The Pros and Cons of Retail Health Clinics

By Healthcare Hacks on 9 November 2009 (Updated 1 March 2010) 9 comments

Next time you are heading to the grocery store, remember to add “healthcare” to your shopping list! Yes, healthcare services are now being offered at local grocery stores, drug stores and general merchandise retailers, such as Shopko, Carnival, Cub Foods, Wal-Mart, Target, CVS, and Walgreens to name a few.

These retail clinics treat common medical conditions, such as colds, sinus infections, earaches, rashes, diarrhea, urinary tract infections, etc…and provide some preventative and wellness services such as flu shots and other immunizations. Care is usually delivered by a nurse practitioner or physician assistant, and many clinics accept common health insurance plans. The first clinic opened at a Target store in Minneapolis in 2000, and the number of retail clinics has grown exponentially over the last eight years to include approximately one thousand clinics nationwide. If you are contemplating using a retail clinic, here are some things to consider.

Wait Time

If you are frustrated from having to wait three weeks to get to see your family doctor and irritated from having to wait a couple of hours once you get there, you might want to give retail clinics a try. No appointments are needed, evening and weekend operating hours are provided and wait times are 15 minutes or less. And in case they can’t see you right away, they give you a restaurant-style pager so you can walk around the store while you wait.

Cost

Retail clinics have an upfront menu style pricing that is not typically found in any other healthcare setting. For example, MinuteClinic charges $62 for allergies, $67 for bladder infections, and $77 for step throat. Minor burns also cost $62 while wart removal costs just $69. Therefore, if you do not have health insurance or prefer to pay out-of-pocket, the prices range between $60 and $70 for most conditions. If you do have health insurance, you will be charged your regular co-pay.

Staff

Retail clinics are staffed mainly by a physician assistant or nurse practitioner. A doctor typically serves as a clinic supervisor and is available for phone consultations and performs routine chart reviews, but is not required to be physically present at the clinic. Therefore, the care is provided by non-physician providers all the time. And while these providers are well trained and appropriately qualified to treat minor ailments, their scope of practice is obviously not as wide as that of a primary care or family doctor. Therefore, the important question is who can they and who can’t they treat?

Physician Assistants

Physician Assistants are healthcare professionals that deliver healthcare services under the supervision of a physician. They diagnose and treat illnesses, write prescriptions in all 50 states, order and interpret tests, and can conduct physicals and counsel patients on prevention. Their education typically consists of 2-3 years of specific graduate studies after a bachelor degree.

Nurse Practitioners

Nurse Practitioners are advanced practice nurses that offer a broad range of healthcare services but do not need to practice under the supervision of a physician. Their scope of practice is very similar to that of PAs, but their education consists of an RN (Registered Nurse) degree and a 2-year graduate degree.

It is important for patients to know that PAs and NPs are not only found in retail clinics. In fact, if you have visited your family physician, OB/GYN or even dermatologist lately, you may have seen a non-physician provider rather than your regular physician.

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Quality

A poll of customers who have used retail clinics showed high overall satisfaction with cost (86% satisfaction), convenience (93%), having qualified staff to provide care (88%) and quality of care (90%). A recent study published in the Annals of Internal Medicine comparing cost of care and quality outcomes at retail clinics versus other settings such as urgent care centers, physician offices, and emergency rooms, found that retail clincs did as well or better than other settings of care in terms of quality.

However, for most people, the idea of receiving healthcare services at their local grocery or drug store is still a foreign one. That is why only 2.3% of American families had used retail clinics as of 2007.

Limitations

If you are generally healthy, and all you need is a prescription for that annoying sore throat on a Saturday afternoon, then the retail clinic might be the place to go. Also, if you are traveling and happen to come down with a minor cold, chances are you cannot get in touch with your regular doctor and your health plan may not cover the doctor available to you. In this case, the retail clinic is a convenient, fast and cheap(er) way to get care so you can resume your fun vacation or get ready for that big presentation or job interview.

However, if you have a complicated medical history or currently suffer from a chronic health condition such as heart disease, diabetes, cancer or asthma, chances are the providers at the retail clinic may not be able to treat you. The reason is they don’t have complete access to your medical file and your conditions are outside the scope of their practice. Moreover, these clinics are not designed to provide a long-term treatment and follow-up plan. In this case, your best bet is still your regular doctor, an urgent care clinic, or the Emergency department.

So how can patients prepare before going the retail clinic? When you plan to visit a retail clinic, Dr. Jennifer Ashton recommends that you know your own medical history, bring a list of all of your medications, get a phone number in case things worsen, and follow-up with your regular doctor.

Retail clinics should be used in addition, not instead of your regular doctor’s care. So don’t be tempted to call your doctor’s office and tell them to “get lost” just because a new MinuteClinic has opened around the corner!

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Guest's picture

I'd save them for emergencies only, when they are the closest place.

Guest's picture

being African, this post makes me turn green with jealousy because it seems that the health care in developed countries is oh so good. If you compare this to the medical situations in My continent there is such an ungodly difference. I can just imagine the world of good such an arrangement would benefit people in Africa. I dont want to paint a bad picture of my home country but it is really very bad. I think this is one of the reasons why there is such a high level of braindrain to developed countries

Julie Rains's picture

MinuteClinics really aren't for emergencies (try your doc, urgent care facilities, or the emergency room instead). They do offer specific services (like flu testing, vaccinations, and strep testing) -- in fact I took my son there one Sunday recently because he was complaining of a sore throat and was running a fever. I wanted to get a quick strep test so that if he had strep, then he could get antiobiotics quickly and get back to school quickly. The clinics do have on-site lab testing plus they can send samples to labs.

The clinics  in this area also post the availability of vaccines (H1N1 and seasonal), and offer these at times convenient to people who may work or go to school -- something that my physician's practice doesn't do (though it is owned by a large organization with the resources to give relevant info to patients but chooses not to advertise vaccine availability -- and actually lists MinuteClinics as a source of vaccinations rather than their community practices).

These clinics follow strict guidelines for assessment, diagnosis, and treatment, something I have found that doctor's offices may or may not  do. In my area, the nurses (Nurse Practitioner) have master's degrees whereas the physician offices tend to use LPNs (about a year of community college). NPs are clear about their scopes of practices; on my last visit, my physician's LPN did not know, for example, that she was not qualified to render independent medical advice (a source of confusion for me, as I thought she knew Board of Nursing regulations).

I will mention though that the morning I took my son in, there was a long wait as he was 10th in line. There was just one person working the clinic (NP) and she was dedicated to the patient she was seeing, so there was no one to ask questions about the wait. There were no available chairs and no one passing out pagers, and though I gave my cell phone number (at the computerized kiosk), that number wasn't used for alerting me to our place in line. He was seen eventually, and it turned out that he had a flu virus based on the onsite testing, and given a prescription for Tamiflu.

None of these services (flu testing, prescription to speed flu recovery, convenient times for vaccinations) have ever been offered to me by my family practice. Still, I would probably opt to go to my regular practice as they do offer a.m. clinics (M-F) for established patients; and just keep asking more questions based on what I've learned from the quick clinics.  

Guest's picture
Stephanie Hunter

I believe that the retail model has potential, but I've seen the positive impact of non-profit models. There's one in Ohio that's doing amazing work in Ohio while serving nearly a million people. http://cli.gs/23yYaM/

Guest's picture
Brad

I think the reason they aren't being utilized too much yet is that many people are just starting to realize they exist. My primary doctor left the practice to work in clinical research, and since then I've used them twice. So convenient, their prices are upfront, and the quality of care is great. The staff is knowledgable, and friendly.

Obviously I wouldn't go there for an emergency such as a broken foot, or for more complete bloodwork or anything like that, but for your regular sniffles, rashes, and flu shots, they can't be beat!

Guest's picture
Rosa

Our clinic ran out of seasonal flu vaccine, and suggested we go to one of the retail clinics for it. They're a good idea for vaccinations, or for when you're self-diagnosing something you've experienced before (like strep or a UTI) and just need confirmation so you can get a prescription.

Guest's picture
GT0163C

At the clinics near me, the wait times can be long (especially on weekends) and the fees steep. My insurance company charges the emergency room visit copay ($100) rather than the doctor visit copay ($20). But my primary care doctor is not open on the weekends. So, for something like strep throat when I don't want to wait until Monday morning, they do work.

Guest's picture
Naperville60563

I've been to the Walgreens clinic a couple times and have been really happy with them. I like that I can get in that same day, within 20 minutes or so, and not having to take time off of work to go to the doctor since they are open til 9pm!

Guest's picture
Christy

I used one of these clinics last week for an animal bite related infection. It was two hours from check in to check out, but since they opened at 7 am, I was still done before my regular doctor even opened. Not too bad an experience. They had TV and magazines in the waiting room to pass the time.