As far as Michael Howe is concerned, the healthcare community should no longer question whether retail clinics are here for
the long haul. The way he sees it, the criticisms about quality and continuity remain theoretical and spoken by a vocal minority.
But even more so, the millions of consumers who are driving demand for retail-clinic services seem to have answered the question
already.
This in-store model with its prepriced services, evening and weekend hours, and technology infrastructure is an interesting
phenomenon in a healthcare system that's reached a tipping point for making fundamental changes. As the CEO of MinuteClinic,
the largest brand among more than 20 retail-clinic organizations, Howe can't find any reason to slow the pace.
"Consumers have already voted," Howe says. "In 2004, MinuteClinic recorded 60,000 patient visits. In 2005, we recorded about
175,000 visits. In 2006, we recorded 350,000 patient visits, and we'll record close to 1 million in 2007. That's a confirmation
from the consumer."
According to Tine Hansen-Turton, executive director of the Convenient Care Assn. (CCA) based in Philadelphia, the convenient-care
clinic (CCC) market is booming. She projects that the number of CCC locations—now at close to 400 nationwide—will double every
year for the next four years with a potential to reach 5,000 locations by the end of the decade. The niche is on pace to end
the year with 700 locations. MinuteClinic, with more than 180 locations, was acquired by retail pharmacy giant CVS last year, so it has a richness of capital
that most other CCCs do not. Nearly all of the clinic brands are independent, but appear to be ripe acquisition targets. Most
recently, Walgreen Co. announced its acquisition of the Take Care brand, which currently operates 50 clinics.
Some of the bullish attitudes among developers are based on the fact that consumers like the product and will keep coming
back. A recent Wall Street Journal Online/Harris Interactive survey found that more than 90% of CCC users nationwide were satisfied with the clinics' quality of care.
Howe says the satisfaction ratings from MinuteClinic patients are above 90% and that 99.3% said they'd come back again. "Any
consumer goods company would kill for half those numbers," he says.
Service Suite
At a glance
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Beyond the convenient hours, walk-in appointments and prepriced services for consumers, the retail clinics' operational charm
comes from what Howe calls right-size engineering. MinuteClinic, like the other brands, specializes in a limited number of
routine services that are single-visit, binary-diagnosis conditions, which can be guided by standardized protocols and treated
by a nurse practitioner (NP). Sore throats, allergies and a dozen other conditions can be treated in the clinics. Vaccines
and routine physicals are also offered. Any patient with needs outside the service suite is referred to a local physician
and not charged for the MinuteClinic visit.
Opponents say the clinics lack true medical oversight and are skimming the "one and done" conditions from primary care physicians,
leaving the PCPs with sicker patients, longer exam times and reduced revenue. Supporters say CCCs stratify the primary care
market into more complex and less complex—a distinction that has never been made previously—while serving the needs of the
less sick, freeing up physicians for complex cases, for which they would actually be reimbursed more.
How much CCCs will affect primary care remains to be seen, however, the LA Times reported last month that HealthCare Partners, a major medical group in Torrance, Calif., began posting prices for 58 of its
routine services, partly motivated by area competition from convenient-care clinics.
According to Howe, local physicians don't have to view MinuteClinics as rivals.
