Retail Health Clinics Enable Physicians to Expand Practice Reach

Following a sizzling growth spurt in 2007 and subsequent slowdown that mirrored the economic downturn, retail health clinics seem poised to rebound. Part of the reason is the healthcare system’s continued battle over rising costs and capacity; increased use and satisfaction by consumers is another. Reflecting the trend, a report by the Deloitte Center for Health Solutions forecasts the retail health clinic market to grow from 10 — 15 percent between 2010 and 2012, then accelerate by more than 30 percent into 2014.

“Consumer reaction to [retail health clinics] is strong enough to where this is going to be part of healthcare delivery,” says Michael Howe, former president and CEO of CVS MinuteClinic. “I think we’ll see an expansion over the next five to seven years to around 6,000 of these around the country.”

And with that growth comes opportunities for physicians.

Clear rationale

Michael Hall, MD, MSC, PA, a diplomate of the American Board of Family Practice, is the founder of the Hall Longevity Clinic in Miami Beach

, a hybrid model for health and wellness. He’s not surprised by the forecast for growth in the retail health clinic market.

“General medicine is what most people need,” Hall says. “Most people don’t need a knee replacement. They just need to go to see a doctor when they’re sick.” Hall believes that healthcare consumers are going to drive a shift in the marketplace that will enable them to circumvent the obstacles that hinder their attempts to see a doctor. “You see it with Urgent Care and MinuteClinic. People are going to these places. You have to have a safe, convenient, trustworthy way of delivering healthcare.”

Howe echoes those thoughts, and says the retail clinics have becoming increasingly popular among several demographics: late Boomers, Generation X, and early Millennials. “Consumer acceptance is very strong. They want convenience, and they want a two-way dialogue. I think there’s an opportunity here for physicians to think of [retail health clinics] as an extension of their practice.”

Creating a link

Howe explains that healthcare reform today is focusing on universal coverage. If that comes to fruition, he says, the capacity won’t be there in the current structure to accommodate the influx of patients. That’s where retail clinics come in. “The retail clinics provide an extension of a physician’s practice,” he says. “We’ve seen that in the markets where physicians have embraced the concept, and viewed them as a way to provide consumers with access during off hours, such as evenings or early mornings, or on weekends.”

It’s a two-way street, according to Howe. He says that about one-third of the patients who came to MinuteClinic locations were young families that didn’t have a primary care provider. The clinic would provide lists of practices in the market closest to those families that were accepting new patients. Physicians who were part of that referral network had an opportunity to expand the cohort they were serving. “They also had an opportunity to expand capacity by encouraging their patients to go to the retail clinics for minor ailments.”

In most markets, there is also an opportunity for physician oversight. Hall explains that many states regulate and require physician oversight at retail clinics. But even where it wasn’t required, MinuteClinic locations operated in that fashion. “We felt that the team aspect of the physician-nurse-physician assistant working together provided better quality,” he says, noting that physician oversight involves record review, consultation, and periodic visits to the clinic to view operations—maybe four to eight hours per week. “But most of it was record review, and much of it was done online through a secure server.”

Taking ownership

Howe expects future growth of retail health clinics to be logical and organized, and that entities like Walgreens and CVS that know how to retail healthcare will be among the dominant players. But he also expects health systems like Geisinger and Kaiser Permanente, which were in the market early on before pulling back, will re-enter on a geographic basis.

He also points out that 38 of the 50 states do not allow corporate practice. In other words, a professional has to actually own the practice that these retail clinics represent. “There’s an opportunity in the newer markets for physicians to come in and own the practices,” Howe says. “There’s typically no investment required, but there is an opportunity by owning the practice to share in the financial gains.”

How can physicians get started? Howe says the easiest way is to simply reach out to the retail health clinic in their area and say, “Hey, I’d love to get to know your practice more; to understand what, if any, role or support I can provide.” A nurse practitioner or clinical professional at the site will put them in touch with the right people.