mead cohen berger shevtsova garfinkle michta grygiel blankenhorn
Entrenched Interests Try to Squash Retail Clinics


Thirty-seven percent of Midwestern families decided to use a retail clinic for minor pediatric health issues rather than a primary care physician, according to a recent study published in the Journal of the American Medical Association. Time has the story:

In a corresponding editorial, Dr. Edward Schor of the Lucille Packard Foundation for Children’s Health in Palo Alto, California wrote that such decisions may become more commonplace: “Retail-based clinics reflect systemic changes occurring within the health care industry to which pediatric practices must adapt.” Retail clinics, which are typically run by nurse practitioners and physician assistants, are not only convenient, but cost patients about 30% to 40% less than office practices

Retail clinics, staffed primarily by nurse practitioners and armed with new technology, hold all the promise this piece ascribes to them. They can bring down costs and rationalize our heath system.

If we didn’t know better, we would say that this is a sign that the “retailizing” of health care is already well on its way to becoming the dominant trend it should. But of course, when it comes to the dense and confusing network of entrenched interests that is our health care system, it’s never that simple:

The lower cost and increased convenience of the clinics are putting pediatricians on the defensive, and the American Academy of Pediatrics (AAP) formally opposes them as an appropriate venue for care of infants and children. AAP officials question the quality of care patients receive, stemming from the fact that children may see different practitioners at each visit.

The AAP has at least half a point. More work needs to done in figuring out how to coordinate major care in a doctors office with minor care in a retail clinic. Nevertheless, the relentless opposition of groups like the AAP to the changes our system so badly needs is discouraging. If we get this right, clinics could be just the beginning. As the article notes, in-person clinics and doctor’s offices could eventually be supplanted by electronic visits, if we have the vision and will to make it happen.

[Walgreens image courtesy of Getty. CVS image courtesy of Wikipedia. Pills image courtesy of Shutterstock]

Features Icon
show comments
  • Thirdsyphon

    I’d say the AAP has half a point at most. For an hourly worker trying to coordinate a doctors’ visit for a sick child, the real benefit of these walk-in clinics is the time that they save.

  • rheddles

    AAP doesn’t have even half a point. When I take my child to his group pediatric practice, I see a different doctor half the time depending on who’s in and available. The days of Marcus Welby are history. Doctors have become employees, not professionals.

    The key to this new environment is getting the appropriate information to the clinician on a timely basis. I have a lot more confidence in the ability of Walgreens, CVS or (shudder) Walmart to implement an effective information system than the AAP or HHS.

  • Maynerd

    Lack of continuity of care for all patients, young and old, is a growing problem. As independent physician practices whither and die, and employee physician models become the norm, there are much higher rates of physician turnover. Both within hospital systems and communities.
    No doubt PA’s and NP are cheaper but there is also no doubt their level of training, experience, and expertise is lower. You get what you pay for.

  • bannedforselfcensorship

    People using these facilities have kids with minor stuff – not leukemia.

© The American Interest LLC 2005-2016 About Us Masthead Submissions Advertise Customer Service