Walk-in clinics are becoming readily available in grocery and discount stores across the United States.  For people who aren't insured or have high-deductible policies, the retail health clinics,  run by companies such as MinuteClinic, Take Care Health Systems and RediClinic, can offer significant savings. Many minor ailments are treated for $49 to $59, which can be significantly less than being seen at a local doctor’s office.

"People with high-deductible policies will go to the clinics because they don't want to spend $100 on a doctor's visit," says Hal Rosenbluth, chairman of Take Care Health, in Conshohocken, Pa.

However, patients, even CDH consumers, with serious ailments should steer clear of the clinics, which are set up to handle minor problems such as sinus infections, pink eye and bee stings. Beyond that, the answer partly depends on whether a person has health insurance, and if so, what kind.

People with traditional insurance, by contrast, usually have to pay the same co-pay as they would at their doctor's office. But a few employers have lowered co-pays for clinic visits in an effort to encourage workers to use them for simple ailments, says Michael Howe, chief executive of MinuteClinic, a subsidiary of CVS. 

Prices Are Posted

One appeal of the clinics is that they post prices for services, such as treating bronchitis or giving a flu shot. Such information is rarely seen in physicians' offices or hospital emergency rooms, and consumer advocates have been pressing for more price transparency.

For many consumers, though, convenience is the main appeal of the clinics, which are usually staffed by nurse practitioners and have one or two examination rooms. On a recent day, Matt Rossi, a 42-year-old lawyer, had a sore throat and stopped at a MinuteClinic in a CVS pharmacy in Bethesda, Md., for a strep test.

On a previous visit, he said, he was diagnosed, was given a prescription for an antibiotic and had it filled at the pharmacy -- all in 20 minutes. "It was simple and convenient," he said. "And with small children and a busy job, that's worth an awful lot." He has taken his three children, ages 5, 8 and 10, to the clinic several times.

Not a 'Medical Home'

Some doctors and physicians' groups, however, disapprove of the retail clinics. Last September, the American Academy of Pediatrics said it "opposes" the clinics because they lead to "fragmentation of care" and raise questions about the quality of care. In particular, the group said children should have a "medical home" -- a doctor who sees them on a consistent basis.

Mr. Rosenbluth of Take Care Health agrees patients need a "medical home" and says the retail clinics don't try to fill that need. But, he adds, "what happens on nights and weekends" when it may be difficult to see a doctor? At those times, he says, the retail clinics can serve people who might otherwise go to hospital emergency rooms for non-emergency needs.

Anne Pohnert, director of operations for MinuteClinic in the Washington, D.C., area, says MinuteClinic tries to establish and maintain a relationship with primary-care physicians by sending them reports of patients' visits. (Some other chains do that as well.) She says the clinics follow strict guidelines on what they will and won't treat.

For example, she says, MinuteClinic won't treat a patient more than four times in one year for sinus infections because that person should see an ear, nose and throat specialist to rule out a more serious condition. Similarly, she says, the clinics won't treat anyone who is 65 and seems to have bronchitis, because the person could have a serious respiratory problem, or congestive heart failure.

Therefore, while retail clinics are a good option in many cases, especially for those with a HDHP, it is important to consider the illness/issue that is leading a person to seek medical care and to consider if a regular doctor’s office is a better choice for a particular condition, even if it is more expensive in the long-run.

Adapted from article in the Wall Street Journal
February 12, 2007