Retail Clinics: Not Just Treating Illness-Preventing It

MARCH 16, 2015
Katrina Rossos
Retail clinics are making preventive health care more acccessible, affordable, and pervasive.
In order to be healthy, one must live with health and wellness in mind. Taking care of our bodies should be everyone’s foremost priority, but the 21st century’s wearisome way of life often drains our energy, pushing fitness, nutrition, and disease prevention to the back burner. Fortunately, the recent expanse of retail clinics is making preventive health care more accessible, affordable, and pervasive.

Retail clinics, or convenient care clinics, are nonurgent walk-in clinics that offer preventive health services and acute care, with some clinics expanding into chronic condition management. Staffed by nurse practitioners or physician assistants and located within pharmacies and supermarkets, the number of retail clinics in the health care market has exploded since their introduction in 2000. Despite criticisms, an ever-increasing number of people head to retail clinics for their low cost and convenience, with visits quadrupling between 2007 and 2009, according to a 2012 study published by the RAND Corporation.1 Retail clinics provide a viable alternative for acute care at cost-effective prices, and they deliver inexpensive preventive health and wellness services—the primary reason for retail clinic visits.

Preventive medicine is the medical specialty that focuses on health, with the goal of fending off sickness and maintaining well-being. All disease prevention efforts promote healthful living in an attempt to avert the onset of illness. Preventive medicine can be broad based, such as an annual physical, or specific, such as immunizations. Retail clinics offer both.

Health Screenings, Wellness Programs
Health screenings, physicals, and wellness programs make up the bulk of preventive medicine within the retail clinic market. Most retail clinics offer an overall health screening with blood pressure and cholesterol checks. Some clinics, including Walgreens Healthcare Clinic, Rite Aid Rediclinic, and CVS MinuteClinic, also provide diabetes screenings.

“Approximately 7 million Americans are living undiagnosed with diabetes or pre-diabetes, putting them at risk for serious complications,” MinuteClinic chief medical officer Nancy Gagliano, MD, said in a 2012 press release.2

The health screenings provided at retail clinics help people gauge their risk for developing certain chronic illnesses, such as diabetes or hypertension. Without making an appointment, an individual can walk into a retail clinic, purchase a health screening, receive a diagnosis, and be advised by a nurse practitioner regarding the condition. If the diagnosis is for a chronic disease, the patient will be referred to his or her primary care physician. With many clinics branching out into chronic condition management, however, patients may not need to leave the clinic.

In addition to screenings and tests to scan for potential health problems, most retail clinics provide wellness programs. For instance, CVS MinuteClinic offers smoking cessation, weight loss, and motion sickness programs as a part of its preventive medicine offerings.

Feeling under the weather, but not sure whether it’s the flu? Several retail clinics sell influenza testing at a cost separate from a wellness visit. Other diagnostic tests that can be purchased individually at certain retail clinics include tests for tuberculosis, HIV, pregnancy, and thyroid disorders. Which tests and screenings are available, independently or within an office visit, varies from clinic to clinic.

Immunizations—What and Where?
Vaccinations are a form of disease prevention, and nearly all retail clinics offer the Centers for Disease Control and Prevention–recommended immunizations that are allowed to be distributed within their particular state. These vaccinations include influenza, hepatitis, tetanus, pneumonia, measles, polio, shingles, and meningitis. About 42% of retail clinic visits in 2009 were for the purpose of receiving a vaccination, according to a report published by the American Journal of Preventive Medicine, up 6% from 2008. Of the vaccinations administered in 2009, 94% were for influenza, the report indicated, making the flu shot the most common immunization received at retail clinics by far.3

The American Journal of Preventive Medicine report proved that retail clinics are, and will further become, a major player in vaccination delivery as they make up a considerable portion of the retail clinic business. With more and more people heading to their neighborhood retail clinic for primary care, nurse practitioners are able to formulate comprehensive patient histories and can counsel patients on what vaccinations they may need. The strengthened relationship between patients and nurse practitioners may cause a further surge in vaccine delivery at retail clinics in the coming years.

Vaccination offerings, how they can be dispersed, and age restrictions vary by state.

Both pharmacists and nurse practitioners can administer vaccinations, but nurse practitioners are certified to issue more vaccinations than pharmacists. So patients heading into a local Walgreens Healthcare Clinic for a flu shot can also get a human papillomavirus (HPV) vaccination.

Parents looking to bring their children in for vaccinations need to do some research. Most retail clinics allow children as young as 18 months to be vaccinated, but infants in need of their first few rounds of vaccinations (eg, hepatitis B, DTap, polio, Hib, pneumococcal disease) will most likely have to be seen by a pediatrician. Pharmacists, on the other hand, may be prohibited by state law from administering vaccinations to individuals younger than 18 years.

Yearly Routine Physicals
All retail clinics administer some type of annual physical, whether it be for school, sports, camp, college, or employment. According to a study conducted by CVS Caremark Corporation, 81% of all nonacute visits to MinuteClinic in 2011 were for physicals.4 In 2013, CVS MinuteClinic became the official sports physical provider for the Pop Warner Little Scholars Program, which runs football, cheerleading, and dance programs across the country, securing a portion of the youth sports physicals market.

Heather Helle, the divisional vice president of Walgreens consumer solutions, said in a press release that “physicals represent a valuable opportunity for families to meet with a trusted health care professional who can screen patients for undetected health conditions, identify children that may be at risk for injury, and provide important health and wellness information and advice.”5

The increased number of patients going to retail clinics for their annual physical is disheartening to some primary care physicians, who develop relationships with the patients they see yearly. But with a faster turnaround for an appointment, and walk-ins welcome, the rise in administration of physicals at retail clinics makes sense, especially when physicals are often required at the same time each year.

Price for Services
The ability to shop around is another added benefit for investigating retail clinics. It is important for patients to research what services are offered at their neighborhood retail clinic before heading out the door. Most retail clinics post a price menu of their wellness and preventive services on their website, so customers know what they will be billed before leaving the house. This kind of transparency is not often presented at the doctor’s office. According to a 2013 Kaiser Family Foundation Women’s Health Survey, 52% of uninsured women and 42% of uninsured men deferred routine preventive health services because of cost.6 Retail clinics may change that.

The Bottom Line
Fixed pricing and flexible scheduling have made retail clinics a go-to destination for disease prevention and wellness. Statistics overwhelmingly show an increase in routine physicals, vaccinations, and health screenings and tests at retail clinics—a hopeful assurance that people will continue to be more prudent about their health. And isn’t that a win– win for everyone?


Katrina Rossos is a freelance writer and journalist living in New Jersey. She graduated from Tulane University with a BA in English and film studies. She was an editor for AOL, and her work has appeared in New Jersey Life magazine, Our Town newspaper, Azula.com, and TheDodo.com.

References

1. Mehrotra A, Lave J. Visits to retail clinics grew fourfold from 2007 to 2009, although their share of overall outpatient visits remains low. Health Affairs. 2012:2123-2129.
2. MinuteClinic supporting diabetes month with free diabetes screenings. CVS Health website. www.cvshealth.com/newsroom/press-releases/cvsminuteclinic/minuteclinic-supporting-diabetes-month-free-diabetes. Accessed February 5, 2015.
3. Uscher-Pines L, Harris KM, Burns RM, Mehrotra A. Growth of retail clinics in vaccination delivery in the US. Am J Prev Med. 2012:63-66.
4. Alexander A. At Analyst Day, CVS Caremark unveils host of new initiatives across the board: front-end, pharmacy, clinics and PBM. Drug Store News website. http://www.drugstorenews.com/article/analyst-day-cvs-caremark-unveils-host-new-initiatives-across-board-—-front-end-pharmacy-clin. Accessed February 5, 2015.
5. Take Care Clinics add concussion education, prevention and awareness to camp, back-to-school and sports physicals. Walgreens Newsroom website. http://news.walgreens.com/press-releases/general-news/take-care-clinics-add-concussion-education-prevention-and-awareness-to-camp-back-to-school-and-sports-physicals.htm. Accessed February 5, 2015.
6. Salganicoff A, Ranji U, Beamesderfer A, Kurani N. Women and healthcare in the early years of the affordable care act. Kaiser Family Foundation. 2013:11.

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