Fostering Patient-physician Relationships in an Era of Retail Clinics

By Katy Mena-Berkley
Tuesday, March 1, 2016

The American College of Physicians (ACP) has outlined some best practices for increasingly popular retail clinics — while stressing the importance of relationships between patients and primary care providers.

Designed to make care accessible and convenient, walk-in retail clinics are typically located in stores with high foot traffic, such as pharmacies and supermarkets.

The idea is simple: Make general health care as easy as doing your weekly shopping. A patient may visit at his or her convenience to see a nurse practitioner or physician assistant qualified to administer vaccinations, conduct physical examinations and refer patients to specialists. Physicians, too, provide care at growing numbers of retail clinics.

During the past several years, however, care at many of these clinics has become more specialized, with staff offering diagnosis and treatment of chronic conditions, such as diabetes and high blood pressure.

The Impact of a New Model

In an effort to clarify the appropriate role of retail clinics, the ACP recently put forth guidelines it hopes will help ensure patients receive excellent care in the right setting.

That is not an idle concern. According to a RAND Corporation study, someone who seeks care at a retail clinic is not as likely to go back to a primary care physician for a subsequent illness and tends to have less continuity of care. The study did not find disruption of preventive care or diabetes management.

“Retail clinics are here to stay, but they must be used correctly,” says Wayne J. Riley, MD, MPH, MBA, MACP, President of the ACP. “Their rise is a legitimate trend that must be acknowledged and underscores the need for expansion of primary care, better coordination between such clinics and primary care physicians, and [for] such care [to] be evidence-based and of high quality.”

The recommendations emphasize that retail clinics should be utilized for treatment of minor conditions, such as ear infections or strep throat, or delivery of vaccinations, such as flu shots. However, care at these clinics should not replace care from a primary care physician.

“If patients overly rely on getting routine care from retail clinics, that can be unwise,” Dr. Riley says. “The establishment of a relationship with a primary care general internist or family physician is best in the long term for one’s health and health maintenance.”

Powerful Partnerships

Proponents of retail clinics say the facilities may actually promote collaboration with primary care physicians.

“We are seeing an increase in providers partnering with retail clinics as they see the value of these partnerships to expand access to care to their existing patients and increase access points for new patients,” says Tine Hansen-Turton, MGA, JD, FCPP, FAAN, Executive Director of the Convenient Care Association, a Philadelphia-based trade association that promotes delivery of healthcare services in retail-based settings. “By working in collaboration with physicians and health systems, retail health clinics help to lower costs for acute illnesses and chronic disease care by providing coordinated and complementary care and reducing emergency department visits.”