Walmart wants to become the nation’s biggest provider of primary care. Primary care. As in long-term management of chronic conditions, not just flu shots and ear infections. Terrifying? Or brilliant? I’m more of the former opinion. I don’t see how a Walmart super center can ever serve as a proper medical home for patients with chronic diseases and multiple comorbidities, and I can’t imagine a model of care involving Walmart clinics that won’t further marginalize mental health services from other medical care or that will really improve care coordination across different systems. But of course I’m biased towards more integrated health care systems like the community health center model, and frankly, I don’t know if I would ever want to work for Walmart as a physician. Then again, maybe a Walmart clinic is a brilliant solution for rural areas, where there are few physicians and lots of logistical barriers to running a clinic. Maybe we just need really crazy ideas like this to shake up the system. What do other people think? Could this ever work? What about the rural med angle?