While the national debate over healthcare coverage rages on, there’s been a market-driven revolution taking place right under the feet of the healthcare establishment. In recent years, there has been a proliferation of mini-clinics promoting fast, easy and accessible healthcare at retail locations — within pharmacies, shopping malls, and even big-box stores.
NPR’s Scott Jagow recently described his experience with a mini-clinic, after being unable to make a timely appointment at his regular doctor’s office. “I scoured the Internet looking for an alternative and stumbled across the Minute Clinic. You’ll find it over behind the potato chips at the CVS. The Website said most visits take about 15 minutes. No appointment necessary. Most insurance taken. It even listed the prices. $62 for a minor illness exam. $62? Heck, that’s not much more than my co-pay.”
The clinic was staffed by a physician’s assistant or a nurse practitioner, and it accepted his medical insurance. The care was immediate and prompt — after 12 minutes, Jagow had his prescription in hand.
The Deloitte Center for Health Solutions has been tracking the growth of these retail health outlets, noting that as of July 2009, there were approximately 1,107 retail clinics in operation in the United States, up 15% from the year before.
Deloitte observes that the growth of mini-clinics has not been without pushback, however:
“The emergence of retail clinics in convenient settings such as pharmacies and grocery stores has sparked controversy. In some states and localities, regulators are fearful that it represents a compromise to safe and effective care. In many communities, local physicians have actively campaigned against retail clinic openings and advised patients to seek care elsewhere.”
In addition, Deloitte notes, the business model had been battered like everything else in the recent recession. Ultimately, though, mini-clinics show a lot of promise. (Full copy of the report here.)
The retail mini-clinics act as a safety valve on an overburdened and over-priced healthcare system. For example, Deloitte’s 2009 Survey of Health Care Consumers found that 13% of consumers had used a mini-clinic over the previous 12 months, and “30% of respondents are likely to use a retail clinic if it would cost them 50% less than seeing their physician.”
The Deloitte report cites evidence that for comprehensive treatments (i.e., inclusive of the visit, lab testing and pharmaceuticals) of five basic illnesses, “retail clinic visits were $51 less than a trip to an emergency room and $55 less than a visit to the primary care physician.”
Businesses also understand the value of these mini-clinics in their health coverage for employees as well. Deloitte cites another survey that “found that 42% of employers provided a benefit for retail clinics.”
Another model is on-site mini-clinics for employees within company locations. As Deloitte observes, this offers compelling advantages for organizations seeking to keep health costs down:
“By hosting and partially underwriting a clinic’s costs, employers have the potential to reduce employee health costs and lost worker time due to long wait times at physicians’ offices. One forecast suggested that 32 percent of large employers (those with greater than 1,000 employees) will have onsite clinics by 2009 – a total of more than 2,400 sites.”
A logical place for mini-clinics is pharmacies. As Gary Ahlquist, Minoo Javanmardian, and Ashish Kaura observe in a recent article that “pharmacies — many of them operated by large publicly traded companies such as Walgreens, CVS, and Walmart — have already begun to reach beyond their traditional role as pill dispensers to meet new demand from patients. Consumers, who have become more responsible for their own medical care in recent years, are turning to retail pharmacies for help in managing medical conditions and their out-of-pocket health-care spending.”
Mini-clinics located within pharmacies offer four significant advantages, they say: trust, since patients already have more contact with pharmacists than other health-care providers and appear to greatly value their pharmacists’ advice; access, as pharmacist are highly accessible, and many are available 24×7; skills and services, as pharmacists are highly trained health professionals, knowledgeable about a range of medical conditions and capable of delivering some advisory, diagnostic, and treatment services; and lower cost, especially since retail pharmacies operate in a highly competitive business environment, and actively promote generic medications.