Retail Healthcare News

Coughing and wheezing, you sit in the waiting room for two hours while flipping through Field and Stream magazine. Finally, your name is called and you are led into the treatment room … where you wait some more until the doctor arrives.

More people are choosing a quicker option for common illnesses — retail health clinics located in malls and pharmacies that are staffed by nurse practitioners and physician assistants.

There are nearly 1,000 retail health clinics in the nation, according to a recent study by Verispan, a number that is expected to rise dramatically in the next few years as chains like Wal-Mart, CVS, Target and Walgreens add more clinics.

A 2007 poll by Knowledge Networks predicted that there will be around 2,000 retail clinics by the end of 2008. Wal-Mart, which until 2007 leased space in its stores to outside companies, announced in April 2007 that is will lend its own brand name, The Clinic at Wal-Mart, to the 400 retail health clinics it plans to open by 2010.

According to an estimate by the Convenient Care Association, an industry trade group formed in 2006, about 7 percent of Americans have tried a retail health clinic at least once.

Frustrated Patient Starts Trend

One company that offers retail health care is MinuteClinic, which currently has 505 locations in 25 states across the country and more on the way.

According to MinuteClinic’s Web site, the company was started up by Rick Krieger when he got the idea after he took his son to urgent care in 1999 in Minneapolis for a strep throat test and ended up waiting two hours.

A year later, Krieger and a few partners started up QuickMedx, which changed its name in 2002. The company has rapidly expanded to become the largest provider of retail health care in the United States, according to its Web site.

Treatment at a MinuteClinic location costs an average of $30 to $110, and the health practitioners are certified to write some prescriptions. The company is also in-network with most major health insurance companies.

Treatment focuses on strep throat and ear, eye, sinus, bladder and bronchial infections. MinuteClinic also provides some common vaccinations, such as influenza and tetanus.

Experts Disagree On Value

A 2007 article in the American Journal of Medical Quality found that retail clinics provide “exceptionally high-quality care” for acute pharyngitis, the medical term for sore throat.

Not all of the medical world’s opinion on retail health clinics has been positive, however. Some medical organizations have pointed out that certain illnesses could be misdiagnosed without proper physician oversight.

Donna Haugland, director of nurse practitioner services for MinuteClinic, said that the company will always refer a patient to a local physician if their conditions are serious. She also said sites have lists of physicians they refer people to and do not simply tell them to go somewhere else.

“We are a focused practice. We treat well people for common family illnesses,” said Haugland. “We have a menu of maybe 30 conditions that we treat, and we don’t treat outside of those conditions.”

She said that they will also refer patients to doctors if they have several things affecting them

One State’s Battle

When MinuteClinic wanted to expand into Massachusetts last year, the Massachusetts Medical Society resisted. The group listed its concerns, including the possibility of retail health clinics driving physicians out of business.

An article in the June/July 2007 issue of Vital Signs, the member publication of the MMS, said, “The matter raises myriad concerns, including patient safety and privacy, continuity and quality of care, and physician practice viability.”

Haugland does not agree, and said that MinuteClinic actually helps private physicians in several ways, including the referrals they provide to patients.

“There are times that we can really lift some things from family physicians, some of the simple, straightforward conditions to allow them to see the more complicated things,” said Haugland. “I think they will actually thrive. My belief, and I think the numbers show it, is that in the areas where we are in and very active, actually it’s a really good reciprocal relationship.”

Among the MMS’ objections was also MinuteClinic’s request to waive certain requirements in the state for health care providers, including having soiled linen area, a separate entrance and exit for patients, a minimum examination floor space of 80 square feet and a patient toilet room with a washing station.

In an interview with the Boston Globe in September 2007, MMS President-Elect Dr. Bruce Auerbach called the proposed waivers an “open surrender of basic standards.”

The Massachusetts state government is still in the process of reviewing MinuteClinic’s application for clinic licenses, and the company does not yet operate in the state.

But despite certain objections, it seems the convenience and low cost of retail health clinics will keep them on the rise.

In the February 2007 issue of the New England Journal of Medicine, Dr. Richard Bohmer wrote, “Given the stresses expected to bear upon delivery of services in the future, such models deserve consideration as one potential mechanism for managing a particular class of medical problems, serving a particular patient need, and maximizing patient benefit with limited resources.”

Source: NBC4.com
Original Publication Date: March 18, 2008