The emergence of healthcare clinics in grocery, drug and big box stores has generated a fair bit of controversy in the medical world. Some people praise clinics for their convenience and affordability while others -- namely, the American Medical Assn. -- say they worry that the clinics provide inferior care and discourage a regular doctor-patient relationship.
Several studies in the current issue of Health Affairs throw some sorely needed light on this topic. One report, by Rand Corp. researchers, is the first examination of the types of patients who use retail clinics and what kinds of services patients seek. The study found that most of these consumers do not have a regular healthcare provider and use the clinics for simple conditions or preventive care. The clinics attract insured and uninsured patients. Researchers found that 43% of the patients were ages 18 to 44 and just 39% said they had a regular doctor.
The study is important because it discounts a couple of the criticisms aimed at retail clinics: That the clinics will be used by patients with serious health problems requiring a doctor's attention (clinic practitioners are typically nurses) and that patients will replace their regular doctor with retail clinic care.
"Since most of these patients do not have a primary care physician, there is no relationship to disrupt," said the study's lead author, Dr. Ateev Mehrotra, of the University of Pittsburgh School of Medicine. "However, future studies should investigate quality, the likelihood that patients are getting needed preventive and follow-up care."
Ninety percent of the visits were for 10 simple acute conditions or preventive care, the study showed, including colds, sore throats, inner ear infections, swimmers ear and screening tests.
Health Affairs also published some accompanying reports on the retail clinic trend. One study found that more consumers are using health insurance at the clinics rather than paying out-of-pocket, and more clinics are now accepting insurance. Another study found that care costs less at one retail clinic chain, MinuteClinics, compared with traditional healthcare settings. Finally, a report by former Los Angeles Times reporter Dan Costello examines the growth of retail clinics. Though there are about 1,000 such clinics in operation now in the United States, some have gone out of business and the growth of this trend is in doubt.
The Convenient Care Assn., an industry group representing clinic owners, praised today's studies. But the questions about the role of retail clinics in healthcare will continue. The American Medical Assn. has published a list for consumers about how to make sure you're getting quality care at retail clinics. And the association recently asked for an investigation on whether some clinics have conflicts of interest because they steer patients to the pharmacy in the store in which they are based. Assuming the quality of care is satisfactory, it seems to me that retail clinics serve a useful role in meeting the needs of people who don't have a regular doctor, who can't afford doctor's office fees or who need after-hours care. Moreover, anything that keeps people with such minor ailments as conjunctivitis or urinary tract infections out of the nation's beleaguered hospital emergency rooms is a very good thing indeed.
-- Shari Roan
Photo: Naomi Medina has blood drawn at a QuickHealth clinic inside a Farmacia Remedios drugstore in Oakland. Credit: Robert Durell / Los Angeles Times.