Physicians pushing state lawmakers to regulate burgeoning retail clinics

Alarmed by the rapid growth of retail health clinics, some physician organizations are beginning to move past voluntary guidelines toward strict regulation.

By Kevin B. O'Reilly, AMNews staff. June 4, 2007.

With the number of store-based health clinics expanding quickly, physicians and lawmakers in at least seven states have explored legislation aimed at ensuring that these new sources of primary care do not worsen quality, patient safety and continuity of care. In some cases, doctors' legislative fights are against industry-supported measures that would loosen existing regulations that could be applied to retail clinics.

Industry watchers say these legislative and regulatory challenges are the next hurdles for retail clinics.

"A year ago, this industry was an interesting experiment, and a year later, it is a viable model. Now, regulators have a tremendous opportunity to either encourage or impede the advance of retail clinics," said Mary Kate Scott, a health care technology consultant. Scott prepared a July 2006 report on retail clinics for the California Healthcare Foundation, a nonprofit organization that aims to expand access for the underserved.

The country's leading pharmacy chains, retail outlets and health systems will have an estimated 1,500 convenient care clinic locations up and running by the end of next year, compared with about 400 today. There could be consumer demand for as many as 5,000, Scott said.

States regulate the extent to which nurse practitioners and physician assistants can operate independently of physicians, along with safety issues such as the proper handling of biohazards. Also, the AMA and national family physician, pediatric and internist organizations have set out standards for how retail clinics should interact with physicians to ensure quality, safety and continuity of care. Clinics say the recommendations reflect what they already are doing, and the Convenient Care Assn. adopted its own set of standards in March.