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BUSINESS OF
Academy of Family Physicians (AAFP), and especially the American
Academy of Pediatrics (AAP) warned about the episodic nature of
retail clinic visits and their potential negative impacts on patient
continuity of care (3-7).
With more than 2,000 locations and 10.5 million patient visits
nationwide, retail clinics are now considered a common feature of
the American healthcare landscape (8). While the majority of PCPs
still do not endorse them and privately lament the competition that
they have brought on, some have reluctantly accepted their presence,
especially with strong scientific evidence backing them up. Numer-
ous peer-reviewed studies to date have shown that retail clinics pro-
vide care that is of comparable quality to that provided in physician
offices and urgent care centers ,(9-12) and represent significant cost- Rooms and unpredictable urgent care centers. PCP practices should
savings over Emergency Room use (9). Patient satisfaction is very
high, especially with no appointments required, short wait times
and after-hours availability (13).
Experts predict that retail clinics are here to stay: their numbers
are expected to keep increasing in the next few years, especially with
the Affordable Care Act (ACA) providing new insurance coverage
to millions of Americans (14). The evidence shows that many patients,
especially middle-aged men, do not have a PCP relationship to start
with (1). Even patients with a regular source of physician care appre-
ciate convenience and accessibility and sometimes use retail clinics
in addition to their PCP. As importantly, hospitals and health sys-
tems looking to increase their access points and reduce their per-pa-
tient costs have invested in partnering with or developing their own
retail clinics .(15-19)
In the face of this new reality, what should PCPs do to stay com-
petitive and relevant? Here are some suggestions that forward-look-
ing physician practices could benefit from considering:
Get out of busy medical centers and closer to
where patients live and work
Most physician offices are located in busy medical centers where
parking is problematic and access is reduced. The majority of pa-
tients prefer to have their primary care physician within five miles
of where they live and/or work. Retail clinics in San Antonio for ex-
ample are located inside CVS, Walgreens and H-E-B stores — places
that are very close to home and that the patient already frequents
several times per week.
Bring on a nurse practitioner or
physician assistant
Busy practices with large patient panels cannot meet the demands
of their patients, and adding new physicians can be cost-prohibitive.
MEDICINE
Non-physician providers such as nurse practitioners and physician
assistants can provide high quality care at lower costs with or without
physician supervision .(20-21)
Offer after-hours care on weekdays
and weekends
Most physician offices are open on Mondays-Fridays from 9 a.m.
to 5 p.m., with some variations. The majority of people are at work
or school during these regular business hours. Therefore, the very
act of going to a physician’s office presents inconvenience. When
patients need primary care on evenings or weekends, the only avail-
able options other than retail clinics are expensive Emergency
consider offering evening and weekend hours that meet patient
needs and preferences.
Reduce wait times
Retail clinics keep wait times to a minimum through the automa-
tion of medical records and the use of efficient processes. Electronics
kiosks provide a quick and easy way for patients to check-in while
the provider is seeing another patient. Parents of teenagers, for ex-
ample, do not want to wait two hours in a busy PCP practice just
to get a sport or camp physical. Physician practices should take a
hard look at their processes and identify bottle-necks and obstacles
that increase wait time.
Without doubt, most patients still prefer to seek care at their PCP
office and value the relationship they have with him/her (22). But
faced with long delays in appointment times, long wait times, and
limited hours, many are using retail clinics in addition to or instead
of their PCP office. PCPs that want to compete in the new health-
care environment of consumerism and value-based care should con-
sider changing some of their practices.
Amer Kaissi is Professor and Director of the Executive
Master’s Program in Healthcare Administration at Trin-
ity University. He is the author of the book “Flipping
Health Care through Retail Clinics and Convenient Care
Models” published in 2014.
The Executive Master’s Program at Trinity is ranked in the Top
10 programs nationally. The part-time, hybrid-learning format is
designed for physicians and managers currently working in a health-
care setting who have decided to pursue a graduate degree while con-
tinuing to work full-time.
continued on page 16
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