America’s Family Physicians Urge Retail Health Clinics To Put Patients’ Health First

The American Academy of Family Physicians issues guidelines to optimize care

LEAWOOD, Kan. — Frustrated with the inconvenient scheduling and high costs in today’s health care system, time and cash-strapped Americans can now stop at their local discount store or pharmacy for quick, convenient, basic health care. But is the growth of retail health clinics a healthy trend?

The American Academy of Family Physicians (AAFP) believes patients can obtain relief for common, acute, minor medical problems at retail health clinics in a limited number of circumstances, such as if a medical problem arises outside their primary care physician’s office hours, or they are out of town and an emergency room visit is not necessary. Nurse practitioners and physicians’ assistants who work at the clinics can diagnose and treat some of the most common minor illnesses physicians treat. Retail health clinics offer a limited menu of services at many different locations without requiring an appointment.

As one of the first physician organizations to speak publicly about the role of retail health clinics, the AAFP began analyzing major retail clinic companies in late 2005. After studying the trend, the organization decided to try to shape the model of care at emerging retail clinics in a way that would benefit patients. Therefore, the AAFP developed a list of desired attributes to encourage patient safety and promote an adequate level of quality in the care retail clinics provide:

Since developing these desired attributes, the AAFP has proactively engaged itself in the retail clinic industry, meeting with leaders of some of the major retail health companies, such as MinuteClinic, TakeCare and InterFit (Redi Clinic). Each of these retail health companies has expressed its support of the AAFP's desired attributes.

Within the past week, the American Medical Association (AMA) released guidelines for retail health clinics that emulate the desired attributes devised by the AAFP. However, the AMA added one guideline that calls on retail health clinics to “encourage patients to establish care with a primary care physician to ensure continuity of care.” The AMA’s additional guideline advocates for patients to have what the AAFP has long called a “personal medical home.”

“Retail health clinics can complement the work of family and other primary care physicians,” said Larry S. Fields, President of the AAFP. “However, retail clinics cannot replace a personal physician who is familiar with a patient’s medical and family history, coordinates and manages care and can perform much more sophisticated testing, diagnosis and treatment.”

“Family physicians have always put their patients first,” Fields said. “And the AAFP has taken active steps to revitalize and reform health care at the patient-doctor level, embracing a new model of patient-centered care that is integrated, convenient and accessible.”

The AAFP is encouraging family physicians across the country to implement the TransforMED model of care, which features many of the attributes patients have said they want and need from the health care system — the convenience they desire and the continuity of care and technology that improve health care outcomes and decrease costs. The AAFP’s TransforMED model of care recognizes that same-day service for even routine physicals keeps patients healthier and happier in the long run. Therefore, the TransforMED model includes the concept of “open access scheduling.” The AAFP has strongly encouraged each of its 94,000 member physicians to implement this flexible scheduling system, as well as expanded office hours, to make office visits more attainable and satisfying to their patients.

When a patient visits his family physician, the physician often provides advice and treatment for more than the concern that prompted the visit. In fact, data indicate that
during a single routine office visit, the average family physician treats four problems, including the acute problem that prompted the visit and a range of preventive and chronic-care services.

“Patients simply cannot get this top-quality, customized care at a retail clinic,” said Rick Kellerman, M.D., president-elect of the AAFP and chairman of the AAFP Retail Health Workgroup.

Furthermore, retail clinics “should encourage patients to have a personal medical home, where their family physician can better control cost, continuity and quality of care,” Kellerman said.

The AAFP does not endorse any particular retail health clinic business model or company. It will continue to communicate openly with retail health clinics and provide input on how they can best work with doctors to benefit the communities and patients they serve.