Collaborate or Compete With Retail-Based Clinics?

We live in a culture of "now." We expect instant downloads and constant cellular connectivity. We are all so busy that it is difficult to wait and schedule services in advance. For many patients, this applies to medical care too.

Because most adults cannot get same-day appointments with their primary-care providers, this void has been readily filled by retail clinics and urgent care clinics. My area of northern Virginia is no exception, with seven retail clinics within 5 miles of my home (up from two clinics just a few years ago).

Retail clinics can be a good option for some patients, as most medical problems do not require an emergency room visit. And the majority of patients with minor problems have difficulty making daytime appointments that cause them to miss work or school. Very few medical practices are open before 9 a.m. or after 5 p.m. Personally, I think that making medical care available when a patient needs it is a good idea. However, as a medical practice owner, I know that retail clinics are in direct competition for my patients. Every patient that is seen at a retail clinic is a patient that was notseen in my office, thus diminishing my bottom line. And, as a pediatrician, I am extremely concerned about the care of children since most providers in these settings are not trained primarily in pediatrics.

Perhaps, when all practices are fully electronic and the exchange of medical information is more seamless, a patient's full medical history will be available, at all times. In the meantime, there can be dangerous gaps in information should a patient not inform the urgent-care provider of a chronic condition or a medication he is taking. There is also cause for concern if the primary-care provider is not told of medicine prescribed by the retail clinic.

Our practice has responded to this need by increasing our hours of operation; with walk-in hours early on weekday mornings and same-day appointments on weekends. Both of these extended clinics are meant for urgent problems, not chronic conditions. Yes, it does cost our practice to staff these extended hours, but we have found that it is worthwhile financially, and more importantly, earns the loyalty of our patient population.

I would advise other practices to develop relationships with local retail clinics in order to establish good communication. This would greatly enhance sharing of medical records with the primary-care office. Unfortunately, our practice has been unsuccessful with gaining the trust of local retail clinics. Nevertheless, it is important to try improving the exchange of medical information between your office and retail clinics.

No matter your opinion on retail clinics, they are here to stay. Increasing your patients' access to your medical office will help direct them back to your practice. Most importantly, improving communication between retail clinics and your office will improve overall patient medical care and continuity.

Rebecca Fox, MD,is the co-owner of a pediatric practice in Northern Virginia and a contributor to Physicians Practice's blog,Practice Notes.What is your relationship with local retail-based clinics? Tell us at editor@physicianspractice.com. Unless you say otherwise, we'll assume that we're free to publish your comments in print and online.

This article originally appeared in the April 2015 issue of Physicians Practice.