Retail Clinics OK With Doc Position

Retail clinics are fine, says the American College of Physicians, so long as they are used as backups to the work of primary care physicians, according to an ACP position paper in the Annals of Internal Medicine.

Patients should talk to their doctors about the proper use of retail clinics, which should be utilized for minor problems like coughs and earaches, but aren’t really equipped to manage chronic diseases such as diabetes. In addition, the clinics should install a system whereby they can refer patients to PCPs if the patients don’t have a doctor, states the position paper, which was published online October 13.

“A balance must be struck between the convenience and access retail clinics provide and the importance of longitudinal relationships between patients and physicians, particularly for patients who have complex medical histories,” says the position paper says. Research has shown, the ACP notes, that the quality of care at retail clinics is similar to the care delivered in traditional settings.

Retail clinics should “promptly communicate” information about a patient visit to the PCP, “including but not limited to the administration of any vaccination, prescriptions, tests, or post-care instructions.”

One of the biggest operators of retail clinics in the country thinks that all of this sounds just fine.

“In instances where patients do not have a primary care provider—about 50% of all visits—MinuteClinic can be a portal of entry into primary care by providing a resource list of primary care physicians in the area who are accepting new patients,” Andrew Sussman, MD, told Reuters. Sussman is the head of MinuteClinic at CVS Health.

The Convenient Care Association, the trade organization representing clinics, said in a statement that most of its members already follow the recommendations in the ACP’s position paper.

The paper is an update of the ACP’s position on retail clinics in 2007. The industry has grown considerably since then.

Tom Charland of Merchant Medicine, a Minneapolis consulting company, tracks trends and growth in “convenient care,” an umbrella term for acute care retail health clinics and urgent care centers. He told Managed Care in March that by his count there were 1,869 retail health clinics in the United States at the beginning of this year, an increase of 266 centers from a year ago.

“Over the past decade,” the ACP position paper states, “business models for these clinics have evolved to accept public and private health insurance, and some are expanding their services to include diagnosis, treatment, and management of chronic conditions.”