Retail Clinics

Objective

To describe pediatric primary care providers’ attitudes toward retail clinics and their experiences of retail clinics use by their patients.

Study Design

A 51-item, self-administered survey from four pediatric practice-based research networks from the Midwestern United States, which gauged providers’ attitudes toward and perceptions of their patients’ interactions with retail clinics, and changes to office practice to better compete.

Results

A total of 226 providers participated (50% response). Providers believed that retail clinics were a business threat (80%) and disrupted continuity of chronic disease management (54%). Few (20%) agreed that retail clinics provided care within recommended clinical guidelines. Most (91%) reported that they provided additional care after a retail clinic visit (median 1–2 times per week) and 37% felt this resulted from suboptimal care at retail clinics “most or all of the time.” Few (15%) reported being notified by the retail clinic within 24 hours of a patient visit. Those reporting prompt communication were less likely to report suboptimal retail clinic care (OR 0.20, 95%CI 0.10 to 0.42) or disruption in continuity of care (OR 0.32, 95%CI 0.15 to 0.71). Thirty-six percent reported changes to office practice to compete with retail clinics (most commonly adjusting or extending office hours) and change was more likely if retail clinics were perceived as a threat (OR 3.70, 95%CI 1.56 to 8.76); 30% planned to make changes in the near future.

Objective

To describe the rationale and experiences of families with a pediatrician who also use retail clinics (RCs) for pediatric care.

Design

Cross-sectional study

Setting

19 pediatric practices in a Midwestern practice-based research network Exposure—Self-administered paper survey Participants—Parents attending the pediatrician’s office

Outcome Measures

Parents’ experience with RC care for their children

Results

1484 parents (92% response) completed the survey. Parents (23%) who used RC for pediatric care were more likely to report RC care for themselves (OR 7.79, 95% CI, 5.13 to 11.84), have > 1 child (OR 2.16, 95%CI 1.55 to 3.02), and be older (OR 1.05, 95%CI 1.03 to 1.08). Seventy-four percent first considered going to the pediatrician but reported they chose the RC because the RC had more convenient hours (37%), no office appointment was available (25%), they did not want to bother the pediatrician after hours (15%), or because the problem was not serious enough (13%). Forty-six percent of RC visits occurred between 8am and 4pm on weekdays or 8am and noon on the weekend. Most commonly, visits were reportedly for acute upper respiratory illnesses (34% sore throat, 26% ear infection, 19% colds or flu) and for physicals.