• Study: Pediatrician views of retail clinics

    From the Journal of Pediatrics:

    Objective

    To describe pediatric primary care providers’ attitudes toward retail clinics and their experiences of retail clinics use by their patients.

    Study design

    A 51-item, self-administered survey from 4 pediatric practice-based research networks from the midwestern US, which gauged providers’ attitudes toward and perceptions of their patients’ interactions with retail clinics, and changes to office practice to better compete.

    Results

    A total of 226 providers participated (50% response). Providers believed that retail clinics were a business threat (80%) and disrupted continuity of chronic disease management (54%). Few (20%) agreed that retail clinics provided care within recommended clinical guidelines. Most (91%) reported that they provided additional care after a retail clinic visit (median 1-2 times per week), and 37% felt this resulted from suboptimal care at retail clinics “most or all of the time.” Few (15%) reported being notified by the retail clinic within 24 hours of a patient visit. Those reporting prompt communication were less likely to report suboptimal retail clinic care (OR 0.20, 95% CI 0.10-0.42) or disruption in continuity of care (OR 0.32, 95% CI 0.15-0.71). Thirty-six percent reported changes to office practice to compete with retail clinics (most commonly adjusting or extending office hours), and change was more likely if retail clinics were perceived as a threat (OR 3.70, 95% CI 1.56-8.76); 30% planned to make changes in the near future.

    I’m not surprised that pediatricians don’t look favorably on care administered by retail clinics. They have some legitimate complaints, if the things they perceive are accurate. Of course, I’d like to know if they would have the same complaints about competing pediatricians as well. A comparison would be nice.

    That said, it’s good to see that they view the access issues of primacy care pediatric offices as the reason they are losing business, and adjusting their office hours accordingly. As I said last week:

    Until we get our act in gear, and start offering the convenience and ease that retail clinics do, traditional physician practices are going to bleed patients to these clinics. Prior coverage of retail clinics herehereherehere, and here.

    @aaronecarroll

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    • It should probably be noted that patients’ views of the treatment received at retail clinics is pretty high, http://www.medscape.com/viewarticle/712169 (only two stores in this study, but it’s consistent with other data I’ve seen).

      As with everything else, there’s a tradeoff – quick access to care vs. access to a doctor with greater knowledge? And for some patients who do have serious chronic conditions, there’s little doubt in my mind that their doctor’s office should just about always be the first choice. But I’m not sure why a child with asthma should be limited to their doctor’s office if they have an ear wax buildup.

    • Considering that Ob-Gyn practices have managed to resolve the problem of labor/delivery events that occur outside of normal office hours, it shouldn’t be all that difficult for a Pediatric or Family Practice to provide some way to provide services during the hours where retail operations are the only alternative to the Emergency Department at a hospital. I have used a retail clinic to handle a laceration on my hand and I have used the local hospital as well. (Yes, I’m a bit careless with sharp objects on weekends.) The retail clinic provided equally effective care at a much lower cost to both me and my insurance carrier. When I went to my regular physician for follow-up/suture removal they told me I could have called their service and he would have opened the office for me. I doubt I would do that to him — as one of the few solo practitioners remaining in the area I want him to have some time off.