More and more parents are bringing their children to retail health clinics out of convenience. Local clinics offer more flexible hours while a typical pediatrician’s office limits appointments to when parents are at work and children are at school. A child with an earache or a routine sinus infection can be treated on evenings and weekends at a nearby Walgreens, CVS, Target, or any of the countless retail-based clinics that have sprouted up around the country. In a world of increasing immediacy, retail clinics offer a quick, accessible alternative to waiting rooms and taking time off of work.
But early last week, the American Academy of Pediatrics (AAP) released a statement warning parents against using retail-based clinics. Their basic sentiment being that quality trumps convenience, the AAP warns that “retail-based clinics are an inappropriate source of primary care for children because they fragment children’s health care and do not support the medical home.”
Pediatricians are trained to have a comprehensive, highly advanced understanding of a child’s health. Qualified pediatricians have the necessary skills and training to understand a child’s health history and adequately treat and diagnose patients. As a result, the AAP argues that a retail-based clinic could easily overlook underlying health conditions because they lack a formal, established relationship with the child.
In response, Tine Hansen-Turton, Executive Director of the Convenience Care Association (CCA), points to the many benefits of retail-based convenient care clinics, notably the close relationship between clinics and local physicians and pediatricians. Below is an excerpt from an official statement of the CCA addressing the AAP’s concerns:
“There are currently more than 1,600 retail-based convenient care clinics in 39 states and the District of Columbia that have served more than 20 million consumers to date including the pediatric population. The clinics offer a quick, affordable alternative for patients with pressing, non-emergency medical needs…
Retail clinics works closely with local physicians and pediatricians. They all use electronic health records (EHR) and actively encourages the sharing of visit records with a patients' family physicians and pediatricians in order to facilitate continuity of care. Additionally, the industry is very focused on quality care and EHRs are also used in clinics to monitor evidence-based practice performance.
In recent years, the number of CCCs and scope of services provided has grown to meet high consumer demand for easy access to high-quality, affordable health care. This is evidenced by the growth rate being highest among hospitals and health systems, and clinic operators have also entered into partnerships with many health systems to further promote continuity of care. Retail clinics are increasingly a valuable part of this nation's healthcare ecosystem (not apart from it), providing easy access to high-quality, affordable care, connecting patients with other providers as necessary, and, increasingly, facilitating care that is being managed by other providers.”
One of the more challenging points to prove is the significance of a pediatric-patient relationship vs. a clinic-patient relationship and its relative effect on quality of care. It is true that a clinician in a retail-based clinic will find it difficult to diagnose and connect with a patient on the very first visit. Dr. Joshua Riff, Chief Medical Director for Target Corporation, acknowledges this challenge as one of the hardest parts of being a clinician.
“The most accurate diagnosis and treatment plan with no connection or engagement to the patient, is guaranteed to result in failure” Dr. Riff writes. Any method of treatment, whether in a clinic or in the pediatrician’s office, needs to engage with the patient’s needs.
So how can retail-based clinics overcome this challenge when faced with first-time patients? Dr. Riff considers this and many other challenges faced by retail-based clinics in the new guide, Convenient Care Clinics: The Essential Guide to Retail Clinics for Clinicians, Managers, and Educators.
“A clinician should not have to spend time deciding what the drug of choice is or what the first line antibiotic choice should be – this is what research is for,” says Dr. Riff. “This is what the guide is for and thousands of articles and texts were reviewed in making this manual. I have always believed that the hardest job of the clinician is to make the patient comfortable with the plan and to buy in to the treatment plan. This guide allows for more time and energy doing this part of the job.”
Parents are now faced with a tough choice when a busy schedule does not align with recommendations from the AAP. But there is comfort in knowing that convenient care clinics value patient’s needs, rely on evidence and as an added bonus, will see you on weekends.