Disruptive Issues in Healthcare: Retailers as Primary Care physicians

“Retail health clinics like CVS Health aim to provide patients with acute care services at a lower cost, eliminating the need to visit the typical hospital for primary care, Ms. Buckley said. The shift in care delivery has caused traditional hospitals and health systems to re-evaluate how they use PCPs and has led many systems to focus more resources on the development of their urgent care facilities. While the downfall of such urgent care clinics is that they typically are not able to provide care for patients’ long-term health issues, retail clinics have begun to partner with PCPs and larger hospital organizations to begin providing those services.”         

https://www.beckershospitalreview.com/hospital-management-administration/these-are-the-8-most-disruptive-issues-in-healthcare.html

I’ll admit it, I used a CVS Minute Clinic for something typically done in the primary care office. However, I was in a bind and needed a PPD placed and read by the end of the week and my usual primary care clinic wasn’t able to do it. I decided to go to the Minute Clinic where I saw a nice physician’s assistant. I got it done. It was convenient and though the cost was out of pocket, it was reasonable. Is this bad? Not sure. Perhaps this is good utilization of such a clinic, but for primary care, I don’t think it it is good for primary care management. The downfall in utilization of these retail clinics is cited above as “that they typically are not able to provide care for patients’ long-term health issues.”These clinics are not set up as PCP offices with support staff etc to be able to follow, refer, track primary care issues. As such, while it was convenient in my case and appropriate, I don’t believe it is appropriate to manage primary care from within one of these clinics. Doing routine health care items as an adjunct to the primary care office as in my case, or when acute minor needs make it not feasible to be seen in the PCP office sure, but as the full time primary care manager role, not good nor safe. Safety is an issue because in primary care, patient issues are often complex with multiple co-morbidities and polypharmacy. These clinics are staffed by mid-level providers (NPs or Pas) with no physician oversight and this could be a safety issue. Perhaps as the article cites, the way forward is for an evaluation overall of the primary care model and how it is best accomplished given the apparent shortage of primary care physicians and current financial and IT constraints. But for sure, the retail clinics are not cut out to function as primary care offices. For now, I’ll leave it up to each to decide their opinion. For me on this day, the clinic served a purpose for an acute need, but I wouldn’t get my true primary care here

Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.