Retail Clinics: Good Idea or the Demise of Provider-Patient Relationship?

Retail and clinic are two words that, when put together, don’t easily roll off my tongue, but the “retail clinic” is apparently an idea whose time has come—
and it may be here to stay.

A retail clinic, by definition,, is located in a major retail or pharmacy chain like Target or Walgreens, or a supermarket chain like Safeway. The clinics provide quick, affordable treatment for routine conditions, and are often staffed by nurse practitioners who can assess illnesses, treat then and prescribe medications. These nurses also can offer preventive services such as vaccinations and immunizations, health screenings and sometimes physicals.

According to a recent study by the RAND Corporation, a growing number of consumers are discovering retail clinics for themselves. In 2009, visits to retail clinics increased fourfold to nearly 6 million.

“The rapid growth of retail clinics makes it clear that they are meeting a patient need,” the authors wrote. “Convenience and after-hours accessibility are possible drivers of this growth.”

In general, compared with freestanding clinics or emergency rooms, the cost of care in retail clinics is lower, so it’s understandable why some consumers and patients see this as a preferable option.

“The primary focus of these clinics is episodic care, making them a very good alternative to the local emergency department for the person suffering from a seasonal cold or general ear infection, or in need of a flu shot or other similar immunization,” writes Geneviève M. Clavreul RN, Ph.D., a healthcare management consultant based in Pasadena, Calif.

She further argues that “retail health care clinics also provide two very important aspects that are lacking in our current system: convenience and a patient-oriented model of delivery,” which is lacking in many physicians’ offices. Mostly, it’s about that wait, Clavreul continues, and in general, waits in the retail clinics are much less.

Additionally, patients often receive a more detailed bill than they might in a traditional clinic or physician’s office, itemizing the charges for provider care, medication, supplies etc..

Though the number of visits to retail clinics continues to increase (Safeway is building more than 100 retail clinics in its California grocery stores, according to a story for California Healthline), the RAND study found that retail clinics still make up a small share of all visits in outpatient settings. Compared to the 6 million annual visits to retail clinics found in the study, emergency departments recorded 117 million visits, and physician offices 577 million visits.

As with any change, there is resistance.

The American Medical Association, the American Academy of Family Physicians, and the American Academy of Pediatrics are on record as opposing the clinics. There are concerns about the disruption of the doctor-patient relationship and the continuity of care. This concern has grown since some retail clinics also began offering care for chronic illnesses such as asthma, hypertension, and diabetes.

Others see the issue as simply a “turf war” between physicians with established practices and the retail clinics.

“These clinics truly are a niche for patients who seek care and treatment and for the nurse practitioners that choose to staff them,” writes Clavreul. “It’s also yet another reason why I think nursing is one of our greatest professions. Where else can you find such a wide variety of existing and rewarding work experiences?”

Do you think retail clinics are a good idea, and do they serve a unique purpose?

What role do you think nurses can or should play in this market?

Tell us what you think.