Convenience of Retail Clinics Should Not Fragment Care

Recommendations for retail health clinics were discussed at the 2017 American Medical Association (AMA) Annual Meeting, including the need for clinics to establish continuity of care and support patients in finding primary care providers.

During the panel discussion, the AMA Council on Medical Services presented a report on retail health clinics and their impact on care.

“Retail clinics have had a steadily growing role in health care over the past decade,” Peter S Lund, MD, chair of the AMA’s Council on Medical Services, and colleagues wrote in the report. “The Council recognizes concerns that the retail clinic model may potentially undermine the medical home and therefore the physician-patient relationship and quality of care. Nonetheless, the Council acknowledges the ease and convenience of retail clinics for minor acute conditions that has increased their prominence in the health care system. As such, the Council believes that, with the appropriate safeguards and guidelines, retail clinics have a complementary place in the delivery of health care.”

Recommendations for retail clinics included assisting patients with securing a primary care provider, using electronic health records to coordinate care with other health care providers, using patient visit summaries to improve care coordination, and using local physicians as medical directors of retail clinics. 

The AMA also stated that retail clinics should limit their scope by restricting services to “minor acute illnesses.” They also emphasized that retail clinics should not expand services to include administering physician-administered drugs, such as infusions and biologic injections. 

The council noted that the cost impact of retail clinics is generally positive, driving ED visits down without impacting the number of primary care visits.

“Retail clinics may have a role to play in providing timely and affordable access to primary care services,” Dr Lund and colleagues wrote. “It is estimated that if the 20 percent of ED visits that are for low-level conditions could instead be treated in a retail clinic, the health care system would save an estimated $4 billion annually.” —David Costill