1. How far can CVS and other pharmacy chains get into the doctoring business?

In announcing Wednesday that CVS Caremark would stop selling tobacco, chief executive officer Larry Merlo said selling cigarettes would be, according to a company press release, “inconsistent with our purpose.” He explained, “As the delivery of health care evolves with an emphasis on better health outcomes, reducing chronic disease and controlling costs, CVS Caremark is playing an expanded role in providing care through our pharmacists and nurse practitioners.”

I’d like to know more about what Merlo has in mind vis a vis that “expanded role in providing health care.”

Drugstore chains like CVS, Rite Aid and Walgreens already offer flu shots. How is that regulated? Is it allowed in all states? Do licensed nurses have to provide them? Did doctors’ groups or health clinics lobby against it?

How else might CVS and its competitors use its pharmacists and nurse practitioners? How much can nurses do before a doctor is required? (And, again, how does that vary by state?) Do any drugstore chains have plans to put doctors on duty? Have any done so?

Finally, with hospitals now expanding their reach and control of their markets by buying competing hospitals as well as doctors’ practices, are any partnerships in the talking or planning stages between dominant hospital systems in various regions of the country and one or more of these drug chains? Imagine the expanded footprint a hospital system would have if it had an outpost in hundreds of retail outlets.