Parents are turning to medical clinics run by companies like CVS Caremark Corp. and Walgreen Co. to treat their children for minor illnesses rather than their pediatricians because of the convenience, a study found.
Parents used the clinics instead of their child’s doctor because the retail health outlets had more suitable hours, their pediatrician had no available appointments or they didn’t want to bother the doctor after hours, according to research published today in JAMA Pediatrics.
This year there will be more than 6,000 health clinics in the U.S. located in chain pharmacies, supermarkets and discount stores, said Jane Garbutt, the lead study author. The clinics started in Minnesota in 2000. Today’s study is the first to show that the frequent use of these clinics for pediatric visits is double prior estimates, she said.
“Although parents consider going to the pediatrician first for care of a minor illness, they choose the retail clinic for reasons of convenience or because they think the illness is not serious enough to warrant an office visit,” Garbutt, a research associate professor of medicine and pediatrics at Washington University School of Medicine in St. Louis, said in a July 21 e-mail. “Most retail clinic visits occur when the pediatricians’ office is open. Parents and pediatricians do not discuss retail clinic visits.”
Walgreen, the largest U.S. drugstore chain, has about 370 Take Care Clinics. CVS operates more than 650 clinics called MinuteClinic in the U.S. Target Corp. and Kroger Co. are among the other retailers that have similar health clinics in their stores.
The researchers surveyed 1,484 parents and found that 23 percent had used the clinics for pediatric care. The most common visits were for sore throats, ear infections, colds or flu and for physical exams. Nearly half of visits by children to the clinics occurred from 8 a.m. to 4 p.m. during the week and 8 a.m. and noon on the weekend.
Only 42 percent of the parents who used the clinics for their children told their pediatrician about the visit.
“The failure to communicate about services received could lead to fragmentation and duplication of care and inappropriate care,” Garbutt said. “Pediatricians will need to directly address parents’ need for convenient access to care and discuss retail clinic care with their patients.”
She said the data “raise concern” about the possible frequency of unnecessary antibiotic prescriptions for children who go to these clinics. More studies are needed to examine this issue.
The clinics are usually staffed by non-pediatric nurse practitioners and physician assistants who provide care for those ages 18 months and older, the authors said. They are different from urgent care centers because they have more limited care options, don’t have on-site diagnostic services such as X-rays and can’t perform minor procedures.
The clinic prices are fixed and transparent and can be less expensive than visiting a doctor or emergency room. Many of the clinics accept health insurance and Medicaid, Garbutt said.
“The big ones have figured out a business plan that works,” said Edward Schor, who wrote an accompanying editorial in the journal, in a July 19 telephone interview. “If your child has an ear ache and it’s 9:30 at night, you can pack them up and go to one of these places. They will examine the child. They have a pharmacy right there, so you can get your prescriptions filled. They have a one-stop shop.”
Schor is senior vice president for programs and partnerships at the Lucile Packard Foundation for Children’s Health in Palo Alto, California.