From Robert Whitcomb's "Digital Diary,'' in GoLocal24.com

As insurers, drugstore chains, such as Rhode Island-based CVS, with its Minute Clinics, and the likes of Walmart team up to provide direct health care, independent physician groups face growing pressure. Many doctors have decided to throw in the towel and become hospital employees. Meanwhile, many physician groups (including the one I use) are extending their hours and making other changes to be more convenient for harried patients in order to better compete with the retail clinics.

The clinics are a response to America’s astronomically expensive, fragmented and inefficient health-care system. They offer a range of services for injuries and illnesses that can often be treated by a nurse, nurse practitioner or physician’s assistant at a cost considerably less than a physician would charge and much, much less than a hospital emergency room.

But will your local Minute Clinic get to know you, especially if you have a chronic illness, as well as  your primary-care doctor, so as to be in a position to adjust your care over time? And what sort of relationships will develop between local physicians and retail clinics, considering that they’ll often be competitors? The retail health-care revolution is just getting going. The old model of American health care is falling apart; it’s economically unsustainable.