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

Leigh Page

Disclosures

March 18, 2015

In This Article

How Easy Is It for Physicians to Compete?

There are two basic ways to compete with retail clinics: provide same-day appointments, and extend office hours into early evenings and Saturday morning. Of course, extending hours requires an extra time commitment from physicians and staff. And although same-day appointments aren't difficult in the long run, the transition can be challenging, according to doctors who have made the change.

The goal behind same-day appointments is, "Do today's work today," Dr Lee said. Before the shift, "we still did the same amount of work as we do now, only 2 weeks later." To move the schedule forward 2 weeks, physicians and staff had to work extra hours, he said.

Dr Lee said his practice keeps 10%-30% of slots open in its appointment book up to the day of the appointment. Patients can either call up or walk in, but the practice prefers that they call first. "The schedule is often completely filled by the end of the day," he said. "If they come in for a rash, we take care of whatever else needs to be done," such as a tetanus shot. If the open slots are not all getting filled, the practice may call patients with chronic diseases and ask them to come in for necessary check-ups.

There are other ways to offer same-day appointments. Dr Wergin, the AAFP president, provides same-day slots to patients with a limited set of conditions that basically match what the retail clinics treat, such as sore throat, ear infections, sinus infections, bladder infections, and pinkeye.

When these patients go into an examination room, an orange flag is put on the door, and either Dr Wergin or his physician assistant ducks into the room between visits with other patients. He said it's possible to squeeze in these patients without upsetting the schedule because the visit is very short. "The patient may bring up other matters, but unless it's an emergency, we ask them to make a regular appointment," Dr Wergin said.

Dr Wergin also sees patients on Saturday. On Saturday morning at another location, he only sees patients who show up and does not take appointments. The extra time commitment is worth the trouble, he said. "It's a joy, especially for parents with children," he said. "They'll grab my arm and say, 'I want to thank you so much. I know you didn't have an appointment, and I appreciate it so much that you could fit me in." He thinks the extra hours enhance patient loyalty. "When they experience this, they're my patient for life," he said. "They would walk through a wall for me."

How Many Clinics Are Too Many?

Despite talk of retail clinics being the wave of the future, their numbers are still underwhelming—just over 1400 from coast to coast, at last count. In a 2013 report,[8] the Center for Studying Health System Change concluded, "To date, retail clinics have yet to become the 'disruptive innovation' in health care that some observers predicted."

Moreover, retail clinics tend to be concentrated in higher-income suburbs, hardly penetrating many small towns or inner cities. According to the Convenient Care Association, which represents retail clinics, only about one third of Americans live within a 10-minute car ride from a retail clinic, which is considered the maximum distance many people would travel to use one. Still, losing one third of patients is no small disruption to a practice.

Not everyone, however, is skeptical about the growth and impact of retail clinics. A recent report[9] by Accenture predicted that the number of retail clinics would double from 2012 to 2015. The report cited "accelerating forces of change," including greater demand for healthcare under the Affordable Care Act (ACA), as well as hospital systems' growing interest in collaborating with the clinics.

Many physicians are bracing for the challenge. Although Dr Lee lives in an area with just a few clinics, "we see them coming nationally," he said. In Overland Park, Kansas, where CVS and Walgreens clinics are already plentiful, Dr Munger said, "Retail clinics are here to stay."

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