Editor's Corner

Like it or not, retail clinics are gradually becoming a mainstream concept. As this market gathers steam--and it is, despite some initial problems--it's going to change consumer perception of what outpatient care should be. The question is whether traditional healthcare systems are going to be nimble enough to make their own plays.

Some are giving it a try. For example, northern California's Sutter Health is opening a string of Sutter Express Care clinics in several Sacramento-area Rite Aid drug stores. Another example is Atlantic City-based health system AtlantiCare, which is opening retail clinics in several ShopRite grocery stores in its region.

However, many other systems are holding their peace. After all, setting up quickie clinics could be seen as creating competition for existing doctors, fostering a wave of mistrust which could have a nasty effect on relationships. AtlantiCare execs have stressed to physicians that their new clinics don't handle ongoing care, and that they will refer patients into physician practices, but they admit it's a delicate negotiation nonetheless.

It could also be that the systems don't want to divert their talent pool of nurse practitioners--who usually staff such clinics--away from their core business into a still-unproven niche. What's more, with demand for NPs usually outstripping supply by a wide margin, recruiting new ones for retail clinic sites could be a challenge.

Then there are the administrative issues involved. After all, nurse practitioners will still have to work as part of a team supervised by a physician. Clinics will have to establish efficient methods for communicating with primary care doctors, specialists and hospitals. Clinics will also have to develop clear standards for what treatments they will provide, and when a patient is too sick be treated there. Health systems can doubtless handle all of this, but there's definitely a learning curve involved.

However, all that being said, it seems certain that retail settings are going to become another important touch point within the next few years, so providers should get on board. Now's the time to develop standards and systems, hire and train staff, get supervising doctors in place, put together appropriate technologies, and iron out kinks in the business model. Sure, entering this market may be tricky, but putting it off is just procrastination. Better to figure things out now than stumble around later when the stakes are higher. - Anne