Rhode Island stalls expansion of retail MinuteClinic

The growth of quick service specialist MinuteClinic hit a snag in Rhode Island, as the retail-based clinic has withdrawn its application to open five locations in the state.

The Minneapolis-based company was planning to open clinics within CVS stores in the same fashion that it has partnered with retail outlets around the country. The company currently operates more than 70 clinics in eight states.

However, Rhode Island health regulators had concerns about MinuteClinic's facilities, which do not include a sink or restroom. The clinic had applied for a license as an organized ambulatory care facility, a category that includes those provisions as standard requirements.

MinuteClinic, which withdrew its application in December 2005, said it has postponed its expansion plans in Rhode Island "for now," and called the state's regulatory environment "unique," according to a statement by company CEO Michael Howe.

"We've had a very different experience in the eight states where our health care centers are currently located and in the other states where we plan to expand later this year," Howe said.

MinuteClinic plans to expand to more than 150 health care facilities in the coming years, although it will not reveal where that expansion may take place. The company typically partners with large retail outlets, such as CVS, Target and Cub Foods, which carve out space for the clinic near the store pharmacy.

The clinics, which are staffed by nurse practitioners, tout convenience and a quick remedy for common patient ailments like sore throats or sinusitis. Patients often can get in and out, without an appointment, in 15 minutes.

Many physicians, however, have objected to the retail clinic model, saying it further fragments health care and steers patients away from their medical home.

During a public hearing for MinuteClinic's Rhode Island application last year, then-Rhode Island Medical Society president Fredric V. Christian, MD, told the state's Dept. of Health the "convenience care" offered by MinuteClinic was "in no way a substitute" for a relationship between a patient and primary care physician.

Newell E. Warde, PhD, executive director of the Rhode Island Medical Society, said the brush with MinuteClinic has helped some physicians realize that they may need to address some of the issues that have made retail-based clinics popular among patients.

While physicians might need to consider expanding access and operating hours, some may simply have to do a better job of communicating how easy it is for patients to get in and see them, Dr. Warde said.

"Maybe it's working harder at making the general public aware of the access they do have," he said. "That's a common sort of misconception that people have."