MEDICAL RESEARCH

Retail health clinics should be backup to regular MDs, doctors say

Marissa Farris (R) is examined by nurse practitioner Tamara Hauserman-Aggacid in a Minute Clinic in a CVS pharmacy in Chicago, Illinois.

Marissa Farris (R) is examined by nurse practitioner Tamara Hauserman-Aggacid in a Minute Clinic in a CVS pharmacy in Chicago, Illinois.  (REUTERS/Jim Young)

Retail health clinics found inside pharmacies and other stores should be used as backups to people's regular doctors, says a large group of U.S. physicians.

The recommendation is one of six included in a position paper from the American College of Physicians (ACP) that aims to build a framework for retail health clinics underscoring patient safety, communication and collaboration.

"We know that retail clinics are a reality," said ACP President Dr. Wayne J. Riley. "We embrace them as a backup alternative to primary care."

Coughs and earaches are examples of the type of conditions people can take to retail health clinics when their regular doctors are not available, said Riley, who is also a professor at the Vanderbilt University School of Medicine in Nashville, Tennessee.

U.S. retail health clinics began opening their doors in the early 2000s, according to the position paper published in the Annals of Internal Medicine. The clinics offered a limited range of services, for which patients paid out-of-pocket. Some clinics now offer more comprehensive care covered by insurance.

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The ACP first outlined a framework for retail health clinics in 2007, but the industry has evolved since then.

In the new paper, the organization says all patients should have a relationship with a physician, who can talk about the appropriate use of retail health clinics. It also encourages all care settings to provide flexible scheduling and after-hours care.

The organization also says retail health clinics should have a system in place to refer its patients to primary care physicians if the patients don't have one. Also, it says, retail health clinics are primarily responsible for communicating information about a visit to a patient's primary care doctor.

"At minimum, there should be a note that goes from the retail clinic to the primary care provider so that he or she knows the patient went to the retail clinic," Riley told Reuters Health.

The position paper also says there isn't enough evidence to support the use of retail health clinics for managing chronic diseases like diabetes, and recommends against using the clinics for that purpose.

"There is a correct way to use retail health clinics, but then there is a suboptimal way to use retail clinics," Riley said.

Dr. Andrew Sussman, head of MinuteClinic at CVS Health, told Reuters Health in a statement that the new recommendations are consistent with his company's practices, such as providing visit summaries to patients' regular doctors. Often, he said, those summaries are sent via electronic health record systems.

"In instances where patients do not have a primary care provider - about 50 percent of all visits - MinuteClinic can be a portal of entry into primary care by providing a resource list of primary care physicians in the area who are accepting new patients," he said.

The Convenient Care Association, which represents retail health clinics, also told Reuters Health in an email that the recommendations outlined in ACP's position paper are consistent with its own standards and are already practiced by retail health clinics.

"Retails clinics and primary care physician can work well together," Riley said.