It’s a common scenario: It’s after-hours or a weekend and you need to see your doctor. But the office is closed. Or it’s flu season and you can’t get an appointment to see your doctor for two weeks. Maybe you’re out of town and don’t have access to your regular physician. Or you don’t have your own physician.
It’s not exactly an emergency your throat is scratchy and sore but you don’t want to wait to see your doctor. More people are turning to walk-in clinics to treat acute yet minor conditions and basic complaints like sore throats, conjunctivitis, upper respiratory infections and more. Of these visits, more than 44 percent take place when physician offices are closed.
These “safety-net providers” are able to relieve the stress on emergency rooms and offer many people immediate and adequate care without an appointment and with short wait times. They’re different from urgent care centers in that they are located within stores, like CVS, Target, Walmart, Walgreens and grocery chains, and they are almost exclusively staffed by physician assistants or nurse practitioners.
Retail clinics are convenient and affordable, with visits generally costing between $45 and $75, and most take health insurance. Prices are usually posted, so you know ahead of time what you’ll be spending. Many also provide services like immunizations and school or camp physicals. And with pharmacists on staff, they can provide quick access to prescribed medications as well as knowledgeable advice on proper usage of both prescribed and over-the-counter drugs.
Many retail clinics are also useful in connecting people to other sources of health: foods, products and services. For instance, someone with diabetes or hypertension, who needs to be on a restricted diet and adhere to a healthy lifestyle, can have easy access to groceries, medical supplies and other equipment like pedometers and light exercise equipment.
From the time they appeared on the scene in early 2000, visits to these clinics have grown tremendously. By 2012, they recorded about 10.5 million patient visits. The number of clinics also has expanded rapidly: since 2006, their numbers have increased almost 900 percent, from 200 to 1,800.
But retail clinics do have their detractors. Groups, like the American Medical Association, raise concerns such as these:
They question the quality of care.
They are uneasy about the potential overprescribing of antibiotics.
They’re concerned that clinics may interfere with patient-physician relationships and be a lost opportunity for preventive care.
Others feel that retail clinics are a viable alternative to care. Their arguments include:
Care costs less than similar care at a physician’s office, urgent care center or emergency department. Patients are not prescribed antibiotics more in retail clinics than in other settings, data show. The majority of people who seek care at retail clinics report having no primary care physician, so there is no disruption in a relationship that doesn’t exist.
A study that evaluated the quality of care for ear infections, pharyngitis and urinary tract infections found retail clinics were superior to emergency departments and ambulatory care facilities. To go or not to go? Ultimately the decision rests in your hands. Perhaps you know someone who was treated in a retail clinic near you. Why not ask how their experience was?
Personally, I went to my nearby CVS for my flu shot last year because I didn’t feel like driving to my doctor, about 15 miles away. I was passing right by the store and needed to go in to buy some things anyway. I’m happy to say that the specially trained pharmacist who dispensed the shot was both professional and gentle.
A growing trend over the last several years has been an increased availability of “retail health clinics.” These clinics have popped up in drugstores like CVS and Rite Aid, and big-box superstores, like Walmart. At first glance, a retail clinic may seem like a quick and convenient way to receive your health care, but what are you really getting from these services? Let’s investigate.
We moms tend to worry about our kids a fair amount, and think up ways to help them, even when they’re older. Case in point: I’m itching to tell my college-age son Chris about my latest helpful-because-I-care idea. It stems from an incident last year where Chris had the flu and wound up going to the local emergency room because the university clinic had a two-day wait. This year, I’m going to arm Chris with a back-up: retail health clinics.
Retail health clinics are part of the big trend to make health care more convenient. “Twenty years ago you had to go to an emergency department if you got sick and needed immediate care. Now we have an explosion of options, such as retail health clinics,” says Dr. Ateev Mehrotra, a researcher on the topic and an associate professor of health care policy at Harvard Medical School.
Retail health clinics began showing up 15 years ago. Today, there are about 2,000 clinics across the United States, located mostly in drugstores, supermarkets, “big box” stores, and other large retail chain settings. The clinics are usually open from 7 a.m. to 7 p.m., seven days a week, and they’re staffed by a nurse practitioner or a physician assistant. They offer all kinds of health services: everything from treating minor illnesses like colds, pinkeye, and urinary tract infections, to complete physicals (including lab work and screenings), to vaccinations and even help with smoking cessation.
Retail health clinics have many perks. They’re easy to get into, with extended hours and no appointments necessary.
They have set prices for each service, which you can see in advance on their website. For example, a wellness visit is $59 at Walmart. A cholesterol screening at CVS is $59 to $69. “We have found in our data that clinics are 30% to 40% cheaper than a doctor’s office visit, and 80% cheaper than an emergency room visit,” says Dr. Mehrotra. The clinics also take private insurance and Medicare.
But does the lower price translate into poorer-quality care? “We’ve found that the quality of care at retail clinics is equal to or superior to some doctor’s offices, because the clinics are more likely to follow national guidelines of care,” says Dr. Mehrotra.
Despite all the perks, retail health clinics may not be right for everyone. “Health care is different for older adults. The care you’ll need for even a simple problem might be more complicated. For example, a urinary tract infection will affect an older woman much differently than a younger woman, putting the older woman at risk for dehydration, confusion, falls, and even sepsis,” says Dr. Mehrotra. And if you have a chronic health condition, a simple illness might signal something bigger that might only be caught by a clinician who sees you regularly, such as your primary care doctor.
Geriatrician Dr. Suzanne Salamon, an assistant professor at Harvard Medical School, is concerned that the details of a patient’s visit to a retail health clinic might not be sent to her. Although clinics offer this service, not everyone takes them up on it. “The risk with that is, scattered care from multiple places can lead to mix-ups,” says Dr. Salamon. “And if people don’t bring their complete medication lists to a clinic, the clinic may prescribe something that will interact with medications they’re taking.”
What you should do
A report from the American College of Physicians published recently in Annals of Internal Medicine maintains that retail clinics are fine for a short-term illness or as a back-up when you can’t see your doctor. But they should not replace a long-term relationship with a primary care physician. “Going to a retail clinic is fine for minor issues like a flu shot or a sore throat, particularly if you’re generally healthy,” says Dr. Mehrotra.
That means a retail health clinic would be a great option for my son Chris, or for anyone who’s generally healthy and needs to see a health care professional right away. But there are still a few things to keep in mind if you do visit a retail health clinic, even for a flu shot:
- Bring a complete list of your medications with you.
- Tell the clinician about your medical history and any other health conditions you have.
- Ask the clinic to send details of the visit to your doctor.
- Consider a follow-up appointment with your doctor when you have time, so that everyone is on the same page when it comes to keeping you healthy.
First, let’s define what these clinics are and what they aren’t.
Most exist in large, recognizable retail chains that have a national presence. They tend to have extended hours compared with your standard physician’s office often opening earlier and closing later, in addition to being open on the weekends. Generally, retail clinics are staffed by a nurse practitioner or physician assistant, rather than a full physician. However, retail clinics do have the resources to diagnose and treat a wide range of ailments, as well as perform physicals, screenings and lab work.
The Good and the Not-So-Good
In addition to the greater availability of hours, retail clinics are more likely to see walk-in patients and can often come with a lower price tag. Most clinics list their prices directly on their website, which eliminates any guesswork. According to researchers at Harvard University, retail clinics tend to be about 40 percent less expensive than a typical doctor’s office and 80 percent less expensive than an emergency room visit.
Yet, while researchers have also found that this reduced price does not correlate with a reduced standard of care, there are some things you get from a primary care physician that you can’t get from a retail clinic. For instance, a retail clinic isn’t likely to have a full understanding of your health history, which would lead to a misdiagnosis. And if you visit a retail clinic and receive treatment, those records might not ever make it to your primary care physician, which could leave some holes in your complete health history.
Retail clinics can be a suitable supplemental healthcare option if you need treatment for a minor illness and can’t get in to see your full-time physician. However, visits to a retail clinic should not take the place of an established relationship with a doctor who knows you and your health history.
If you do visit a retail clinic, make sure you bring along a detailed copy of your health history, including a list of your allergies and current medications. This can help ensure you aren’t accidentally prescribed treatment that conflicts with a medication you’re already on. And, once you finish your appointment with the retail clinic, ask if a record of the visit can be sent to your doctor—which most clinics are happy to do.
Above all, your goal should always be to make sure all of your healthcare providers are on the same page. While this is easiest to achieve with an established relationship with a primary care physician, visits to a retail clinic can be a convenient and accessible way to get the treatment you need, when you need it.
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