Retail clinics avoid medically underserved areas

Under criticism from physician organizations and others for further fracturing an already disjointed health system, store-based health clinics and their supporters have argued that these nurse-practitioner-staffed offices offer uninsured patients affordable, walk-in care at convenient locations.

But most retail clinics -- 86.4% -- are located in well-to-do areas that are not classified as medically underserved, according to a May 25 Archives of Internal Medicine study (link).

The study of nearly 1,000 retail clinics found that medically underserved populations are half as likely to live near quick-care health outlets. The communities lacking retail clinics have 43% more people in poverty, 50% more black residents and 34% more Hispanics, the study said.

"Retail clinics have engendered strong feelings on all sides of this debate, and it's important to get strong evidence to really understand their effects," said the study's lead author, Craig E. Pollack, MD, a Robert Wood Johnson Foundation Clinical Scholar and senior fellow at the University of Pennsylvania's Leonard Davis Institute of Health Economics.

"These results aren't surprising, because there's an uneven distribution of so many goods and services in our society," Dr. Pollack said. "On the other hand, many proponents of retail clinics said they would be particularly beneficial to underserved populations. In that regard, wouldn't they have expected retail clinics to more likely be located in areas with medically underserved populations? That's not what we found."

About 30% of retail clinic patients say they do not have a regular source of primary care, according to the Convenient Care Assn., an industry group. Quick-care outlets, which treat common ailments such as strep throat, charge 30% to 80% less than hospital emergency departments, urgent care centers and medical clinics, the group said. There are about 1,500 retail clinics nationally, according to the CCA Web site.

Dr. Pollack said the next step is to examine the cost and quality of the care that retail clinics provide. The CCA said nine in 10 retail clinic patients rate the quality of care highly.