Physicians see both risks and benefits in retail care

By Matt Kuhrt

As retail health clinics proliferate through the healthcare marketplace, physicians are increasingly exposed to them both as consumers and competitors, according to a New York Times blog post by Danielle Ofri, M.D., a physician at Bellevue Hospital and an associate professor of medicine at New York University School of Medicine.

The convenience is appealing, but there remain risks to be addressed, wrote Ofri. Retail clinics appeal to consumers because they respect patients' time and provide transparency on costs, two metrics on which physician practices have long been weak. Where consumers may not discover the cost of a doctor's office or hospital procedure until they receive a bill, they can go online and not only figure out what a retail clinic will charge, but also which clinic offers the best price.

Consumer response to this type of convenience and transparency has been sufficiently impressive to grab the attention of traditional healthcare providers, who more and more are getting in on the action themselves.

As tempting as the convenience can be, however, it doesn't always outweigh the risks involved with retail healthcare provision. For example, Ofri described weighing the option of getting a flu vaccine at O'Hare International Airport and wondering just who was administering it: "Was she a nurse, a pharmacist, an airport employee? Who was certifying this kiosk? Were they storing the vaccine in the proper manner?" Ofri wrote. "Did they have equipment available to handle allergic reactions?"

For the treatment of relatively low-acuity conditions, retail clinics appear to offer quality of care about on par with those of traditional physicians. When it comes to complex or ongoing treatments, however, physicians worry about a decline in quality and consistency as patients' care becomes less coordinated. The American College of Physicians suggested in a recent position paper that retail clinics are better suited to support traditional medical care rather than supplanting it, and advised clinics to coordinate with patients' primary care physicians or to provide referrals to doctors, FiercePracticeManagement reported previously.

The ease of use associated with retail clinics also raises their potential for overuse as patients seek examinations for conditions that might otherwise resolve themselves without intervention, noted Ofri's post. Thus, some experts have suggested that the relative inconvenience of scheduling a doctor's appointment is more of a feature than a bug when it comes to overall healthcare costs.

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