Retail Clinics to the Rescue

Just as some reached for bullhorns to pronounce a crisis in the US health care system because of the worsening shortage of general internists, along comes a new option for people who want primary care—the retail clinic.

Retail clinics are low budget, low profile affairs staffed primarily by nurse practitioners and housed in places like Wal-Mart and CVS. They are to be distinguished from urgent care centers which are larger in size, freestanding, staffed by physicians and others, and equipped to manage a slightly higher level of care (e.g. suturing lacerations).

Can retail clinics help avert the crisis mentioned above? Yes and no.

No, because a study published in Health Affairs this week finds that 90% of visits to retail clinics are for simple things like sinusitis, blood pressure checks and immunizations. These problems constitute only 13% of visits to general internists, 30% of visits to pediatricians and 12% of visits to emergency rooms. The study shows that retail clinics cannot match the spectrum of services offered by primary care physicians.

Yes, because 60% of visitors to retail clinics do not even have a primary care provider. One third of them are uninsured altogether. These people can now get at least some inexpensive primary care services at a convenient time and place, whereas in the past they either got nothing or found themselves waiting forever to be seen in an emergency room.

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