Health Affairs, 27, no. 5 (2008): 1271 doi: 10.1377/hlthaff.27.5.1271 © 2008 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Medical Storefront

PROLOGUE

The Medical Storefront

As the following papers make clear, retail clinics represent the latest effort to marry primary health care with convenience. Some 3.4 million Americans have so far accessed at least one of the roughly 1,000 such clinics now thought to exist. Margaret Laws and Mary Kate Scott cite projections by others that 2,500 to 6,000 clinics could exist by 2013.

In the first study of its kind, Ateev Mehrotra and colleagues report on why the patients show up. More than 90 percent of clinic visits are for just ten clinical issues, such as sinusitis and immunizations. Many retail clinic patients are young adults, ages 18–44. They are arguably the medically homeless: they typically lack their own primary care doctors, and they usually pay out of pocket for care. If retail clinics didn’t exist, write the authors, we don’t know where these patients might have sought care, if at all.

Meanwhile, Marcus Thygeson and colleagues compare the characteristics of patients using MinuteClinics in the Twin Cities with those getting their care in more traditional settings. Care costs less at the MinuteClinics, but what happens to overall costs as more take advantage of those "storefront" facilities?

Still, even if retail clinics are clearly filling some void in health care—inexpensive, convenient, routine care for those without primary care doctors or without insurance—are they a viable business proposition? Under the rubric of a new feature in Health Affairs—"Report from the Field," a collaboration with the Henry J. Kaiser Family Foundation—we sent Dan Costello of the Los Angeles Times to find out about the current state of play in the retail clinic market. Costello reports some hiccups of late, with the overall pace of expansion slowing even as some retail clinic chains go out of business or file for bankruptcy. Whether these events represent a temporary pause or a permanent break in this disruptive innovation in health care delivery remains to be seen.

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