Retail Clinics

Retail clinics are medical clinics located in pharmacies, grocery stores, and “big box stores," such as Target and Walmart. These clinics offer extended weekend and evening hours, walk-in availability, and short wait times. Thus, many visits to retail clinics are in the evenings and weekends, when primary care offices are not available. The clinics treat a limited range of health conditions, such as minor infections and injuries, and provide vaccines and other preventive care. Usually, a nurse practitioner or physician assistant delivers this care; prices are typically fixed and transparent.

Retail clinics have also generated great controversy. There have been concerns about their quality of care, including the overprescribing of antibiotics, lost opportunities for preventive care, and the disruption of existing patient-physician relationships. There have been competing claims on their impact on spending, with some arguing they reduce spending and others arguing they increase it.
 
I have been involved in 15 publications (see below) that have covered a broad array of questions in this area. RAND has published a research brief that summarizes our work, and my publications provide more details.
 

Profile of Retail Clinics

  • Mehrotra A and Lave JR, “Visits to Retail Clinics Grew Fourfold from 2007 to 2009, Although Their Share of Overall Outpatient Visits Remains Low,” Health Affairs, Vol. 31, No. 9, September 2012, pp. 2123–2129. 
  • Uscher-Pines L, Harris KM, Burns RM, and Mehrotra A, “The Growth of Retail Clinics in Vaccination Delivery in the U.S.,” American Journal of Preventive Medicine, Vol. 43, No. 1, July 2012, pp. 63–66.
  • Ashwood JS, Reid RO, Setodji CM, Weber E, Gaynor M, and Mehrotra A, “Trends in Retail Clinic Use Among the Commercially Insured,” American Journal of Managed Care, Vol. 17, No. 11, November 2011, pp. e443–e448. 
  • Mehrotra A, Wang MC, Lave JR, Adams JL, and McGlynn EA, “Retail Clinics, Primary Care Physicians, and Emergency Departments: A Comparison of Patients’ Visits,” Health Affairs, Vol. 27, No. 5, September/October 2008, pp. 1272–1282
  • Pollack CE, Gidengil C, and Mehrotra A, “The Growth of Retail Clinics and the Medical Home: Two Trends in Concert or in Conflict?” Health Affairs, Vol. 29, No. 5,vMay 2010, pp. 998–1003 
  • Reid RO and Mehrotra A, “Primary Care Practice Response to Retail Clinics,” AMA Journal of Ethics, Vol. 15, No. 11, November 2013b, pp. 937–942.
  • Wang MC, Ryan G, McGlynn EA, and Mehrotra A, “Why Do Patients Seek Care at Retail Clinics, and What Alternatives Did They Consider?” American Journal of Medical Quality, Vol. 25, No. 2, March/April 2010, pp. 128–134.
  • Rudavsky R and Mehrotra A, “Sociodemographic Characteristics of Communities Served by Retail Clinics,” Journal of the American Board of Family Medicine, Vol. 23,vNo. 1, January/February 2010, pp. 42–48. 
  • Rudavsky R, Pollack CE, and Mehrotra A, “The Geographic Distribution, Ownership, Prices, and Scope of Practice at Retail Clinics,” Annals of Internal Medicine, Vol. 151,vNo. 5, September 1, 2009, pp. 315–320.
 

Quality and Delivery of Preventive Care 

  • Mehrotra A, Gidengil CA, Setodji CM, Burns RM, and Linder JA, “Antibiotic Prescribing for Respiratory Infections at Retail Clinics, Physician Practices, and Emergency Departments,” American Journal of Managed Care, Vol. 21, No. 4, April 2015, pp. 294–302.
  • Reid RO, Ashwood JS, Friedberg MW, Weber ES, Setodji CM, and Mehrotra A,“Retail Clinic Visits and Receipt of Primary Care,” Journal of General InternalvMedicine, Vol. 28, No. 4, April 2013a, pp. 504–512 
  • Mehrotra A, Liu H, Adams JL, Wang MC, Lave JR, Thygeson NM, Solberg LI, and McGlynn EA, “Comparing Costs and Quality of Care at Retail Clinics with That of Other Medical Settings for 3 Common Illnesses,” Annals of Internal Medicine, Vol. 151, No. 5, September 2009, pp. 321–328 
 

Spending and Impact on Use of the Emergency Department

  • Martsolf G, Fingar KR, Coffey R, Kandrack R, Charland T, Eibner C, Elixhauser A, Steiner C, Mehrotra A. Association Between the Opening of Retail Clinics and Low-Acuity Emergency Department Visits. Annals of Emergency Medicine. 2016 Nov 4. pii: S0196-0644(16)30998-2. 
  • Ashwood JS, Gaynor M, Setodji CM, Reid RO, Weber E, and Mehrotra A, “Retail Clinic Visits for Low-Acuity Conditions Increase Utilization and Spending,” Health Affairs, Vol. 35, No. 3, March 2016, pp. 449–455 
  • Weinick RM, Burns RM, and Mehrotra A, “Many Emergency Department Visits Could Be Managed at Urgent Care Centers and Retail Clinics,” Health Affairs, Vol. 29 No. 9, September 2010, pp. 1630–1636.