NCL Health Issues
As the United States is facing an increasing shortage of primary care physicians, Americans are turning to other sources of primary care. One delivery model that has attracted growing attention is the retail clinic, which focuses on providing convenient and accessible services at lower, easy-to-understand costs. These clinics are expanding rapidly across the country, from fewer than 100 in 2005 to thousands today.
These clinics are typically located in large retail settings, such as drug stores or big box stores. They are staffed largely by physician assistants or nurse practitioners, who can write prescriptions and have phone access to physicians. The growth of retail health clinics has been limited to parts of the country with legal frameworks that enable such clinics to deliver care and prescribe medication. The care offered through these clinics is restricted to a limited number of generally minor and easily treatable illnesses such as strep throat or urinary tract infections. Retail clinics often provide school and camp physicals, flu shots, and cholesterol checks.
The growth of retail clinics in America has generated debate on how they deliver health care to the consumer. The retail clinic provides convenience to the consumer by with extended weekend hours, central locattions, and fast service with an average wait time of less than 15 minutes - with no appointment necessary. Also many of the clinics post the cost of their services clearly for patients. However, critics argue that there are problems with quality of care due to staffing issues, continuity of care, and there is concern about how the clinics might impact the traditional doctor-patient relationship.
As retail clinics expand, state legislatures have taken a variety of approaches to regulating them. Some states are expanding the scope of practice for nurse practitioners, while others are moving for greater involvement by physicians. A handful of states require that physicians be on-site to support the nurse practitioners. Still other states such as Pennsylvania and California have called for expanding the scope of practice of nurse practitioners, including increased autonomy at retail clinics. Many states have seen bills aimed at additional regulation of clinics. Specifically, a few states have proposed laws restricting clinics by prohibiting the provision of medical services where tobacco is sold.
Given the complexities of the issue, we believe stakeholders will benefit from the opportunity to engage in an open and balanced discussion. NCL has found that multi-stakeholder forums help both consumers and policy makers navigate complex issues. Along with a final report on the forum, NCL will develop consumer education, including factors to consider when visiting a retail clinic. NCL will also summarize the issues state and federal policy makers and regulators should be considering as clinics expand. The report and consumer education pieces will be posted to the NCL website, and NCL will distribute the report to appropriate policy makers.
Thinking about visiting a retail health clinic? Start here with these FAQs
When should I use a retail health clinic?
Retail clinics are designed for providing basic services – cold, flu shot, strep test, etc. Retail clinics are intended for non-emergency and non-urgent use. Often a nurse practitioner or physician assistant provides the care.
Will my health insurance cover my visit to a retail health clinic?
Contact your insurance company to determine if the services are covered BEFORE you go. Ask the retail clinic if there are any other fees. Oftentimes, the fees-for-services are listed as they will be charged, while other times additional procedures might result in additional fees.
How will I know whether a clinic is legitimate?
The Convenient Care Association certifies its member clinics based on a variety of conditions, but not all retail clinics are members of the Association. You have the right to know whether or not a clinic and its practitioners are legitimate. Check to see if the clinic – or at least its practicing providers – are accredited or certified and don’t use their services if the clinic is not certified. Don’t be afraid to inquire about the practitioners’ licensing and certification to ensure that the clinic is legitimate.
What should I tell the retail clinic?
Be sure that you provide whoever cares for you with a detailed medical history – any conditions you may have, medications you may be taking, reactions to medications, past surgeries, history of treatment for disease, allergies, etc.
What should I tell my primary care provider?
Be sure to communicate back to your doctor anything that was prescribed or diagnosed while at the clinic. Get a report form the clinic and take it back to your doctor. And if you take a child, always report back to your pediatrician.
What if I don’t have a primary care provider?
Many of those who visit a retail clinic report that they do not have a primary care provider.
While a retail clinic can provide some basic services when you are in a pinch, it is best to have a primary care provider who knows and understands your entire health history and not just a single condition or ailment.