Opinion > Columnists > Randy Scholfield

Posted on Fri, Jul. 18, 2008

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Feel good about retail medical clinics

Most Americans can share horror stories of trying to schedule a doctor's appointment -- if you want to get in quickly, well, good luck.

You have about as much chance as getting a private audience with the pope.

Routine checkups often must be scheduled weeks or even months in advance. Once there, better find a magazine and expect to wait some more.

I've never understood why doctors' offices make people wait so long. Don't they know we have jobs, lives?

If an appointment is for 1:30, patients should expect to be seen at that time -- and if the doctor is running behind, the customer deserves an update or apology.

That's why I like the idea of the walk-in clinics opening up in Walgreens and other retail stores.

Many doctors get queasy at the mention of retail clinics.

But for those of us on the receiving end of America's dysfunctional health care system, this is something to feel good about.

In Wichita, Walgreens is opening four retail clinics by the end of the month, with two more planned by the end of the year.

They're the first to enter the Wichita market. I bet they won't be the last.

Nationally, Wal-Mart, Kroger (owner of Dillons), Target and other retailers are moving aggressively to open these walk-in clinics, which serve an important niche: the need for quick, affordable care for minor ailments such as sore throats and ear infections, as well as routine services such as vaccinations.

Retail clinics typically charge a low-cost flat fee for services -- say, $30 for a flu shot -- and are staffed by nurses and physician assistants. Most try to see patients within 15 minutes.

By all accounts, consumers are greeting these outlets with open arms.

And why wouldn't they?

The U.S. health care system is a basket case. Millions of Americans are uninsured or underinsured. Those who are most in need of health care and coverage often can't get it.

Even the insured have trouble getting access.

Critics, including doctor groups such as the American Medical Association, complain that retail clinics disrupt the patient-physician relationship and work against the idea of a "medical home" where patients receive some continuity of care. They've raised concerns, too, about quality of care.

If the retail clinics were trying to do what physicians do, I might agree. But nurses and physician assistants already treat many of the minor ailments in doctors' offices, and they're well-qualified to do so.

By letting walk-in clinics handle some of these routine tasks, maybe doctors would have more time for the complicated medical problems that truly require their specialized knowledge. Also, Walgreens clinics refer patients who need a doctor, perhaps helping some find a family physician.

Many Americans without insurance already have no medical home. Isn't it better that they receive care at retail clinics rather than do without -- or end up in hospital emergency rooms, driving up costs even more?

Moreover, studies show that millions of Americans aren't getting the immunizations they need. Convenient walk-in clinics could greatly boost the rate of immunizations and reduce contagious illnesses.

The evidence suggests that retail clinics provide access to quality health care and encourage competition and innovation. A 2005 Wall Street Journal/Harris poll of retail clinic users found that 80 percent were satisfied with the cost of their care, 89 percent liked the quality of care, and 88 percent thought the staff members were qualified.

At least some doctors and hospitals are taking notice of this trend, opening their own retail-like clinics, offering patients walk-in appointments and expanded evening and weekend hours.

The competition from retail clinics is a healthy thing that improves quality of care.

Granted, retail clinics aren't some wonder cure for what ails American health care -- more like a Band-Aid. Our soaring health care costs are mostly related to treating the complications of chronic illness.

Doctors would be justifiably concerned if retail clinics moved into treating more serious ailments. I really don't want to see someone getting an appendectomy at QuikTrip.

Still, Walgreens, Wal-Mart and other retailers are working to give consumers what they want -- some level of affordable, convenient health care.

What's not to like about that?

Instead of complaining about retail clinics, the medical profession should follow their lead.

Randy Scholfield is an Eagle editorial writer. His column appears on Fridays. Reach him at 316-268-6545 or rscholfield@wichitaeagle.com.