'Retail' Medical Care: The Wave Of The Future In Temecula?

Short wait times, quick treatment, and inexpensive service are among the chief reasons some people are choosing to go “retail” when it comes to getting medical care for their non-life-threatening health conditions.

“This is the wave of the future in this country,” said Jon Colbert, MinuteClinic district manager of operations for Orange County and the Inland Empire.

MinuteClinic, which is touted as the largest provider of retail-based medical clinics in the United States, is a division of CVS Caremark Corporation. This summer the company opened a new clinic inside the CVS/pharmacy store at 29610 Rancho California Road in Temecula. It is the second clinic location in the city and only the third in Riverside County, but the company has 11 clinics in San Diego, 10 in Orange County and 11 in Los Angeles.

Not surprisingly, at least one study backs up MinuteClinic’s business strategy.

“Use of retail medical clinics located in pharmacies and other retail settings increased 10-fold between 2007 and 2009,” according to a November 2011 study from the Rand Corporation.

The study found that simple acute conditions may be easily managed at a retail clinic. Conditions like upper respiratory infection, bronchitis, ear infection, flu, and conjunctivitis, were the most common seen at retail clinics, according to the study.

No appointments are required at MinuteClinic and most health insurance is accepted. For patients paying cash or credit, treatment prices are posted at each clinic and on www.minuteclinic.com. The cost for most treatment starts at $79.

Wait times are about 20 minutes at any MinuteClinic, and check-in is via an in-store kiosk, Colbert explained. Prescriptions written by a MinuteClinic staff member can be filled at the CVS store or transferred to any pharmacy outside the CVS company, he added.

Not everyone buys into the retail medical clinic model. A 2008 article in Health Affairs Journal cited concerns about failed business strategies, the ability to deliver quality care and regulatory concerns.

Colbert believes MinuteClinic has carefully negotiated the hurdles, and said now is the time for retail clinics, noting that Southwest Riverside County has the right demographic. According to the Rand study, “The determining factors in choosing a retail medical clinic over a physician's office were found to be age, health status, income and proximity to the clinic. No link between availability of a primary care physician and retail clinic use was found.”

Females between the ages of 18 and 44 were most likely to use the clinics, the Rand study showed.

Perhaps most surprising was that researchers found people in good health and those with median incomes of more than $59,000 were more likely to use retail clinics.

None of this was news to Colbert.

“Our focus is basic simple care. ER and urgent care are bogged down,” he said. “Nobody wants to wait five hours to be seen for a bladder infection.”

Colbert said MinuteClinics will see everyone, but there are limitations. Physicians’ assistants and nurse practitioners -- not doctors -- see patients. Urgent medical conditions require referrals or a 9-1-1 call. Additionally, MinuteClinic employees do not treat patients with chronic pain or mental health conditions, Colbert explained.

“We’re not a primary care,” he said, noting that careful documentation and a judicious approach to prescribing medications, particularly antibiotics, are among the company’s protocols.

How this retail trend will affect rising health care costs is unknown, according to the Rand Study.

“Care initiated at retail clinics is 30 percent to 40 percent less expensive than similar care provided at a physician's office, and 80 percent less expensive than such care provided in an emergency room,” the study found.

"If the growth in retail clinic visits that we noted represents substitution for other sources of care, then the increase in retail clinic use could lead to lower costs," said J. Scott Ashwood, the Rand study's lead author. "However, if these visits represent new utilization or induced demand — in other words, patients are seeking care when they would have otherwise stayed home — then costs could increase. Answering these questions requires additional study."