In my last blog post I talked about the severe shortage of physicians over the next decade. One way this problem will be addressed is through the establishment of more retail and workplace health clinics. Although physicians may balk about these clinics replacing the traditional doctor/patient relationship, they unfortunately cannot clone themselves. Patients have to go somewhere to get care when the wait time to see a doctor is untenable or they have a minor emergency that must be addressed immediately, and their physician is not available.
Workplace and retail clinics fulfill those needs, with qualified nurse practitioners who are fully trained to handle many of the basic care needs of individuals. The clinics offer extended evening and weekend hours, provide care on a walk-in basis, and, with the digital tools now available to most healthcare providers, they can communicate a summary of key issues directly back to a primary care physician.
By the end of 2012 nearly 70 percent of large and very large employers will offer some type of workplace health care. Clearly it is better for employees to have this care available through work where they can access not only basic care, but high quality prevention and wellness programs, monitoring of chronic conditions, physical therapy, nutrition counselling, and, in many companies, state-of-the-art fitness centers. These services improve the health of employees, result in less absenteeism, better productivity and higher employee satisfaction. They make it easy for an employee to get critical screenings like mammograms,blood pressure and blood sugar checks, and maternity care. Although not without issues and concerns, particularly regarding the privacy of an individual’s health information when treated in a workplace clinic, they are, nevertheless, a win/win for employees and employers in this era when there are simply not enough physicians.
Millions of individuals who do not work for large companies, and who have had increasing difficulty finding a primary care physician, are turning to retail clinics for their basic health needs. These include such health concerns as: colds, coughs, ear aches, cuts, bruises, stomach complaints, flu-related symptoms, and strep throat. There are over 1,300 retail clinics located in pharmacies, strip malls, and in grocery chains. Those numbers are growing by approximately 10% annually.
In 2014, federal health legislation mandates that broader health coverage must be offered to more than 30 million Americans. Retail clinics are working hard to attract these consumers by expanding and offering new services such as: management of chronic conditions, setting of broken bones, and counselling on various conditions and addictions such as smoking cessation.The clinics are subject to oversight by government health agencies who set the quality standards and safety practices that they must follow
Among the key players in the retail clinic space are: CVS Caremark, Walgreen, Wal-Mart and Safeway. Several have an affiliation with a local hospital so they can refer individuals with more serious issues for treatment.
Insurers are also supporting retail clinics because a trip to a retail clinic is generally less expensive than a visit to the doctor’s office. Many insurers will reimburse patients for retail clinic visits; some are opening their own retail clinics or are aligning with existing clinics to offer this option for basic care.
Although the benefits of retail and workplace clinics align with the goals of healthcare reform — increasing access and reducing cost, — and these clinics help to address the severe shortage of physicians, particularly primary care physicians, the landscape is very murky. There are many logistical, quality and accountability issues to be worked out. Communication of information from a clinic visit to an individual’s personal physician or specialist needs to happen so that all of a patient’s information is available at the point of care. Once again there is an opportunity and a necessity for patients to be involved in overseeing their care so that they are receiving the best that is available. It is a challenge that will go on for many years.