House of Delegates issues guidelines for in-store clinics

Rapid growth in the number of such facilities has generated concerns over their quality and safety.

By Tyler Chin, AMNews staff. July 3, 2006.

Chicago -- With quick clinics opening in chain stores across America staffed by nurse practitioners and physician assistants, the AMA House of Delegates made clear during the Association's Annual Meeting that, while it's not against the facilities in principle, it believes they are no substitute for a long-term relationship with a doctor.

The house adopted a report June 13 establishing nine guidelines for the operation of in-store clinics. The action comes as pharmacy chains, shopping malls and retailers around the country, including Wal-Mart Stores Inc. and Walgreen Co., rapidly move to lease space to in-store health clinics to treat nonurgent minor conditions such as colds, ear infections and strep throats.

These clinics target the insured, uninsured and underinsured who value the convenience and flexibility of getting treatment on a walk-in basis instead of having to schedule an appointment to see their physician.

While the clinics say they complement and are not intended to replace physicians, delegates at the AMAAnnual Meeting expressed concern about the clinics' impact on quality care, leading the house to adopt the guidelines and direct the AMA to monitor the effects of the clinics on the health care marketplace, then report its findings back to the House.

"The guidelines that were passed are ones that we'd use when asked for [our] opinion of store-based clinics," board Trustee Rebecca J. Patchin, MD, an anesthesiologist and pain management specialist in Riverside, Calif., said at a press conference following the house's action. "What we're interested in is making sure that they are operated in a way that protects the public. That's what the guidelines are intended for and to provide some parameters to provide quality care."