire of current symptoms and a basic health history, a U.S.-based “clinician” (doctor or nurse practitioner) will message a “personalized treatment plan” that will likely include a prescription or recommendation for over-the-counter drugs (made easy with the advent of Amazon’s RxPass), along with any relevant self-care strategies. Patients have 14 days to message back any questions they may have relating to their “visit.”

Amazon Clinic currently uses a network of online consultation services from Health Tap and Steady MD. They operate in 32 states,² addressing 18 conditions with co-pay-like, flat-fee consultation prices that range from $30 for issues like birth control and allergies, to $49 for issues like heart burn and herpes.

Patients can also get an online prescription renewal consultation for one of five ailments for only $30 – another opportunity to push patients to the Amazon Pharmacy. Amazon Clinic only accepts cash, but patients can use a debit card from their HSAs or FSAs.

Just the Tip of the Iceberg

Amazon Clinic is expanding quickly, recently buying One Medical for $3.9 billion.³ One Medical has 188 offices in 29 markets serving 767,000 members. The acquisition adds New York, Arizona and the District of Columbia to the list of states Amazon Clinic will be able to serve. A year earlier, One Medical bought Iora Health for $2.1 billion. Iora Health focuses on Medicare Advantage patients.

Amazon Clinics seems poised to reduce nonemergent health care to a series of questions, resulting in prescriptions that can ultimately be provided by artificial intelligence programming. One can easily see how this process will be extremely self-serving for RxPass subscriptions and Amazon Pharmacy, “The pharmacy that really delivers.”

Food for Thought for Chiropractic

While the above is in sharp contrast to chiropractic care, the driving factors leading these innovations should be noted. Amazon Clinic boasts the following advantages:

• No waiting room
• No appointment needed
• Personalized treatment plan
• Message your clinician at any time

With its slogan, “Doctor visits made simple,” it is obvious that Amazon Clinic (and other tech companies) are looking to take the time-consuming hassle out of health care. With drugs as the obvious course of treatment for the vast majority of addressed ailments, this methodology seems like a no-brainer. And for those patients who don’t know any better, it is.

Fortunately, this is another scenario in which chiropractic care has clear advantages. Hands-on, truly personalized care that is non-drug, with the goal of wellness, will always result in better outcomes. But maybe there is a page from the Amazon Clinic playbook we should consider:

• How important is it to limit, if not eliminate, the time-consuming hassle factor for your patients?
• Are there things you can streamline in your practice, like online forms and shorter wait times?
• Is “no appointment necessary” something your office can accommodate?
• Can your patients message you or a member of your team any time they need to? If not, what can they do if they need you immediately?

Technology can be a wonderful thing, but at the end of the day, it’s people that matter most. What can you do to make your care more accommodating and ultimately more accessible?

References

1. Petersen D. “Is AI Designed to Sell More Drugs?” Dynamic Chiropractic, Sept. 1, 2020.
2. Note: As of March 2023, Amazon Clinic is currently not available in: Alaska, Arizona, Arkansas, Delaware, District of Columbia, Idaho, Indiana, Kansas, Kentucky, Minnesota, Mississippi, New Hampshire, New Mexico, New York, Oklahoma, Rhode Island, Tennessee, Vermont, and West Virginia.
3. Landi H. “Amazon Scoops Up Primary Care Company One Medical in Deal Valued at $3.9B.” Fierce Healthcare, July 21, 2022.