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The Illinois
Academy of Family Physicians compiled this issue brief to address
family physicians’ concerns regarding retail health clinics.
This abbreviated document serves as a ready reference and
educational tool with references listed for further research. Background:
Seven years ago, the first retail health clinic (RHC) opened
in Minnesota. Today,
there are more than 230 RHCs in 20 states. In
While IAFP has a
neutral position on the entry of retail health clinics in Illinois,
IAFP does not want to remain silent.
It is important for these clinics to serve the needs of
patients, while preserving and protecting the existing
physician-patient relationships.
Retail health clinics must have the same goal of high quality
care and patient safety as family physicians’ practices.
IAFP is committed to investigating and discussing family
medicine concerns with any retail health business that plans to
operate in Illinois. Major
vendors in IL:
CVS, Walgreens, Walmart Target,
Kroger Major
Clinic companies:
MinuteClinic, TakeCareClinic, Medical Marts Policy:
AAFP Policy states: Desired
Attributes of Retail Health Clinics: The AAFP has identified the
following attributes that are important to the patient care offered
by retail health clinics. It is the individual physician’s choice
whether or not to work cooperatively with a retail clinic operation,
using the following attributes as a guide in decision-making. Scope
of Service -- Retail clinics must have a well-defined and limited scope of
clinical services. Evidence-based
Medicine -- Clinical
services and treatment must be evidence based and quality
improvement-oriented. Team-based
Approach -- The clinic should have a formal connection with physician practices
in the local community, preferably with family physicians, to
provide continuity of care. Other health professionals, such as
nurse practitioners, should only operate in accordance with state
and local regulations, as part of a "team-based" approach
to health care and under responsible supervision of a practicing,
licensed physician. Referrals
-- The clinic must have a referral system to physician practices or
to other entities appropriate to the patient’s symptoms beyond the
clinic’s scope of work. The clinic should encourage all patients
to have a ‘medical home." Electronic
Health Records -- The
clinic should include an EHR system sufficient to gather and
communicate the patient’s information with the family
physician’s office, preferably one that is compatible with the
Continuity of Care Record supported by AAFP and others.
(June Executive Committee 2006) AAFP
Commission on Practice Enhancement 2007 Annual Report:
Actions from AAFP’s 2006 annual meeting asked the Academy work
with insurance companies to ensure there are no financial incentives
for patients to seek care outside of their medical home, such as a
retail health clinic. AAFP staff distributed a letter advocating the
Academy’s new copayments and retail health clinics policies and
asked health plans to indicate how they handle the co-payments for
retail health clinic visits. An article in AAFP News Now will
highlight the advocacy letter and how the major national payers are
handling this coverage in their benefit plans. Additionally,
the American Medical Association has developed guidelines which ask
in-store clinics to follow state laws and general medical protocols,
establish ways to interact with local physicians, use electronic
health records, inform patients of nurse practitioners'
qualifications, and keep the facilities sanitary and hygienic.
And, the American Academy of Pediatrics has publicly opposed
retail health clinics as insufficient to provide care to infants and
children. Concerns:
Many concerns have been voiced by the medical community through
published articles, letters to the editor, and interviews.
Overall, the most frequently cited are the following:
Solution: The medical community has offered numerous solutions to the health care crisis overall and the resulting emergence of retail health clinics as a solution. Here are a few suggested solutions:
Primary care
physicians want to be the primary source of care for our patients.
RHC’s can’t replace that relationship for a patient who
relies on a family doctor for evaluation, diagnosis, treatment,
counsel and encouragement. A
physician has the patient’s trust.
You can’t buy that with your shampoo. References:
Kaiser Family
Foundation: http://www.kff.org/ Resources: FPM's Retail Clinic Toolkit (AAFP Members Only) -- Compilation of online resources to help AAFP/IAFP members respond to the presence of retail health clinics in their area. On AAFP website, www.aafp.org . |
