When a Walk-in Clinic Makes Sense
You’ve probably seen the signs prominently displayed—“Get Your Flu Shot Here” or “Walk-In Care”—at retail pharmacies and stores like Wal-Mart and CVS. These walk-in health clinics—healthcare services provided by certified nurse practitioners and physician assistants in drugstores and big-box chains—are part of a growing trend to make healthcare more convenient and affordable. But consumers and doctors alike wonder: Are these walk-in clinics reliable when it comes to diagnosing and treating ailments?
The ongoing debate
Although walk-in clinics have been shown to reduce the cost of healthcare, more research is needed on the care services that are most appropriate for these settings. Traditional primary care physicians are often wary of storefront clinics: The American Academy of Family Physicians contends that walk-in clinics take patients away from primary care practices and lead to fragmentation of patient care.
However, nearly half of walk-in clinic visits occur after 5 p.m. and on weekends, when many doctors’ offices are closed, and a large percentage of visitors don’t have a primary care physician. Thus, the clinics may help bring new patients into doctors’ offices by way of referrals for follow-up care.
According to the American College of Physicians (ACP), research has shown that, for acute, uncomplicated conditions, quality of care is similar to that provided in a typical office setting. A 2014 study published in the American Journal of Managed Care found that treatment of ear infections, sore throats, and urinary tract infections was better on average than care provided at ambulatory care facilities, such as urgent care clinics and emergency rooms. Still, walk-in clinics aren’t meant to replace the doctor-patient relationship.
The affordable and transparent pricing, convenient locations, walk-in availability and on-site prescriptions are attractive features to consumers who often have to choose between waiting days to see their primary care doctor for minor complaints or spend hours on an expensive emergency room visit. However, primary care physicians are better equipped to manage ongoing care for their patients. Treating people with an understanding of their medical and family history is important to quality care.
A popular resource
Walk-in clinics are gaining in popularity: There are more than 1,900 U.S. locations, according to the Convenient Care Association (CCA), a trade group of companies and healthcare systems that provide healthcare to consumers in retail locations.
The clinics are used mostly by people ages 18 to 44, but the number of older adults using these clinics more than doubled between 2006 and 2009, to 15 percent. The walk-in clinics are attractive because of their convenience. You don’t need an appointment, and wait time is usually less than 30 minutes.
An average visit lasts from 15 to 25 minutes and costs $75, which is usually covered by insurance or Medicare. According to one analysis, visiting a walk-in health clinic costs $55 less than visiting a doctor’s office and $279 less than visiting an emergency department.
More than 97 percent of walk-in clinics, including those in major chains such as Target, Wal-Mart, Costco, CVS and Walgreens, belong to the CCA, which has an established set of quality and safety standards that members are expected to follow. These include adherence to evidence-based guidelines to diagnose and treat patients and a commitment to monitoring quality on an ongoing basis. Walk-in clinics must also comply with state and local health regulations.
Yet, as services in walk-in clinics have begun to expand, questions have arisen about the clinics’ role in care delivery. In a position paper published online in October 2015 in Annals of Internal Medicine, the ACP expressed concern about the growing scope of walk-in clinic services, particularly concerning the diagnosis, treatment, and management of chronic conditions.
While the organization acknowledges the role of walk-in clinics as a complement to traditional care models, it suggests establishing a balance between short-term convenience and the long-term benefits of an ongoing relationship with a primary care physician.
The authors also pointed out that although the clinics may be convenient for such services as getting a flu shot or relief from a urinary tract infection, they may not be appropriate for people who take prescription medication or have multiple or chronic health conditions, such as patients with cancer who must undergo testing before getting certain vaccines or antibiotics.
When used in the right circumstances, walk-in clinics can provide you with convenient nonemergency care for minor injuries or episodic ailments when your doctor isn’t available. However, many older adults have complex healthcare needs, so it’s imperative to partner with a provider you trust for ongoing care.