Walk-in Clinics Get a Good Report Card
We really couldn’t find any strong evidence that the retail clinics are providing inferior care in the United States, within the limits of what they do — providing quick relief for acute conditions among the relatively young and healthy (not complex medication management or long-term follow-up for people with chronic conditions)…
What seems to be particularly attractive about the retail clinics for the young and healthy is their convenience — they’re open nights and weekends, often without requirements appointments, and without long waiting times. Almost half of their visitors arrive when regular officers are closed, making these clinics far more convenient to those who work.
Wait.. you mean market-based clinics attract a greater percentage of the population who is typically uninsured, cost less, and provide the same quality care?
Mind. Blown.
“One might assume that these retail clinics would therefore offer services in regions that might not have great primary care, but that doesn’t appear to be true; the clinics are statistically most likely to be located in regions with low poverty and high median incomes. Indeed, after adjusting for locations of pharmacies and supermarkets, the RAND corporation found that retail clinics are less likely to be located in medically-underserved areas, and are often quite urban.”
Serving a need; the essence of capitalism.
There just has to be something wrong with a clinic that lets you just drop by, rather than making an appointment a week in advance. Besides, my medical home primary care physician knows me by name (after he reads it off my chart)!
Ok, I’m being facetious. I went to a retail clinic for a sinus infection and it was rather convenient. I really like my PCP, but I also like the convenience of a retail clinic.
That makes sense, since when you’re young and healthy the desire to see the doctor is often outweighed by the desire to avoid the healthcare system.
This sounds almost too good to be true…but it’s very much true! I went to one of these retail clinics not too long ago from a chest pain that I started having one Tuesday night. The service they provided blew me away. I had no idea of these retail clinics until one of my friends mentioned it to me, I went to one without even calling, I only had to wait for about 5-10 minutes to be seen and I was out of there within 20 minutes. They ran all sort of tests, they even provided me with samples of medication for me to take home and try before buying my own. It worked just perfect! It was super convenient and I must say I was a very satisfied costumer.
I really like these walk-in clinics. Great practicality.
I’ve read the Rand study that found retail clinics were less likely to be in low-income areas. We can assume it’s because they don’t attract enough business. On the other hand, I suspect a Community Health Center in the same area would have a waiting room that’s packed to capacity. Even though retail clinics are half the cost of a traditional clinic, this phenomenon is an example of people more willing to part with their time (waiting) than their money to pay cash at a retail clinic.
retail clinics are great-cheaper and more efficient. the market working at its finest
I made heavy use of hospital system retail clinics while in college. As I didn’t have a PCP (and the student clinic was a joke as far as trying to get an appointment), I would simply stop by a retail clinic and be seen very quickly.
At 10 AM, an otherwise healthy 14 yo identical twin girl presents to her pediatrician with a low grade fever and classic otitis media. She is prescribed a 10 day course of an appropriate antibiotic, which she takes right away. At 4 PM, she presents in the ER and I am called. She smiles as I introduce myself. Her neck is rigid and her fever is rising. I call the best neurosurgeon in the state, who also happens to be the nationally reknown forensic expert in the Karen Quinlan case. He arrives quickly as does her beloved pediatrician. Our professional relationship does not involve time or money. We know that she won’t make it through the night. All her family gathers around her bedside. Everything is done – medically and with the chaplain. At 10 PM, I extubate her and turn off the ventilator. At 10 AM the pediatrician and I stand silently at her autopsy. . . the unforgettable end of the doctor-patient relationship.
I just had the wonderful opportunity of meeting Dr. John Goodman at our annual AAPS meetings in San Diego, where he key-noted. He recognized my name from this blog. We, as physicians need an ongoing dialogue with health care policy economists.
Devon’s post above makes me think. Respectfully, the time – money paradigm is fundamentally flawed. It is a time-money-relationship model. That 14 yo saw her life-long pediatrician that morning. Her sister continued care with the same pediatrician after burying her sister. There is a truly unique form of love in the relationship between doctors and their patients.
For 30+ years, tiny numbers of patients come from NYC, Anchorage, Japan, Germany . . . all over the globe to my tiny beach town. They must decide to jump the time-money continuum because they want to reclaim their life. They fight hard against a combined extreme allergic response to food, mold, chemicals and other allergens with an under-diagnosed immune deficiency – an accidental combination.
It doesn’t matter that it was 1979 and I was the ER pediatrician that night. I remember that teenage smile. I remember the words she spoke. . . so few. . . so optimistic. . . the last words she would ever speak. These are the professional moments that suspend the value of time and money. . . for patient and doctor.
It doesn’t matter if it is tomorrow and the new patient isn’t happy jumping the time-money continuum. . skeptical about forming a long term relationship with me. By the grace of God. . . it may happen.
It is a time-money-relationship continuum. Time and money have numeric value. The physician-patient relationship is ‘priceless.’
Dorothy Calabrese MD
Allergy & Immunology, San Clemente, CA
Dorothy: Good post.
I speak for all our AAPS members – it was a privilege to hear you speak and meet you, Dr. Goodman. Most times, the quality of medical care is technically identical, as in the case of this 14 yo.
I strongly believe that you and NCPA represent our best hope to preserve and forward that unique physician-patient relationship. It is in the best Columbia University alumni tradition. It is your work that is priceless.
Dorothy Calabrese MD
Columbia College of Physicians and Surgeons ’76