In-store health clinics: Convenience is not enough

The AMA establishes guidelines that aim to ensure that in-store clinics don't have an adverse effect on patients' long-term health or the patient-physician relationship.

Editorial. Aug. 7, 2006.

To many physicians, store-based health clinics are like kudzu, the vine that ate the South. Kudzu seemed like a good idea when it was imported from Japan years ago, mostly to stop soil erosion. Alas, kudzu grew too well and too fast -- as much one foot per day -- and overtook native trees and plants.

And just like kudzu, the growth of store-based clinics is so rapid, it's unrealistic to think it can be stopped. With that in mind, the AMA House of Delegates approved a report that provides the basis for the most effective response to the situation. The report, from the AMA's Council on Medical Services, sets guidelines for how such clinics should operate, especially when it comes to the critical issues of physician involvement and continuity of care. It also calls on continued monitoring of the growth and impact of store-based clinics.

Certainly, there's plenty going on to track. The clinics are staffed by nurse practitioners or physician assistants -- in itself, a source of concern to many physicians and to the AMA -- and are growing at the retail equivalent of a foot per day.

MinuteClinic started this wave of activity when it set up shop at a St. Paul, Minn., Cub Foods in 2000. The company now has 100 clinics in 10 cities, and it is projecting another 300 to 500 clinics during the next three to five years. (CVS, one of the nation's largest drugstore chains, in mid-July announced it would buy MinuteClinic.) Wal-Mart, the 800-pound gorilla of retailing, is opening its doors to store-based clinics. It seems every major retailer operating pharmacies is eyeing opening its own clinics or inviting an outside firm to come in and set up shop.