Retail Clinics: Do They Help or Hinder Health Care Delivery?

We used to call it “doc-in-the-box”—a free-standing clinic where you could get seen without appointments and for less than it would cost to go to an emergency room.

These clinics more recently are known as urgent care centers and they’ve continued to evolve. The latest nomenclature is “retail clinics.” They’re popping up in grocery stores, pharmacies and Wal-Marts in urban and suburban settings, and they are staffed almost exclusively by nurse practitioners.

There are many pros and cons to these retail clinics, which are discussed in a new report by the California Health Care Foundation. It is co-authored by Mary Takach, RN, MPH, a policy specialist at the National Academy of State Health Policy.

According to the report, these clinics are proliferating. Currently, there are more than 1,000 in 37 states, and the nurse practitioners mostly see people with sore throats, earaches, rashes, upper respiratory infections, urinary tract infections and other minor health problems.

Employing nurse practitioners who see patients outside a hospital setting means that the cost of these visits is lower than if patients received care from a physician in an emergency room. That’s a plus for everyone, but especially for underinsured patients who have high deductibles.

On the other hand, these clinics are sometimes still too expensive for underserved, uninsured consumers. Some also fear that continuity of care becomes a problem when patients forego visits to their regular doctors for an appointment with a nurse at a retail clinic.

According to the report, every state has different rules and regulations for retail clinics and each state differs in the policies that regulate physician oversight for the nurse practitioners. Only Massachusetts treats the retail clinic as a new and separate entity with its own set of regulations tailored for this type of health care delivery.

The study concludes that there appears to be little continuity from state to state on how these clinics operate.

What do you think are the pluses and minuses of retail clinics?

Do they help bring down the cost of health care or just complicate and fragment health care?

Tell us what you think.