Retail Clinics

Retail Clinics

DOI: 10.4018/978-1-4666-6355-8.ch006
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Abstract

This chapter addresses the poster-child of convenient care models, namely retail clinics. Retail clinics are walk-in clinics located in grocery stores, drugstores, and general merchandise retailers such as Wal-Mart, Target, CVS, Walgreens, etc. They offer a limited scope of diagnostic and treatment services for common medical conditions, as well as preventative and wellness services. Most retail clinic visits are for simple conditions and services such as upper respiratory infections, urinary tract infections, immunizations, and tests. Care is delivered by a nurse practitioner or physician assistant, and many clinics have up-front menu-style pricing, a feature that is unparalleled in the American healthcare system. The clinics operate on a walk-in basis with no appointments needed and very short wait times, and are open on evenings and weekends when most physician offices are closed. The chapter discusses the evolution, operations, and stakeholders of retail clinics, and highlights the research related to their outcomes, such as cost, quality, continuity of care, and patient satisfaction. The author describes how some operators are expanding the scope of services to include management and treatment of chronic conditions and conclude that the future of retail clinics in terms of numbers and usage rates looks very bright.
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An interesting thing happens when discussing retail medical clinics: individuals cease to be referred to as ‘patients,’ and begin to be referred to as ‘consumers.’ Retail clinics have placed patients in a role of medical consumer within the era of consumer-driven healthcare. — Schleiter, 2010

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Introduction

Retail clinics represent a major revolution in healthcare in the last decade (Fottler & Malvey, 2010). Never before has a delivery option epitomized such a value proposition: convenient locations, walk-in care, short waiting times and affordable prices. Scott was first to address this value proposition in a report to the California Healthcare Foundation in 2006: “Most efforts to address escalating healthcare costs attempt to innovate within the insurance system but don’t tackle the underlying structural costs of delivering healthcare. Labor overhead and technology expenses in the U.S. healthcare system are often assumed as givens, even as health insurance benefits are cut to the point that neither the scope of benefits nor the expectations of what consumers will pay provide a compelling value proposition. As the trend in health insurance shifts more costs to consumers, the public has indicated that they are willing to approach at least their basic, routine, and elective healthcare needs with an eye towards price and value” (Scott, 2006, p. 3). In one of the first major media stories reporting on the topic, the Wall-Street Journal exclaimed: “With catchy slogans like “You're Sick! We're Quick!” retail health clinics are spreading fast in supermarkets, drugstores and big-box chains across the country, luring patients with walk-in treatment for minor ailments like strep throat - at about half the cost of a typical doctor visit” (Landro, 2006, p. 1). The concept was so foreign to healthcare delivery that Bohmer likened it in 2007 to the fast-food industry: “The originators based their design on the McDonald’s hamburger chain, in which customers select items from a limited menu. The services listed are highly standardized interventions and require no physician evaluation. Diagnoses are made by using a simple binary test (such as for a streptococcal throat infection) or by applying a rigid, protocol-based decision rule. In some cases, no diagnosis is required (such as for a hepatitis vaccination). In addition, the conditions treated and therapies offered require no or minimal follow-up (for instance, clinics offer diabetes screening but not treatment), and decisions can be guided by highly specified protocols. More important, the conditions can be diagnosed and treated quickly” (Bohmer, 2007, p. 766-767). Healthcare strategy expert Preston Gee commented in 2007: “There's a hassle factor. Filling out forms and sitting in an office and feeling kind of intimidated by the whole medical milieu -we don't like that. You can go to a [retail clinic] you're comfortable with and buy a beach ball while you're waiting” (Callahan, 2007, p.1).

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