Pharmacy-based retail clinics, which offer extended hours and low prices, are an increasingly popular option for pediatric care.
Many parents in search of convenient care for their children are visiting retail clinics located in pharmacies instead of their primary care pediatricians for minor illnesses, a new study reports.
These clinics, found inside special Walgreens, CVS, Target, Kroger, and other chain pharmacy locations, offer treatment for common illnesses, are frequently open at night and on the weekends, and often have shorter wait times and lower prices than the physician’s office or the emergency department. However, professional organizations, such as the American Academy of Pediatrics and the American Academy of Family Physicians, have voiced concerns about the quality of care offered by these clinics as well as the possible negative effects of fragmented care on overall health.
Given the conflict between these professional opinions and evidence suggesting that more parents are using the clinics, researchers investigated how often parents who normally visit pediatricians use retail clinics and why. Their study
was published online on July 22, 2013, in JAMA Pediatrics
The researchers surveyed 1484 parents in the waiting rooms of 19 pediatric offices in a Midwestern practice-based research network from December 12, 2011, through April 20, 2012. Parents who had taken their child to a clinic provided information on the reason for their visit, time of visit, and whether they had informed their pediatrician about the visit. Parents rated their satisfaction with the clinic on a 4-point scale from very satisfied to very dissatisfied.
Approximately 23% of parents surveyed had used a retail clinic for pediatric care, and 47.8% of clinic users had done so more than once in the previous year. Among parents who visited a retail clinic, 36.6% did so because the clinic offered more convenient hours, 25.2% could not get an appointment with their pediatrician, 15.4% did not want to bother the pediatrician after hours, and 13% did not think the condition was serious enough to warrant an appointment with the pediatrician. Approximately 55% of weekday clinic visits occurred during normal pediatrician office hours, between 8AM and 4PM.
Parents most commonly took their children to a retail clinic for acute upper respiratory tract illnesses, including sore throat, ear infections, and cold or flu. According to the parents, antibiotics were prescribed during clinic visits to 85.2% of children with ear infections, 78.6% of those with sore throats, and 67.7% of those with cold or flu. Although 61.7% of parents were satisfied with their retail clinic experience, only 41.8% reported the visit to their pediatrician.
Retail clinics may offer convenient and effective pediatric care to busy parents, the researchers note, but the lack of communication between parents and pediatricians concerning their use may lead to duplicative and potentially unsafe care.
“Pediatricians can address concerns about quality of care, duplication of services, and disrupted care coordination by working to optimize communication with the [retail clinics] themselves, as well as with their patients regarding appropriate management of acute minor illnesses and the role of [retail clinics],” the researchers write. The researchers also expressed alarm at the amount of unnecessary antibiotics prescribed to children in retail clinics, according to parent reports.
Nonetheless, the study’s results indicate that more parents are using retail clinics because they are convenient. In an accompanying editorial
, Edward L. Schor, MD, writes that the convenience, low costs, and price transparency offered by retail clinics are likely to ensure their continued success and that physician practices must improve in these areas in order to retain patients.
“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 writes. “To meet our responsibilities, practices must change.”