Alternative Models of Care Delivery

A retail clinic is a clinic within a store or pharmacy that a patient can visit without an appointment in order to receive standardized health advice from a nurse practitioner.  Retail clinics are becoming increasingly common, and businesses such as Walgreen’s and CVS are planning to open many such clinics in Massachusetts.  The clinics seem popular with patients who find accessing traditional healthcare to be inconvenient or costly, but so far, physicians and hospitals have responded to retail clinics with guarded skepticism.  Some doctors, at least, feel that retail clinics divert resources needed to fix the primary care system, and many worry that retail clinics could make healthcare more fragmented than it already is.  Hospitals have been hesitant to attach their brand names to store-based clinics.  Large healthcare systems, however, should pay attention to retail clinics, for there is much to be learned from their example.

One advantage of retail clinics is that they can help bring new patients into a healthcare system.  A recent study, for example, found that 20% of people visiting a retail clinic in Pennsylvania did not have a primary care physician and that 18% of visitors were referred either to a primary care physician or to a specialist. 

Second, the clinics seem to deliver cost-effective healthcare.  Many common ailments, such as the common cold or a sore throat, do not require a visit to the doctor.  By having nurse practitioners evaluate and treat these conditions, patients save money.  The limited service menu of retail clinics allows them to operate with relatively low overhead costs.

A third reason for large healthcare systems to pay attention to retail clinics is that fact that these clinics are a potentially disruptive innovation.  A disruptive innovation can be defined as a product or service that is not as good as existing products or services but that is simpler and cheaper.  Such an innovation can take root in an undemanding part of the market and can then be improved until it starts to attract mainstream consumers.  Healthcare systems must be vigilant if they are to protect their share of the market.

A fourth advantage of retail clinics is that they promise to be financially successful.  Fluctuations in demand will undoubtedly be a challenge, but it is predicted that new retail clinics will recoup their initial costs within a few years if they are staffed correctly.

Finally, healthcare systems should consider entering the retail healthcare market because they would have at least one advantage over everyone else in this market.  The electronic medical records of healthcare systems will allow them to integrate retail care with other forms of care.  This integration of care will benefit patients and will make it easier to follow up on them and to detect any underlying conditions they might have.  Healthcare systems such as Partners HealthCare are planning to at least explore the possibility of opening retail clinics. 

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