The American Academy of Family Physicians (AAFP) believes that patient-centered primary care delivered through the Patient-Centered Medical Home (PCMH) is foundational to a health care system that improves the quality and efficiency of care. The AAFP continues to monitor market-based developments in health care delivery that are evolving to meet the expanding needs of patients for timely, convenient, transparent, and consumer-centric health care.
The AAFP continues to observe and respond to the ongoing development of retail clinics in America. While retail clinics may provide a limited scope of health care services for patients, this can ultimately lead to fragmentation of the patient’s health care unless it is coordinated with the patient’s primary care physician’s office.
Furthermore, retail clinics are not the only source of convenient care available for patients today. The overwhelming majority of family physicians offer same-day scheduling in their practice and roughly half of all family physicians have extended office hours for patients to seek care. This easy access, combined with the adoption of the principles of patient-centered care, allow family physicians to provide care that is highly convenient while avoiding overall fragmentation of care.
The AAFP opposes the expansion of the scope of services of retail clinics beyond minor acute illnesses and, in particular, opposes the management of chronic medical conditions in this setting. Protocol-based decision and diagnostic models are used in most non-physician led retail clinics, resulting in a missed opportunity to address more complex patient needs. These missed opportunities range from preventive care services to critically important diagnoses which may not be specifically covered in the pre-generated protocol decision program. The AAFP is committed to the development of a health care system based on strong, team-based patient-centered primary care – defined as first contact, comprehensive, coordinated, and continuing care for all persons.
Care delivered in retail clinics can be a component of patient-centered care, but must work in coordination with the patients’ primary care physician to ensure that care is not further fragmented. Fragmentation and unaccountable silos of care are in direct opposition to achieving continuous whole-person care with improved health outcomes for both the individual and society. While the AAFP recognizes the demand for the advancement of patient centered-ness in the American health care delivery system, it should not be at the expense of comprehensive coordinated longitudinal care. (2006 COD) (2013 COD)