Whether it’s to treat a sinus infection, get a sports physical or catch up on school vaccinations, millions of Americans will visit convenient care clinics this winter to receive health care without the hassle or delay of making appointments.
Also known as “retail” clinics, convenient care clinics have grown significantly in popularity since first appearing two decades ago. Often operating in pharmacies or big-box stores, they offer late night and weekend hours with easy walk-in service. The convenience they offer has become understandably popular among consumers. There are expected to be more than 2,800 clinics nationwide by next year with a capacity to serve 10.8 million patients.
But as convenient care clinics are frequently turned to for ad-hoc treatment when needed, they are not giving patients what they most need to stay happy and healthy for the long haul: a ‘medical home.’ That’s a primary care practice where the same clinical team always treats them and focuses on keeping them healthy, all while learning about family or personal medical histories and patient preferences. This centralized coordination, based on an ongoing doctor-patient relationship, is widely regarded as making the difference between good and bad care.
Many convenient care clinics today do not offer the coordinated care that a true patient-centered medical home would provide. For example, unless specifically requested by patients, convenient care clinics often may not communicate with other medical providers. This means that key elements of care, such as visit summaries, medical history and lab work might not be shared with a patient’s ‘regular’ doctor.
Consider the case of a patient with diabetes who drops in to have his blood glucose levels checked (a service that most convenient care clinics now offer). While this might not seem like a big deal, chronic diseases such as diabetes require long-term, tailored management plans developed in conjunction with a primary care doctor, along with regular monitoring visits. By splitting care among many different providers working in different settings, the patient enables none to have a complete picture of his health. Ultimately, he puts himself at risk for dangerous complications.
Given this, how can the health care system incorporate the increasing popularity of convenient care clinics while addressing the gaps in care they can introduce? For the National Committee for Quality Assurance (NCQA) the answer is clear: We must formally bring them into the world of patient-centered medical homes. This has worked successfully in places like Walt Disney World in Orlando, FL where “cast member” employees’ on-site medical care at the Magic Kingdom is connected to local Walgreens pharmacies and convenient care clinics that are integrated into the rest of the care system serving Disney employees.
Convenient care clinics have grown to serve a valuable and obviously popular role in our health care system. The rise of convenient care clinics is also part of a larger trend of decentralizing care, with patients ultimately receiving more care at home. As these new models of care evolve, it is critical that the various components of our health care system connect to each other. The best convenient care clinics try to ensure that the same providers treat repeat patients and quickly share information on services provided and prescriptions written with the patient’s regular primary care doctor. But for those that don’t, it is time we worked to change that by bringing them into the medical home.
Margaret E. O’Kane is president of the National Committee for Quality Assurance.