Retail Clinics as Health Care Providers

health-care-providerPeople are increasingly going to a retail clinic for primary, non-emergency health care.  Retail clinics are less expensive and more accessible than conventional health care providers and studies show the results are largely the same.

Also called primary care, mini, walk-in, or convenient care clinics, retail clinics are located in retail stores, pharmacies and supermarkets.  They’re staffed by nurse practitioners, registered nurses with advanced education and training; and physician assistants, health care professionals licensed to practice medicine under a physician’s supervision.  Although the services provided by retail care clinics form a narrow range, they concern the most common family medical needs:  bronchitis, colds, flu, ear nose & throat infections, preventive care, childhood diseases, headaches, pink-eye, head lice, diarrhea, preventive-care, physicals, lab tests, etc.

The use of retail medical clinics increased  ten-fold between just 2007 and 2009.  A major driver of this increase is cost.  Health care costs are increasing at twice the rate of inflation and employees’ share of company health insurance costs have increased dramatically with higher co-payments and deductibles.  As a result, people are more careful spending their health care dollars.

Retail clinics are responding with big savings in routine primary care. In one example, an earache treated in an emergency room cost $184,  $95 in a doctor’s office,  but only $59 in a retail clinic.  Generally, medical care at a clinic is 30-40% less than a doctor’s office and 80% cheaper than the same medical service delivered in a hospital emergency room.  Physicals, commonly required for schools and athletic programs, cost $25-$49 at a retail clinic but $50-$200 at a doctor’s office.  And unlike most other health care providers, retail clinics post the services they provide and the prices they charge on their web sites.  Moreover, major insurance companies, as well as Medicare and Medicaid, cover most services provided by retail clinics.  Retail clinic coverage by Aetna, alone, increased ten-fold between 2007-2009 in a study conducted by the American Journal of Managed Care.

If you or your child wake up Sunday morning with an ear ache or you sprain your ankle playing flag football Saturday afternoon, a doctor appointment is not an option; but a visit to a retail clinic is.  They’re open 12 hours a day, 7 days a week, a god-send when your doctor is not available.  In most cases, there are no long waits and walk-ins are accepted.  The alternative is a trip to the hospital and an average 4 hour wait in the emergency room.

One of the reasons  retail clinics can run so efficiently is their limited  focus on just non-emergency primary care.  They’re not staffed or outfitted to treat concussions, broken bones, or heart attacks.  In fact, they will refer you to another care facility if there’s a temperature of over 103; and they won’t treat babies under 18 months old.

But what they do cover fills such a need that there are now more than 1250 retail primary care clinics throughout the U.S. from just 175 in 2006.  2/3s of these are in drug stores; the remainder in retail settings such as Wallmart, Target, and major super markets.  Minute Clinics, located in CVS drugstores, is the largest chain of primary care clinics with over 600 in 24 states.  According to the experts, retail clinics will continue to increase their presence on the medical provider scene.  In fact, Minute Clinics and Wallgreen’s Take Care Clinics have seen double-digit. growth this past year; and CVS expansion-plans call for 450 more clinics by 2015.

A recent survey by the Deloitte Center for Health Solutions of health care consumers found that, once given information about these primary care clinics,  half of those interviewed would be receptive to using retail clinics for primary non-emergency medical care.  Furthermore, respondents felt comfortable being treated by nurse practitioners and physician assistants.  Interestingly, those having higher incomes, $59,000 and up, were the most open to being treated at a retail clinic.

It’s no surprise that primary care physicians see retail clinics as competitors.  Citing the fact that clinics often operate without a physician in attendance, the American Medical Association has chastised insurance companies that encourage the use of retail clinics with reduced or eliminated co-pays.  However, the rising cost of medical care has already loosened the steel grip of doctors and all things medical.  Recently, pharmacists were given leeway to administer vaccinations; and nurse practitioners have, for some time now, been licensed to conduct examinations, treat illnesses, conduct tests, and write prescriptions.  Similarly, for the last 35 years physician assistants have been authorized  to set bones, conduct x-rays, interpret laboratory tests, and perform the basic tasks required of any primary doctor.  The cost-savings of seeing these medical professionals, when appropriate, is making the practice wide-spread.

If retail clinics seem like a viable medical care option for you, check them out now, before you need one.  Southern California is the home of several CVS Minute Clinics.  And other retail clinics can be found on Google or in the phone book.  Check their websites or, better yet, visit them yourself and ask for a tour.  In either case, get answers to these questions:

  • What are their hours?
  • What services do they and don’t they offer?
  • Do they accept your health insurance?
  • How are they staffed?
  • Do they accept walk-ins/appointments?

Retail clinics aren’t the only options available when you need medical attention and a doctor is not available.  We’ll look at the others in future blogs.