Vital Signs Blog

JAMA Pediatrics study shows high use of retail clinics even during pediatricians' office hours

Simply extending office hours may not be enough for pediatricians to persuade patients to come to them rather than to retail clinics, according to a new study posted on the JAMA Pediatrics website. It found that almost half of children's visits to in-store healthcare facilities occur when pediatric offices are likely to be open.

The survey conducted by researchers at the Washington University School of Medicine found that when parents took their children to a retail clinic, 47% of the reported visits occurred between 8 a.m. and 4 p.m. on weekdays or between 8 a.m. and noon on Saturdays.

“Many parents first considered going to the pediatrician for care but were unable to or believed they would be unable to get a convenient, timely appointment for an office visit,” the researchers wrote. They concluded that pediatricians “will need to directly address parents' need for convenient access to care.”

The researchers, who had a 91.9% response rate, gave 1,484 parents in the waiting rooms at 19 pediatric offices of a Midwestern “practice-based research network” a questionnaire to fill out between December 2011 and April 2012. Among respondents, 37.4% had used a retail clinic themselves and 23.2% had taken a child to one.

Reasons for going to a retail clinic included: More convenient hours at the retail clinic, 36.6%; no appointment was available with their child's pediatrician, 25.2%; parents didn't want to bother the pediatrician after business hours, 15.4%; and problem wasn't considered serious enough for a doctor visit, 13%. Reasons for the visit included: sore throat, 34.3%; ear infection, 26.2%; cold or flu, 19.2%; and physical exam, 13.1%

According to the parents, among children with an ear infection, 85.2% received antibiotics, as did 78.6% with a sore throat and 67.7% of those with a cold or the flu.

In an accompanying editorial, Dr. Edward Schor, with the Lucile Packard Foundation for Children's Health, Palo Alto, Calif., wrote that retail clinics' business model of convenience, low-cost services and transparent pricing reflects the systematic changes occurring in healthcare and concluded that pediatric practices need to adapt.

“Pediatricians need to analyze families' desire for convenient, high-quality care at low cost and balance that desire against their own needs for practice autonomy, revenue, professional satisfaction and personal time,” Schor wrote.

Follow Andis Robeznieks on Twitter: @MHARobeznieks


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