Shifting the Paradigm: The Inexorable Growth of Retail Based Clinics & Urgent Care Centers in HealthCare
Blog post by Joe Babaian
Change Before You Have To. – Jack Welch
What did Jack Welch mean when he said this? Does it apply to Healthcare?
With the retailization of healthcare, for better or worse, we see we are in the midst of a paradigm shift. Primary Care as we knew it is changing and the landscape is all new. The shift towards instant-access medicine and fewer connections with a traditional primary care clinic offers both great access advantages and cost savings as well risks we should consider.
Dan Munro wrote “Is This The End of Primary Care?” in Forbes and discussed his top 3 reasons that “the trajectory for many primary care physicians is entirely unsustainable….” Dan lists:
- The economics for the old model of low‒acuity [family] primary care simply doesn’t work
- New models of low acuity/primary care are pushing prices even lower
- In a mobile, smartphone‒connected world, the value proposition around primary care is being redefined
People are on the go and don’t have the time or patience to schedule visits and wait for low-acuity care. Sports physicals, minor injuries, vaccinations, and common complaints are often being handled at convenient retail based clinics or, for slightly more complex services, at urgent care centers that are more than happy to treat walk in patients that don’t need or require emergency medicine at the ED.
Recently, I had the opportunity to interview Dr. Juliet Breeze, CEO of Houston based Next Level Urgent Care, on her views of where the market for retail clinics and urgent care is headed. Not surprisingly, Dr. Breeze was spot on with her comments:
The millennial generation is used to convenience. The need for convenient care combined with an increased amount of consumerism due to high deductibles, is generating a lot of need for affordable healthcare options that are easily accessible.
Dr. Breeze also notes how the current insurance environment has worked to change the landscape. We see many factors working together to point us towards the change we see all around us in the healthcare arena:
With the ACA, emergency room use has gone up as more patients have insurance but may not have good access to primary care physicians. Urgent care facilities will continue to be important as our nation struggles to provide accessible and affordable care.
According to a great new report from the Robert Wood Johnson Foundation on The Value Proposition of Retail Clinics:
It’s estimated that up to 27 percent of ED visits could be handled appropriately at retail clinics and urgent care centers, offering cost savings of $4.4 billion per year
That’s a pair of stunning figures. The report is well worth your time to review in full. Part of the efficiency of our healthcare system depends on patients using the right services for their present needs. Seeing the shift away from unnecessary ED visits to easily accessible retail clinics or urgent care centers is heartening – more choices, flexible choices, and accessible choices can and should lead to “best fit” medicine for individuals. Education remains key, but it’s not difficult to see the attraction to the new options.
Reviewing this chart from the RWJF report leaves little doubt about why people are using retail clinics and urgent care centers. We can consider convenience, value, and specific financial reasons:
Finally, we can put these changes in context as that helps frame where we are right now. The RWJF report notes that even with the recent growth of retail clinics, traditional primary care is far from being on life support:
[Retail Clinics are] representing upwards of 2 percent of primary care encounters in the United States
Let’s consider all the implications along with the #hcldr community of professionals, patients, clinicians, administrators, lurkers, and advocates! Come ready with your experiences and ideas to help form the conversation.
Please join us on Tuesday, May 5, 2015 at 8:30pm Eastern (for your local time click here) as we discuss the following topics:
- T1: What do you see as the positives and negatives of the growth of Retail Based Clinics & Urgent Care Centers?
- T2: What do you see as the future for traditional primary care practices? Their Clinicians? Their patients?
- T3: What personal and/or professional experiences have you had with Retail Based Clinics & Urgent Care?
- T4: What can we, as healthcare leaders and patients, do to make sure this growth brings real value to healthcare without compromising outcomes/experience?
Resources
“Retail Clinics Hit 10 Million Annual Visits But Just 2% Of Primary Care Market” Bruce Japson, Forbes, April 23 2015 http://www.forbes.com/sites/brucejapsen/2015/04/23/retail-clinics-hit-10-million-annual-visits-but-just-2-of-primary-care-market/ Accessed May 2 2015
Personal Interview, Dr. Juliet Breeze, CEO of Houston based Next Level Urgent Care, May 2015
“Building a Culture of Health – The Value Proposition of Retail Clinics” The Robert Wood Johnson Foundation, April 2015 http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2015/rwjf419415 Accessed May 2 2015
“Building boom for urgent care centers shows no signs of letting up” John George, Philadelphia Business Journal, May 1 2015 http://www.bizjournals.com/philadelphia/blog/health-care/2015/05/building-boom-for-urgent-care-centers-shows-no.html Accessed May 2 2015
“Is This The End Of Primary Care?” Dan Munro, Forbes, November 3 2014 http://www.forbes.com/sites/danmunro/2014/11/03/is-this-the-end-of-primary-care/ Accessed May 2 2015
“The Trend Toward ‘Healthcare Retailization” David Nash, Medpage Today, January 21 2014 http://www.medpagetoday.com/Columns/FocusonPolicy/43896 Accessed May 1 2015
“Antibiotic Prescribing for Respiratory Infections at Retail Clinics, Physician Practices, and Emergency Departments” Ateev Mehrotra, MD, MPH; Courtney A. Gidengil, MD, MPH; Claude M. Setodji, PhD; Rachel M. Burns, MPH; and Jeffrey A. Linder, MD, MPH, AJMC, April 21 2015 http://www.ajmc.com/journals/issue/2015/2015-vol21-n4/Antibiotic-Prescribing-for-Respiratory-Infections-at-Retail-Clinics-Physician-Practices-and-Emergency-Departments Accessed May 2 2015
“How retail clinics can bridge healthcare gaps” Zack Budryk, FierceHealthcare, April 21 2015 http://www.fiercehealthcare.com/story/how-retail-clinics-can-bridge-healthcare-gaps/2015-04-21 Accessed May 1 2015
Image Credit
Change – m.a.r.c.
hcldr 
Reblogged this on HealthcareVistas – by Joseph Babaian and commented:
#Hcldr tonight will discuss Urgent Care & Retail Clinics and how they are part of the changing Healthcare environment. Do join us at 830p E for this special chat!
[…] This evening I had the privilege of participating in the #HCLDR chat. This evening’s topic was entitled: Shifting The Paradigm: Retail Clinics & Urgent Care Centers. […]
To this paradigm shift we should add Telehealth. With Facetime app, this primary care will become more prevalent.