HomeHealthHealth CareCan a Drugstore Be Your Only Doctor?

Can a Drugstore Be Your Only Doctor?

You walk into a local drugstore chain to buy shampoo and find that the in-store health clinic offers flu shots, and there’s no wait. You’re late for that shot, so you get it – and accept the doctor’s offer for a blood pressure test.

You’re done, just 15 minutes after you walked in, satisfied that you received great care effortlessly with little or nothing out of pocket, as the clinic accepts your insurance.

Is there a catch? Could be. With your full medical history in front of her, would your GP give a different interpretation of your blood pressure numbers than the retail clinic nurse specialist? Did the clinic even send your blood pressure data to your doctor? If you don’t have a GP, do you have to accept the practice nurse’s casual remark that your blood pressure is “a little high”?

Similar questions may arise for any service you receive at a retail health clinic.

But there’s no denying that these clinics—usually located in pharmacies, supermarkets, and other large stores—offer something too many Americans lack: easy access to a number of quality basic health care services, often at a lower cost than a traditional doctor’s office. , physician-staffed emergency room or emergency room.

Will retail health care benefit your long-term health?

The bottom line: If you’re considering getting health services from a retail clinic, it’s wise to consider how this form of health care will serve you in the long run — not just how quickly you can check off your to-dos.

“We now have a plethora of health care options,” said Dr. Ateev Mehrotra, a professor of health care policy at Harvard Medical School and a hospital physician at Beth Israel Deaconess Medical Center in Boston. “Choice is a good thing, but it creates new problems — for example, patients must self-triage,” to determine which health care facility is best suited to diagnose and treat their minor illness or injury.

“There are also trade-offs between cost, quality and convenience, and navigating all of that is complicated,” he adds.

Retail clinics can offer a good price for basic services

As a popular entry point, retail clinics have become a major force in the American healthcare system. CVS, with more than 1,100 MinuteClinics, treats sore throats, may be able to remove stitches or surgical staples, and so on. Walgreens has hundreds of clinics that can treat back pain, headaches, and urinary tract infections, among other things. But what value can consumers expect from a for-profit clinic with no physician on site?

You can usually find good care at a competitive price, researchers have found.

“For a select group of conditions, retail clinics provide care of equivalent quality to other institutions,” concluded a Rand Corp. report. from 2016.

And researchers at Northeastern University reported in 2019 in the journal Medical Care that retail clinics on average charge less than other healthcare institutions for comparable services.

They are best for younger people without chronic conditions

Whether retail clinics are a good option for you depends at least in part on your age and general health.

“People who go to these clinics tend to be younger, healthier and less likely to see a primary care doctor,” says Dr. Mehrotra. “For what we looked at in our research — things like urinary tract infections, sore throats, sinusitis — the care this population receives in a retail clinic is equal to, or in some cases better than, what they could receive in a retail clinic.” emergency room or emergency room.”

But for older patients, especially those with multiple chronic illnesses, “continuity of care is really important — knowing their history and medications,” says Dr. Mehrotra. “It may not be the best option for them.”

Most retail clinics do not provide comprehensive primary care

Physicians are concerned about the long-term effectiveness of healthcare provided in a retail environment only by mid-level providers such as nurse practitioners. And according to the Rand report, only about a third of retail clinic users reported having a primary care physician.

Dr. Mehrotra’s research has shown that “visiting retail clinics negatively impacts continuity of care — seeing the same doctor over and over again,” he says. “And many studies show that greater continuity of care is associated with better outcomes.”

Doctors’ organizations agree. “Family physicians build long-term relationships with patients and take a holistic view of their health,” Rebecca Beeler, a spokesperson for the American Academy of Family Physicians, said in an email. “This makes our healthcare providers uniquely positioned to provide proactive, preventative care that prioritizes patient well-being over the long term.”

“Unfortunately, people in the U.S. have been going to primary care less often in the last 10 or 15 years,” says Dr. Mehrotra. “In our study, most patients told us, ‘I don’t have a doctor.’ But for patients, it is easier said than done to end up in a GP practice.”

Indeed, according to an analysis by KFF, a nonprofit health policy organization, more than 97 million Americans live in regions where primary health care professionals are short.

Retail health clinics are expanding their service offerings

Despite the shortage of clinicians, major retail healthcare players are beginning to provide a wider range of health services by partnering with health systems and even acquiring primary care chains.

CVS, which has partnered with Cleveland Clinic and added the HealthHUB brand to 900 of its MinuteClinics, provides services such as chronic disease management for people with diseases such as diabetes. And Walgreens is partnering with VillageMD to open full-service primary care primary care physician offices in addition to some of its drugstores.

Patients face challenges in integrating their health records

Regardless of the type of retail clinic, it is important for patients to consider how information about their medical condition and care will be communicated between the clinic and other provider organizations. Even for the minority of health systems that own or partner with retail clinics, tracking patients’ personal health records over time is difficult, according to 46% of healthcare executives and clinicians surveyed in 2022 by the NEJM Catalyst of the Massachusetts Medical Society.

“Ideally, you want to have your medical records in one place — all of them,” says Kenneth Hertz, chief consultant at KTHConsulting, which provides advice on medical practice management. “Because your records are fractionated in different locations, it’s hard to get the full story.”

Hertz and his wife have experienced fragmentation with their own medical records.

“At our local clinic, which is staffed with physician assistants and nurses, they have health records for my wife and me, but they don’t send any information to our GP,” Hertz says. “But my wife is that person who always gets printouts and takes them to our doctor’s office so they can scan them. It acts as its own health communication network. So integrating records is clearly a problem.”

Retail clinics are unlikely to resolve continuity of care and medical record issues anytime soon. But for millions of Americans who prioritize convenience or have limited access to medical professionals, the nurse practitioner at the back of the store can fill some important gaps in care.

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