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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.

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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.