In modern America, health care is undergoing radical changes due to shifting internal and external dynamics. One of the least noticed, but possibly quite important, is the introduction of retail medicine which includes clinics hosted by corner store pharmacies, big box stores and groceries. These new forms of health care delivery are being primarily driven by consumers who want high quality care on their own terms which typically means short wait times and at reasonable cost.
Convenient care clinics found in local pharmacies are usually staffed by physician assistants or nurse practitioners, medical professionals who have historically been supervised by a physician. However, with much of the nation experiencing physician shortages, more states are granting greater autonomy to the advanced practice providers and are allowing them to make diagnoses, write prescriptions and make referrals to specialists.
With an annual national expenditure of more than $3.8 trillion on health care, more retail organizations are recognizing that forays into this business field can be quite lucrative. One of the emerging leaders in retail medicine is CVS which has introduced almost a thousand "MinuteClinics" into stores nationwide, and plans to expand to more than 1,500 by 2017. The consulting firm Accenture predicts there will be almost 3,000 such retail clinics in the U.S. by the end of 2015.
The kind of patients that utilize these retail clinics are usually between 18 and 44 years of age, although the latest research suggests older patients are increasingly using them. The most common issues remedied are infections like ear or respiratory, as well as vaccinations and screenings. Almost 20 percent of visits are for some type of chronic condition.
There are a number of benefits that are driving growth in this type of medical care. First of all, the convenience is almost incomparable. Parents can hop in the car with a sick child and reach a clinic at a local Target or Wal-mart in just a few minutes. Many of these clinics are open early and stay open well into the night. Once there, they do not require an appointment and the wait time is less than or comparable to a doctor's office.
Secondly, the price point for these walk-in clinics is highly competitive. Although there is still considerable variation in the cost of visits, some retailers like Wal-Mart have a set price. These prices are typically under a $100 per visit, making them considerably cheaper than a visit to a doctor's office or an Emergency Room. These low prices make these clinics especially attractive to people without insurance.
Finally, in addition to convenience and cost effectiveness the availability of a qualified medical professional may be sufficient. These retail organizations understand that many parts of the country do not have primary care physicians, so strategically placing a PA or NP in some of these areas can make that pharmacy or grocery store an important community resource, which in turn will elevate revenue.
As with any new type of business, there are flaws in the system. These offices do not provide the comprehensive type of care that patients typically receive in a traditional clinic. There may not be testing or follow up to determine if the health issue is more serious than it presents. Because time is at a premium in these operations, most examinations are relatively cursory. Furthermore, these clinics rarely have access to patient records which could help alert providers to health issues which could complicate treatment. There is also the concern that these clinics may recommend drugs or products that generate added revenue for the pharmacy they reside within.
With the rapid expansion of retail clinics, it appears unlikely that this is merely a fad. The growing presence of these convenient care outlets will likely siphon off patients from traditional clinics. While only about three percent of Americans currently use these walk-in clinics for treatment, if widespread acceptance does permeate society, there will likely be competitive pressure for other medical organizations to prioritize fast service and low prices.
Article written by:
Robert Moghim, M.D.
CEO, Health Carousel Locum Tenens