Patient Choice of Retail Clinic or Physician Office for Care

One of the recent health care phenomenon is the growth of retail clinics, which are often located in drug stores, supermarkets or large discount stores and which tend to offer very basic treatment for common illnesses such as sore throats.  The physician community has watched the rise of these clinics with unease, raising quality concerns which may have some validity but may also be a surrogate for economic fears.  The payer community, after initial hesitation, has embraced these clinics, since they tend to be much less expensive than a traditional physician office visit or certainly an urgent care or emergency room trip.  The limited research to date suggests quality is not significantly different at the clinics.

A recent study published in the Annals of Family Medicine looked at why patients chose to use a retail clinic as opposed to visiting a physician’s office.  (Annals Study) A survey experiment of about 500 adults in Georgia offered them choices for treatment of a urinary tract infection or influenza, with a price point of $59 or $75, a same day appointment or a wait of one day or more and use of a nurse practitioner at a retail clinic or a physician in his or her office setting.   While the respondents preferred to see the physician on the same day.  A cost savings of about $31 would lead them to use a retail clinic and a savings of $82 would cause them to wait a day or more for care, all other things being equal.  In general, the time and cost savings of a retail clinic were viewed favorably.  Appointment wait time appeared to be the most important determinant of where a patient would seek care.

Because retail clinics do not appear to be making much money for their owners at this point, they have looked for opportunities to expand the range of services provided, particularly in regard to relatively routine care for chronic illnesses.  As this expansion occurs, the clinics may become more of an economic threat to physicians.  Some forward-looking physician groups and hospitals have partnered with retail clinics or offered their own version.  But it can be anticipated that some providers will seek to create new regulatory barriers for the clinics.  Unless serious quality concerns are validated by research, policymakers should encourage these clinics, not hinder them, since consumers should have as wide a choice as possible and because these clinics are playing a role in reducing overall health costs.  And physicians who are concerned about competition should focus on reducing appointment wait times and the cost of their services.