Inmar Inc. | November 5, 2013

Yes, they can and they should. Retail clinics are on the rise. With Affordable Care Act (ACA) taking effect, the affordability and convenience of the retail clinic has huge appeal for the millions of previously uninsured who do not have a primary care physician.

The beginning lines of the Oath of the Pharmacist state, "I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow, I will consider the welfare of humanity and relief of suffering my primary concerns." Patients' quality of service is the key desired outcome, which is one of the goals of a retail clinic.

With an expected growth to 2,800 clinics by 2015, healthcare systems must look closely at the reasons for this increase and address them within their own practices to prevent financial loss as well as lapses in patient care.

In my opinion, the benefits of the retail clinic are immeasurable. While healthcare systems argue that chronic conditions need the monitoring of a primary physician, retail clinics can show that many patients who do not have a primary care physician would never have received a diagnosis of high blood pressure, high cholesterol or diabetes without their screenings and diagnoses.

Retail clinics are good sources for low-acuity ailments such as sore throats and colds. However, there is a trend for them to do more, such as managing chronic conditions like high cholesterol, diabetes, asthma or hypertension. One of the nation's largest drug chains announced in 2013 that its clinics would enter the arena of chronic care management, assessment and treatment — clearly veering into an area that had been primary care territory.

The millions of uninsured who have no access to healthcare can only benefit from having convenient access to low-acuity care that could keep bronchitis from becoming pneumonia. Retail clinics potentially offer complete patient visibility and with the right partnerships could help monitor newly discharged patients to help ensure they stay on their formulary plans for recovery and maintenance, only pushing patients back in to a health system when it is necessary.

Retail clinics do not have to be a competitor for healthcare systems and physicians. Instead, they can be a community partner to keep emergency rooms and urgent care clinics open for more serious ailments and help treat minor ailments efficiently without adding great cost to an overburdened system. Further, retail clinics with in-house pharmacists can help manage therapies for specialty pharmacy and increase adherence among patients if they can handle the strict guidelines for reporting and outcomes management.

There is a need for retail clinics to be aware of cost/value relationship. With the relationship between retail clinics and pharmacies, there are significant time and resource savings to patients. However, patients on tight budgets should feel free to fill prescriptions where most affordable. This is imperative for retail clinics to operate fairly and avoid conflicts of interest when administering patient care. With retail clinics part of for-profit retail chains, they must be wary of the temptation to increase pharmacy margins by filling prescriptions or recommending products they sell.

Professional and special interest groups have voiced their issues, citing concern about further fragmentation of care, lower quality and higher cost and the ultimate risk to patients' long-term health outcomes. Retail clinics on the other hand argue that they actually improve access to medical care for an underserved population and that they can serve as a gateway to health systems through strategic partnerships -- a first step to medical care. Insurers are becoming more supportive of retail clinics particularly for large-scale initiatives such as flu shots and the lower costs for care.

According to a study from the RAND Corporation, primary care physicians need to change the way they do business to compete with the convenient care available at retail clinics — same day appointments, walk-in clinics, online visits and creation of their own retail clinics are suggested ways to remain competitive with retail clinics. Retail clinics are a reality. Is the best response for healthcare systems to partner with them to provide as much quality patient care as possible?

The ACA will offer many of the nation's lower income residents their first opportunities to seek medical treatment on a non-emergency basis. Retail clinics provide a first step to healthcare by providing convenient service with lower co-pays and the blessing of insurers. If a condition is severe, retail clinics can refer patients to healthcare systems and specialists as needed.

Both sides have merit and sound arguments, but what is your take?

  • Will patient care suffer from a growth in retail clinics?
  • Is there a way to consistently treat patients who use multiple clinics?
  • Will retail clinics stay with low-acuity patients or will they expand for the possibility of an increased revenue stream?

I would like you thoughts on this timely and often controversial topic. After all, convenient care does not mean inferior care. Please join the conversation by leaving your comments below.


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