Along with buying items such as socks, corn chips and shampoo, consumers can now get a quick medical diagnosis from a nurse practitioner or physician assistant at dozens of retail stores across the country. Retailers such as Bartell, Cub Foods, CVS, Eckerd, Osco, Rite Aid and Target are installing in-store clinics with specialist companies such as MinuteClinic, Minneapolis, and Take Care Health Systems, Conshohocken, Pa.
The growth of in-store clinics prompted the American Academy of Family Physicians, which has worked with MinuteClinic and Take Care, to develop a list of necessary attributes for such clinics. The AAFP says in-store clinics should have:
* a well-defined and limited scope of clinical practices;
* evidence-based and quality-improvement oriented clinical services and treatment plans;
* formal connections with community physicians;
* codified systems for referring patients when symptoms exceed a clinic's scope of services;
* use of electronic health record systems that can communicate with the patients' family physicians.
Last year, the AAFP decided against fighting the growth of such clinics. In a memo, AAFP Board Chair Mary Frank, M.D., stated that "rather than expending energy in an ultimately unsuccessful attempt to `stop' the retail clinic model," the goal should be to ensure that the clinics provide accurate information and operate under desired AAFP guidelines.
There are indications of strong support for such clinics. In a Wall Street Journal Online/Harris Interactive Health-Care Poll in October 2005, 83% of respondents agreed that retail clinics could provide basic medical services on weekends or evenings when doctors' offices are typically closed.
The AAFP that same month passed a resolution at its scientific assembly calling for an investigation into the growth of retail health clinics; identification of the essential elements clinics should include; and leadership for helping clinics meet community needs. A working group came up with the list of attributes, which was distributed to AAFP members Dec. 21, 2005, and posted on the AAFP Web site Jan. 3.
The AAFP reports there are about 89 retail clinics operating, though there might be thousands up and running by the end of next year.
Retail giant Wal-Mart is in the middle of a pilot test involving four different medical providers to open 12 clinics. There are six open now; the first opened Sept. 1, 2005. According to spokeswoman Sharon Weber, any future direction Wal-Mart takes with retail clinics will be based on the customer response to those in the pilot.