>>http://www.nytimes.com/2015/07/12/business/how-cvs-quit-smoking-and-grew-into-a-health-care-giant.html

Sometimes changes that seem to make perfect sense turn out to be dreadful own goals. I'm reminded of a manager in a quaternary care public (socialized care) hospital who once announced that patient questionnaires about surgeon politeness and willingness to explain were being introduced so that departments and surgeons could be compared and rated. In response, the head of orthopedics observed that there were 36 patients booked in his clinic that afternoon, but that best practice guidelines were that he should see one patient every 20 minutes, meaning 12 patients in the afternoon clinic, or eleven if he took a break. He promised that those eleven patients would give a glowing tribute to his explanations and politeness.

The point is that physicians are overburdened in many or most healthcare systems with physicians in the habit of shouldering the load and pressing on. In the US environment, primary care physicians already complain of overwork and are looking for ways to reduce patient load and hours. If devolution of chunks of primary care towards pharmacies is cast as a positive change, you should expect primary care physicians gladly to take the opportunity to reduce hours and alter service offerings to improve their own personal and family lives, a change that international experience says never can be undone once it starts.

Then you need to expect that while some of the nurses are very good, people who never were trained to examine patients or identify abnormality predictably will miss silent infarcts or tumors or ulcers. The ambulance chasers then will set their sights on CVS, multi million dollar lawsuits will flow like water and suddenly patients are being pushed back towards physicians... whose books still are full with people with illness that CVS will not touch. Sorry, says the receptionist, we're completely full and in any case Dr Jones is out of practice with upper respiratory problems and ethically would need to do some courses if she wanted to resume that sort of service which isn't practical when we're bursting at the seams like this.

Been there, done that. So far the end position has been that options and/or access is reduced while the cost goes up and up.