Would you go to a mobile clinic at a Dollar General store? : Shots - Health News Dollar General's primary care experiment could help solve rural America's care shortage. But it's getting a chilly reception in Tennessee.

A mobile clinic parked at a Dollar General? It says a lot about rural health care

  • Download
  • <iframe src="https://www.npr.org/player/embed/1202188258/1205245200" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript

AILSA CHANG, HOST:

Dollar General, with its big yellow sign, has 19,000 stores nationwide, more than any other retailer. Eighty percent of those are in small towns. And now Dollar General is pairing up with a mobile clinic operator for an experiment to bring health care to rural residents. Reporter Sarah Jane Tribble traveled to Tennessee and discovered that winning patients isn't as simple as just setting up shop in a parking lot.

SARAH JANE TRIBBLE: The mobile clinic looks like a cross between a small RV and a food truck. One side is covered with a bright blue and yellow poster - vaccinations, physicals, prescriptions. When registered nurse Kimberly French arrives for her shift, she snaps a cord on an exam chair back into place. We talk over the hum of the air conditioning.

KIMBERLY FRENCH: A lot of it's already set up. I come in and just make sure everything that's lost its way on the trip is back where it goes.

TRIBBLE: The van has been trying out different Dollar General locations since late last year and trying to win people over. French uses an iPad to connect patients with a nurse practitioner or physician assistant. She can also do labs, give shots and just be with the patient - that is, when there are patients.

FRENCH: We don't have any appointments so far today, but that could change. Last night, we didn't have any appointments and three or four people showed up all at one time. So...

TRIBBLE: The clinic is owned and operated by mobile health provider DocGo, as in doctor on the go. The company is based in New York. Business boomed for DocGo during the Covid-19 pandemic. But in recent weeks, the company has faced scrutiny for how they are delivering care in New York and their use of public funds there. Meanwhile, here in Tennessee, with its partner Dollar General, the company is trying to figure out health care in rural America. Bubba Murphy was walking into a Dollar General when I stopped him to ask about the mobile clinic.

BUBBA MURPHY: Oh, I like it because we don't have to go to town and fight all that traffic.

TRIBBLE: Dollar General says its partnership with DocGo complements the retailer's effort to increase access to healthy products like vitamins and supplements, particularly in rural America. The whole idea, they said, is to test and learn. Seventy-two-year-old Lulu West moved to Tennessee years ago and already has a primary care doctor she trusts.

LULU WEST: When you say mobile clinic outside a Dollar General, it just kind of has a connotation that you may not really be comfortable with, you know what I mean? A little doctor by the grocery store, you know? I don't know.

TRIBBLE: Outside another Dollar General location not far away, I met business owner Nichole Clemmer. She's not impressed.

NICHOLE CLEMMER: It's just another way for them to make money, because I'm thinking, what the hell do they have to do with health? But it could be beneficial. Now, if it was free, then yes. Then I'd be, like, all for it if it was free.

TRIBBLE: It's not free. DocGo and Dollar General are both for-profit companies. DocGo takes private and public insurance. And there's a self-pay option, too, though the company declined to provide exactly what that cost is. Tom Campanella is a longtime health care executive and understands the business of running mobile clinics. Having a health care van sitting outside a Dollar General could mean more traffic for the store and help people.

TOM CAMPANELLA: They have a tremendous opportunity, given their existing footprint, to have a major impact on health there.

TRIBBLE: There is rural America. Health industry watchers say providing care at thousands of Dollar General locations could be a game changer for areas that don't have enough doctors. Primary care physician Carlo Pike is always busy. He's been around for decades in northern Tennessee. He says developing a relationship takes time and ongoing attention.

CARLO PIKE: If I can do this relationship right, maybe we can keep you from getting a sugar of 500 or from, you know, grandpa climbing up a ladder and trying to fix something he has no business with and falling off and breaking his leg.

TRIBBLE: To introduce the mobile clinic, the DocGo van goes to community gatherings and gives out swag. But it didn't work in Cumberland Furnace, the most rural location they tried. Lottie Stokes is president of the community center there.

LOTTIE STOKES: They have called and asked to come down here and I wouldn't ever answer them back.

TRIBBLE: Stokes sees no need for the mobile clinic. She'd rather just call the local EMTs and fire department.

L STOKES: Yeah, I know them guys. I know they're legit. You're looking at somebody that I don't know that well that's calling me to ask for permission to come down here and set up for our events that I don't know when I have somebody that's local that I know.

TRIBBLE: Stokes may not think there is a need for the clinic, but after we stopped talking, her father-in-law, Bobby Stokes, quietly called me over. He's nearly 80 and said he and his wife went to the mobile van one night. She couldn't breathe. They pulled into the parking lot and climbed on.

BOBBY STOKES: We wasn't in there five minutes. They done the blood pressure test and what they need do and put her in a car so they can get her to the hospital, to the emergency room.

TRIBBLE: I asked if DocGo wanted payment - did he give them money?

B STOKES: I don't guess they did because I didn't give them none.

TRIBBLE: What about your insurance card?

B STOKES: Didn't even give them that.

TRIBBLE: Nothing at all?

B STOKES: Nothing. They were more concerned with her than they were, I guess, with getting their money.

TRIBBLE: Stokes says his wife would not have made it through the night.

B STOKES: They told me to get there, and I took them at their word. My car runs fast (laughter).

TRIBBLE: He and his wife got the care they needed. The question remains, though, of whether this particular marriage of health care and retail could help enough patients in rural America.

I'm Sarah Jane Tribble in Tennessee.

CHANG: This story was produced in collaboration with KFF Health News.

Copyright © 2023 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.