Retail Health Clinics Still Subject of Disagreement

Discussion
Aug 05, 2011
Bernice Hurst

It’s fair to say the American Medical Association (AMA) has never totally approved of retail health clinics. Policy adopted in 2007 was opposed because co-pays could be waived or reduced by insurers; policy adopted in July 2011 suggests taking action "by communicating directly with insurance companies on what it sees as the consequences of steering patients to nonphysician-staffed clinics," according to amednews.

Although few studies have been done to date, cthealthpolicy.org’s Project Fellow, Nelson Mendoza, believes patients "have received similar quality of care and preventive services, and incurred similar prescription costs as patients at physician offices and urgent care centers. The emergency room had lower quality and higher prescription costs."

Concerns, he said, revolve around the possibility that clinics in retail locations will have a conflict of interest over prescriptions. Locations are more often in affluent areas rather than those where people are uninsured and/or can’t easily access healthcare providers. Disruption of continuity with a regular provider may present potential problems along with clinics taking "short lucrative appointments" from healthcare centers.

An American Academy of Family Physicians (AAFP) statement on its website in 2010 also opposed expansion, "in particular, the management of chronic medical conditions in this setting."

That said, research by Merchant Medicine, reported on dailymarkets.com, predicted an increasing number of clinics ranging from double to triple the current total by 2015. At a minimum, its "2011-2015 Walk-In Clinic Market Forecast," claimed the number "would increase by 33 percent during the next five years." Amongst the possible reasons are growth in what they called accountable care organizations (ACOs) and their impact on both retail and urgent care. There is also a shortage of primary care physicians enabling clinics to fill gaps. On the basis of cost, convenience, quality and flexibility, market forces will continue to drive growth, the report says.

According to ama-assn.org, the consultants’ CEO, Tom Charland, also believes ACOs could lead to significant developments in telemedicine so patients can receive care from their homes if they are in an area short on accessible primary care facilities — more, then, for both the AMA and the retailers to worry about.

Discussion Questions: Will AMA intervention have any effect on the growth of retail health clinics? Is there a way forward that will help consumers, retailers and healthcare providers offer the best possible service?

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8 Comments on "Retail Health Clinics Still Subject of Disagreement"


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Tony Orlando
Guest
9 years 9 months ago

Something needs to be done in marrying the AMA folks with these clinics. Health care is a nightmare, and getting worse, so it would be beneficial for both parties to work together, sharing the proceeds, and providing basic needs at an affordable price. Can it be done? I believe it can, and all of us without basic care will be served better.

Joan Treistman
Guest
9 years 9 months ago

As a caregiver for many in my family, I am a cynic when it comes to any intervention by AMA or insurance carriers. I’ve experienced the barriers created by insurance providers, the CDC, doctors, hospitals, etc. Self interest is more at play than interest in the patient. When all the organizations come together as one to develop health care options for US citizens I will listen with an open mind. However, when one organization tries to raise a red flag, I question their motive and the resulting risk for patients.

If the AMA has doubts about retail locations for medical consultation and administration, I wonder what is behind their “doubts.” If people feel they are being helped then they are being helped.

Gene Detroyer
Guest
9 years 9 months ago

The U.S. healthcare system is wracked with self-interest. That is, everyone’s interest except the people. Physicians have to be against the clinics because it takes their most profitable business away. Hospitals are against it because it takes their most profitable business away. Pharmaceutical companies are against it because it is harder to influence these clinics to prescribe their most profitable drugs than it is to convince the doctors to do so.

Retail health clinics can be a significant help to our healthcare problems. If the AMA got behind them it would help considerably. With the AMA on the other side, it will slow their progress.

Roy White
Guest
Roy White
9 years 9 months ago
It is perhaps understandable that the AMA and other physician associations would oppose the expansion of retail health clinics, but, intuitively, it would seem that the clinics, either with doctors or nurse practitioners, relieves pressure on the health care system rather than increases it. The brutal truth is that going to the emergency room at a hospital in an urban area for relatively minor ailments not only stresses you to a considerable degree but probably also stresses the system even more. Because there is a real market need for such healthcare services, it is unlikely that AMA intervention will have any effect on the long-term expansion of the clinics and their capabilities. My personal usage, admittedly not statistical survey, is that the clinics are professionally run and if the ailment is outside of their scope they are quick to advise you to “see a doctor.” The fact of the matter is, healthcare is difficult to access on an immediate basis in urban markets and the clinics fill a very real need. I’m skeptical about the… Read more »
Al McClain
Guest
Al McClain
9 years 9 months ago

The main objection I have to retail health clinics is when they are not staffed by physicians. It seems logical to me that urgent care centers where one sees an actual doctor would provide significantly better advice/treatment than where only a nurse is available. Maybe not for cuts, scrapes, and colds, but do you really need to seek treatment for those?

Jesse Rooney
Guest
Jesse Rooney
9 years 9 months ago
The AAFP statement is spot on. Retail clinics, for all their value, are not equipped to handle chronic conditions that do need physician oversight. There’s obvious an opportunity here for the both the retail clinics and traditional service providers to profit from this by having the retail clinics appropriately refer patients to partnered doctors’ offices more capable of handling their chronic issues. In return, physician offices might recommend partnered clinics to patients needing flu shots or with stomach bugs, thereby freeing up the doctors for patients that really need physician attendance. However, until the clinics are capable of effectively directing patients to doctors for appropriate issues and until doctors can learn to work with the clinics, there will be an impasse. That impasse will hinder the clinics more than the doctors simply because the clinics are the limited service facilities. In order to bridge this gap, the clinics really need to proactively reach out to, and partner with, traditional service providers. They’ve got more to gain and a lot more to lose than the doctors.
Christopher Quirin
Guest
Christopher Quirin
9 years 9 months ago

We operate 18,000 blood pressure kiosks at retail. It has always been a social mission to keep the public/consumer informed. This is not a replacement for the doctor but an adjunct. More users reach out to the pharmacist for additional information, and that usually turns into a referral to a primary care doctor.

Tim Henderson
Guest
Tim Henderson
9 years 9 months ago
If AMA’s goal is to obliterate retail health clinics, then they’re bound to fail. Two key forces ensure that health clinics will continue to be viable choices: (1) lack of consumer access to quality, affordable healthcare, and (2) key demographic and lifestyle changes, e.g., consumers taking greater control of their healthcare, and consumers who are more knowledgeable about healthcare and healthcare options. It’s the latter demographic and lifestyle shifts that I believe AMA fails to account for, i.e., this isn’t merely a question of whether retailers should have health clinics. It’s an issue that cuts to the heart of how consumers feel about the U.S. healthcare industry and how they want to access healthcare. AMA could play a key role, were they to act less to impede access to health clinics and instead act to ensure the clinics maintain standards of quality so consumers can access the clinics – as well as traditional healthcare facilities – with confidence. And even if AMA chooses to maintain their wrongheaded stance, that may actually motivate clinic providers to… Read more »
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