Who's minding the store? Health clinic beyond aisle nine

As retail-based clinics open up, it's important to remember that convenience should not trump quality, and the physician is the key player in the health care team.

Editorial. Nov. 7, 2005.

In one trip to the local Wal-Mart or Target, depending on where you live, you can pick up a gallon of milk, a car battery -- and a strep test. That's because the nation's two largest general merchandise retailers, along with some grocery chains and other retail outlets, are renting space to store-based clinics.

The name of the game is convenience. Instead of waiting for a doctor the next day to check your sniffles, or taking off work to squeeze in a sick visit because of your sore throat, why not just stop by and have a nurse practitioner check you out? For the retailers, the object is to offer another service to their customers, and perhaps have them spend a little money in the store while they wait, and take their prescriptions to their in-store drug counter.

Certainly, there's nothing wrong with making health care more convenient and available to patients. But a quick visit to a store-based clinic is no substitute for regular care from a physician. Health care isn't just about convenience; it's about quality as well.

Here's the way many store-based clinics work: A nurse practitioner or physician assistant is aided by diagnosis software in determining what might be the reason for a patient's particular symptom. Generally, if the diagnosis is going beyond a minor, easily treatable condition, the NP or PA is supposed to consult with a physician assigned to, but not present in, the clinic, and if necessary recommend that the patient seek further care elsewhere.