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What Physicians Can Learn From Retail-Based Clinics

September 30, 2015

Retail-based clinics (RBCs) have surfaced in thousands of pharmacies, grocery stores and “big-box” retailers across the country. Analysts predict growth will continue. RBCs are typically staffed by nurse practitioners and physician assistants and offer convenient hours and walk-in appointments. Many physicians are concerned about this new form of competition popping up in their neighborhoods, but if you embrace the challenge, you can learn a thing or two from these clinics.

The biggest draw to RBCs is convenience. In a recent study, patients cited convenient hours and locations and the ability to receive care without an appointment as major factors in choosing to use these clinics over another source of care. Private practices have found it difficult to compete with these convenient features, but some physicians have figured out a way improve their access.

Practices are extending their office hours to include early mornings, evenings and weekends and many offices are offering patients same-day access.  Robert Wergin, MD, president-elect of the American Academy of Family Physicians (AAFP) decided to respond to his patients’ needs by building a fast-track clinic in his practice to address many of the self-limiting ailments retail clinics most commonly treat.

Wergin explains that when a patient requests a same-day visit, they’re told to come into his office immediately and are placed in an exam room with an orange flag on the door. When he sees the flag, he examines the patient, offers treatment and moves on; he calls it a “brief self-limited encounter.” Wergin is not alone in his approach, 71% of physicians affiliated with the AAFP report offering patients same-day access.

Continuity of Care
Many physicians are concerned about the effect an RBC could have on a patient’s continuity of care. Could a patient’s visit to a retail clinic lead to a disconnect between the patient and their primary-care physician down the line? Could the RBC provider miss something relating to the patient’s condition that the patient’s physician would not have missed? For example, a physician may not know about an antibiotic prescribed to a patient by an RBC, or an immunization received at an RBC may not make it to the patient’s medical records. These types of care disruptions create fragmentation in a patient’s healthcare.

To reduce this type of disruption, it’s important to work with these clinics, instead of against them. The Convenient Care Association (CCA), a national trade association for RBCs, encourages its members to build collegial relationships with the traditional healthcare system and share patient information as appropriate to ensure continuity of care.

Another way to ensure continuity of care is to have a conversation with your patients regarding their use of retail clinics. Since RBCs are separate entities from a physician’s office, they can’t release protected health information without the consent of patient. Emphasize to your patients the importance of communicating with RBCs about his or her established primary-care provider and ask them to authorize the RBC to share information with you about the care they received at the clinic. 

There is a fundamental difference between RBCs and primary-care physicians: RBCs are designed to quickly handle simple ailments, while primary-care physicians deal with complex, long-term healthcare issues. This difference in functionality means RBCs may not be as harmful to patient volume as some physicians fear. Most people use an RBC as an after-hours option, primarily for non-emergency sick visits or for things like physicals or flu shots. Since these types of issues don’t require a doctor’s attention and can be handled by clinical staff, there shouldn’t be a large amount of overlap that would disturb your relationship with your patients.

Instead of competing with RBCs, consider exploring what your practices can offer patients that retail clinics cannot. For example, your practice might provide services with a more personal touch, it may provide better continuity of care or a more comprehensive wellness visit. Once you determine what your practice does best, market it to your patients. You may even find that your services appeal to a certain group of people, which can help further target your marketing strategy.

RBCs fill a void in the healthcare system, but there will always be a place for private practices. Evaluate your practice and look for ways you can work with these clinics, instead of against them. You may even find you can learn something from their business model.

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