Can You Really Compete With Retail Clinics -- and Succeed?

Leigh Page


March 18, 2015

In This Article

Retail Clinics Are Everywhere

Retail clinics have been siphoning off patients from doctors' offices for years. Located in chain pharmacies, big-box retailers, and grocery stores, they treat low-acuity conditions, such as sore throats and children's ear infections. They see patients on a walk-in basis, making it possible for busy people to visit them while on errands, and at a relatively low cost.

Should physicians compete head-to-head with these operations, or should they differentiate themselves, focusing on higher-acuity care? And should they ask patients not to use these clinics, or cooperate with them and get referrals in return?

Can You Compete on Convenience?

Retail clinics are at the cutting edge of a "convenience revolution," according to Ateev Mehrotra, MD, a leading researcher of retail clinics and associate professor of healthcare policy and medicine at Harvard Medical School. "People today expect care right away," Dr Mehrotra said. "It's now part of our society." In patient interviews, "people told us, 'I called my doctor's office and they say it's a 3-4 day wait, and I just want to get care,'" he said.

The clinics are stripped-down, lower-cost versions of urgent care centers. Rather than using doctors, they usually employ nurse practitioners (NPs), who adhere very closely to evidence-based guidelines. In recent years, retail clinics have branched out from treating simple acute conditions to providing preventive care, such as flu vaccines.

According to a study[1] in Health Affairs that Dr Mehrotra coauthored, almost one half of patients who use the clinics do so when doctors' offices are normally closed. Retail clinics take walk-in patients and are open 7 days a week. A few of the clinics run by CVS Health, the industry leader, were even open on Christmas Day, according to the CVS website.

Doctors initially resisted the convenience revolution. Robert A. Lee, MD, a family physician in Johnston, Iowa, said when he first started practicing, the goal was to have your appointment book filled 2 weeks out. "It meant you were very busy," he said, but he realized his patients weren't happy. "The patient says, 'I'm sick today,' and the doctor says, 'Great, I'll see you in 2 weeks."

Dr Lee, who is a member of the board of American Academy of Family Physicians (AAFP), has introduced same-day scheduling to compete with retail clinics. Many of his peers have done the same. The AAFP reported[2] that asof 2012, 73% of AAFP members allowed for same-day scheduling, 43% had extended early morning or evening hours, and 32% had weekend hours.

In Overland Park, Kansas, AAFP board member Michael L. Munger, MD, is also providing same-day appointments, and he says the changes make his practice a formidable competitor of retail clinics in the area. When patients visit one of the clinics, clinic personnel usually ask them if they want a report of the visit to be sent to their doctor. Since Dr Munger's practice implemented same-day appointments 2 years ago, the number of reports from the clinics have fallen by almost 70%—indicating that fewer patients are using them, he said.


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