A study in the latest Health Affairs took a snapshot of utilization and costs associated with retail clinics. These are the small clinics located in Wal-Mart, CVS, Walgreen’s and the like. They were touted by proponents as low-cost options for primary care. They are usually staffed by nurse practitioners or physician assistants.
Aetna reviewed claims from 2010-12. The researchers found that 58% of clinic visits for low-acuity conditions represented new utilization. In other words, the group of patients who used retail clinics had more overall visits than those who did not. It’s not hard to imagine the legion of patients who showed up at one of these clinics with a cold, which was diagnosed as “sinusitis,” and antibiotics and a steroid shot were dispensed. All cost; no benefit. The study found a $14 per person per year increase in total costs associated with the retail clinics. Overall health outcomes were not studied.
I hope that this study helps hasten the death of the notion that family medicine delivers better health at a lower cost through early detection and prevention. Family physicians deliver valuable care as much by the things we don’t do to people as those we do. Judgment trumps access trumps aggressive treatment and medicalization of normal life.