Walk-in clinics help to cure US healthcare ills

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Walk-in retail health clinics have moved from oddity to near ubiquity in just two years in the US. They provide nurse practitioners, who treat minor illness, perform examinations and offer preventive medicine such as vaccines for about $50.

Take Care, acquired last year by the drugstore group Walgreens, estimates it will open one clinic a day and have more than 400 by this time next year. The industry is expected to reach 5,000 to 10,000 retail clinics in the next few years.

"Patient demand could warrant significantly more than 5,000-10,000 clinics. What will limit it is the availability of nurse practitioners," says Peter Miller, chief executive of Take Care.

The explosion of walk-in clinics is one of several significant moves to reform US healthcare by business and other groups outside the traditional medical industry. They range from clinics in retail stores to internet social networking for doctors, retailers' rethinking pricing policies for prescription drugs, widening support for cost-effectiveness studies of medicines, and financial service industry help for hospitals.

These seemingly unrelated examples could change the system at some of its weakest points. They are tackling problems including inexpensive access to basic healthcare for everyone, transparency in medical information, and personal accountability for one's own health.

Walk-in clinics have been set up in some of the largest drugstore and retail groups, including Wal-Mart, Target, CVS and RiteAid. Their business model seeks to offer basic healthcare for patients, whether insured or uninsured. They treat minor illnesses at low cost, and could help to head off higher costs with preventive medicine while leaving physicians time for complex cases. In addition, they generate a computer patient record for each visit, which could help to spur wider adoption of electronic health records.

"We are serving as a critical entry point for patients," says Mr Miller. "In many cases, there are patients that haven't been in the healthcare system in years."

Since it opened over two years ago, the established medical community's concern in one of Take Care's first markets of Kansas City has shifted. In some months 10-15 per cent of its patients are referrals from doctors.

Clinics see potential to expand services, including helping with obesity and patient health and wellbeing, "transforming how healthcare is practised today", says Mr Miller.

Doctors are not to be left behind. Sermo, the internet networking site for doctors, has emerged to give physicians a network to discuss their medical cases or problems, find new information such as drug data, operate their business better, or post personal information.

Sermo has up to 40,000 US physician members, recently adding 2,000 each week. Dr Daniel Palestrant, founder and chief executive, says: "It could be indispensable But it also does what we want to do - and that's help fix healthcare."

Healthcare costs have also attracted new reform efforts. Wal-Mart, the world's largest retailer, launched a $4 plan for 30 days' supply of commonly used generic drugs. It has targeted $10bn of savings by squeezing out pricing anomalies and making generic drugs pricing more transparent.

Hospitals have seen their bad debts continue to soar as uninsured patients or those with less insurance fail to pay large bills. As people are required to take on more costs, this debt has created a vicious cycle that is destabilising US healthcare, experts say.

McKinsey & Co says financial institutions have expertise either being used or implemented in the future that could help the healthcare payment system, with "electronic payment processing capabilities that the sector needs".

US healthcare is changing and adapting with these new ideas, either paving the way for potential federal policy reforms, or in lieu of their absence.

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[LaL 418]

Walk in clinics are a fabulous supplement to the healthcare of people insured or uninsured.

[w¡n9Nµ7 §£@¥€r 123]

Yeah I use a walk in clinic as my primary source of healthcare. It's 1/2 a mile from home and convenient.

[chispas 0]

My own physician opened one of these clinics in one of the drugstores near his office. They said they did it for the overflow of patients who come in with colds, flu, or just have a specific concern. They keep our medical records on computer, so when I go to the walk in all the information is updated immediately. I've gone for a cold and it was more efficient than sitting in his office waiting.

[Flames9_RN 358]

Yep walk in health clinics can be great!! Emergency rooms at hospitals were not intended for people suffering from the sniffles.

[Amby 490]

walk in clinics are so convenient unless they're busy] then you might be waiting a long long time. I think that's the only downside I've experienced

[almaty 19]

i agree sister amber

[Mags 112]

We've had walk in clinics in the UK for a few years. I'll admit they can be a bit hit and miss and many people who go to the walk in clinic are then simply referred to the ER (A&E). They have then waited twice as long for treatment. Also Nurse Practitioners are actually pretty limited in what they can and can't do; many times you'd have someone queue to then be told that the nurse can't give them the prescription they need or that they don't offer the treatment required for that ailment.

Perhaps they can do more over here in the USA (plus you have that no healthcare thing too...).

[Dr. Obvious 49]

We used the Minute Clinic when my husband had an ear infection. Ear infection was $55, I think from the menu, and the RX $29. They definitely do not treat everything though, only those things from the menu. So, you have to check and see if you have a menu item before you go down there.

[Aymerlu 3]

I use walk in clinics all the time! I can call my kids pedi when they are sick and have to wait hours to get them in or I can drive a mile up the road and get right in! He's a cool doc too! The first time I saw him I was 16 and had got a piece of metal in my eye. Years later he still remembers my first visit and all the places I have worked!