Payment & Delivery Models

Retail health clinics’ convenience should not fragment care

Kevin B. O'Reilly , Senior News Editor

Retail health clinics should follow a set of principles designed to ensure continuity of care and support the goal of securing a primary medical home for patients.

Those are among the take-home messages from actions taken by the AMA House of Delegates (HOD) at the 2017 AMA Annual Meeting in Chicago.

Retail health clinics “have been playing a steadily growing role in health care,” according to an AMA Council on Medical Service report the HOD adopted. The first such clinics opened at the turn of the millennium, and recent estimates indicate there will be more than 2,800 retail health clinics this year. Patients value the convenience of these outlets because they have later hours and offer “clear pricing at the point of care,” the council’s report says.

The HOD adopted a policy to say that any individual, company or other entity that establishes or operates retail health clinics ought to follow certain guidance as set forth. Among other things, delegates said that retail clinics:

  • Must help patients who do not have a primary care physician or usual source of care to identify one in the community.
  • Must use electronic health records to transfer a patient’s medical records to his or her primary care physician and to other health care providers, with the patient’s consent.
  • Must produce patient visit summaries that are transferred to the appropriate physicians and other health care providers in a meaningful format that prominently highlights salient patient information.
  • Should work with primary care physicians and medical homes to support continuity of care and ensure provisions for appropriate follow-up care are made.
  • Should use local physicians as medical directors or supervisors of retail clinics.

Delegates also said retail clinics should not “expand their scope of services beyond minor acute illnesses” such as sore throat, common cold, flu symptoms, cough, sinus infection or others. They also should not provide services such as infusions or injections of biologics, the new policy says.

In addition, retail clinics should have a “well defined and limited scope of clinical services” and should list the services they offer as well as the qualifications of the on-site health professionals before providing care. Any marketing that retail clinics do should also list the qualifications of the on-site health professionals providing care, the policy adds.

Delegates also reaffirmed previous policy on retail health clinics, the corporate practice of medicine, the physician-led health care team, physicians’ choice of practice and vaccines administered outside the medical home.

The AMA will work with other stakeholders so that spending on a physician’s patient that happens in a retail health clinic is not wrongly attributed to the patient’s primary physician if that doctor “could not reasonably control or influence that spending.”

Read more news coverage from the 2017 AMA Annual Meeting.