May 18, 2012

In-store health clinics’ popularity grows

As in-store health clinics continue to expand in the Pittsburgh market, research is raising concerns about their long-term viability.

Featuring upfront, no-frills menus limited to routine needs, retail clinics embrace a 15-minute, fast-food approach to health care that has gained in popularity.

Since the first such clinics opened here two years ago, the number has grown. The Pittsburgh area is expected to have 24 retail clinics by the end of the year, almost evenly divided between Take Care centers at Walgreens and MinuteClinics at CVS.

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Retail health clinics are popular, but lack oversight

The story on the website goes something like this. It’s cold in Minnesota during the winter. And when you have a sick child, that cold is your enemy. A small prescription or pinkeye can turn into an ordeal if you end up digging your way out. Doctors’ offices close, and many parents end up in the emergency room with sick kids. One Minnesota dad decided that there must be a better way to deal with the issue. And thus Minute Clinic was born.

Minute Clinic is that ubiquitous storefront nurse who can diagnose very basic issues like ear infections and strep throat in convenient locations like your local pharmacy or (as I discovered recently) the skyway. The idea is simple enough. A person is sick; the problem is not a huge one. A nurse practitioner diagnoses and sends you back out into the world, prescription in hand to take on the day. And hey, if the Minute Clinic happens to be in a pharmacy, even easier.

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Retail clinic users lack personal doctors

Retail health clinics are attracting patients who are not “routine users of the current health-care system,” authors of a new study say.

“For these patients, the convenience offered by retail clinics may be more important than the continuity provided by a personal physician,” said the study’s lead author, Dr. Ateev Mehrotra, a Rand Corp. researcher and professor at the University of Pittsburgh School of Medicine.

The study, by the non-profit Rand Corp., is believed to be unique in that it examined the types of patients using the system. The findings are also published in the September/October issue of the journal Health Affairs.

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Health Plans Continue to Eye Retail Clinics to Build Market Share and Reduce the Costs of Care

Walk-in retail clinics, launched in Minnesota eight years ago, continue to carve a niche as providers of basic, uncomplicated health care. Despite recent missteps, slower than anticipated growth and opposition from physician groups, the clinics are becoming an established member of the nation’s health care delivery system, and health plans increasingly are contracting with them.

The reasons: cost, convenience, growing consumer and employer acceptance, generally high-quality care, and a recognition that these clinics can help relieve pressure on overburdened (and expensive) hospital emergency rooms (ERs). Large and small insurers (as well as Medicare) cover their services, typically with modest copayments. Blue Cross and Blue Shield of Minnesota recently dropped its required copays to encourage member use of local retail clinics.

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Store-based clinics fill a need, study finds

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.

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Prepared Patient: Retail Clinics – Health Care on Aisle One

You’ve got that telltale tickle in your throat again, and you’re pretty sure it’s not just another cold. But your doctor’s office says the next open appointment is in two weeks. You’re traveling for business in another city. You don’t have a primary care physician to call. You’re self-employed and don’t have health insurance.

For all these reasons and more, potential patients are turning increasingly to retail clinics to cure their minor ailments.

According to a 2008 report by Mary Kate Scott of Scott & Co., the number of retail clinics in the United States grew from 150 to nearly 700 clinics last year. Renting space in drugstore chains such as CVS and Walgreens, major retailers such as Wal-Mart, and even hospitals, the clinics are filling a need for convenience, cost and a more consumer-like approach to health care.

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Retail medicine

John White was running a low fever, his sinuses and ears felt full and he was tired, so he walked into a Bradenton medical clinic.

Valerie Fortunato asked a series of questions about his medical history, then performed an examination including checking his ears, eyes and throat, and listening to his lungs and heart.

In about 30 minutes, White left with a diagnosis of a sinus infection and prescriptions for antibiotics, antihistamine and a nasal steroid.

Fortunato is an advanced registered nurse practitioner, and her clinic is a gray-walled box inside a Publix supermarket.

Welcome to another facet of the future of medicine.

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Feel good about retail medical clinics

Most Americans can share horror stories of trying to schedule a doctor’s appointment — if you want to get in quickly, well, good luck.

You have about as much chance as getting a private audience with the pope.

Routine checkups often must be scheduled weeks or even months in advance. Once there, better find a magazine and expect to wait some more.

I’ve never understood why doctors’ offices make people wait so long. Don’t they know we have jobs, lives?

If an appointment is for 1:30, patients should expect to be seen at that time — and if the doctor is running behind, the customer deserves an update or apology.

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NPs Ride the Convenient Care Clinic Wave

Driven by consumer demand, the convenient care clinic (CCC) tsunami seems unstoppable. Despite initial resistance to the nurse practitioner-staffed CCC concept from many physicians, NPs and the CCC industry have pushed forward. They now stand in a national spotlight that is highlighting an innovative and successful approach to delivering affordable, accessible, quality care for minor conditions.

“NPs are the best kept secret in health care, but the healthcare system cannot afford these types of secrets. The CCC industry puts NPs front and center,” says Susan Apold, RN, PhD, ANP, immediate past president of the American College of Nurse Practitioners. The secret is officially out, and Convenient Care Association member clinics are employing NPs to staff 80% to 85% of clinics.

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AMA: Don’t Put Retail Clinics in Stores that Sell Tobacco

The drug stores and big-box retailers opening in-store clinics should make a choice: Stop selling cigarettes, or shut down the clinics. At least, that’s the position the AMA adopted this week at its big annual policy meeting.

The AMA doesn’t oppose retail clinics, but doctors’ groups in some states have called for tighter regulation of the clinics, which are typically staffed by nurse practitioners. We wondered whether the new AMA policy was a back-door way to slow the growth of the clinics

“In no way is this resolution to get back at them,” William A. Dolan, an orthopedic surgeon on the AMA’s board of trustees, told the Health Blog. “It’s ridiculous that a health deliverer should be dispensing cigarettes.

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Satisfaction with Retail-Based Health Clinics Remains High

According to the American Public Health Association, there were approximately 700 retail-based healthcare clinics operating in the U.S as of December 2007. These clinics, also known as convenience care clinics, are typically found in stores such as Walgreens, Target and Wal-Mart, and are usually staffed by Nurse Practitioners and Physician Assistants.

According to the latest WSJ.com/Harris Interactive health care study, U.S. adults who have used these health clinics in a pharmacy or retail chain are generally pleased, as almost all are very/somewhat satisfied with the quality of the care (90%), cost (86%) and staff qualifications (88%). As in prior surveys on this topic, the biggest driver of satisfaction appears to be convenience, with 73 percent very satisfied and another 20 percent somewhat satisfied with the convenience of these clinics. These clinics continue to be a destination for comparatively routine services like vaccinations and care of respiratory infections, and while public acceptance is increasing, they not particularly appealing for attention to more serious conditions.

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Clinics fill gaps in care for patients in a hurry

Dawn Laney had a sore throat and was running out of options.

It was late in the afternoon, and she was flying to Canada the next day.

in Smyrna, near Laney’s home, so she drove there. “I was in and out very quickly,” said Laney, who was tested for strep throat by a nurse practitioner. “I was very impressed.” And she was on the plane the next day.

The MinuteClinic site that Laney visited is one of more than 50 such medical facilities within retail stores in the Atlanta area. The walk-in clinics — open through the early evening and on weekends, when doctors offices typically aren’t — provide care for minor illnesses and offer vaccinations, physicals and other testing.

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