Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Delivering health care at a retail clinic isn’t something to be proud of

Niran S. Al-Agba, MD
Physician
August 9, 2020
255 Shares
Share
Tweet
Share

When I describe it, many of you will instantly recall the Norman Rockwell painting of a doctor holding a stethoscope to the chest of a little girl’s doll.

Historian Neil Harris described that iconic image, published in a 1929 edition of the Saturday Evening Post, beautifully: “Such a willingness to place professional expertise at the feet of childhood magic serves to remind us, again, of things we have forgotten: secret kingdoms inhabited by imaginary beings whose needs seemed as real as those of the people around us. Rockwell’s physician may appear to take the doll’s health seriously as an effort to gain the child’s confidence and trust, but his act of sympathy is also one of grace, accepting his patient’s needs with serenity.”

It’s a classic American image, and meaningful in my profession.  Rockwell knew the importance of rapport between doctors and patients.

Recently, Walgreens announced they will shutter 160 of their “in-store” health clinics to focus on other ways to bring consumers through their door, like partnering with Jenny Craig weight loss centers.

Retail clinics like those targeted by Walgreens are mostly located in drugstores, supermarkets, “big box” retail settings. Touted as a cheaper alternative to urgent care clinics and emergency rooms—early studies showed costs were 30 percent lower compared to care provided in more traditional settings—it turns out 58 percent of retail clinic visits represent a new use of medical services.  The study, published in Health Affairs, revealed the increased use of medical services obliterates any cost savings of utilizing retail clinics.

Retail clinics are accessible and convenient.  They are open from 7 a.m. to 7 p.m., seven days a week, and staffed by a nurse practitioner or physician assistant. They treat a variety of minor illnesses such as colds, pinkeye, and urinary tract infections, and provide an array of preventive services, like vaccinations.

However, retail clinics do not offer big profits for corporations or big savings for consumers.  But then again, is the practice of medicine a profit-generating machine or an art and science?

It depends on who you ask.

In one of the last conversations with my grandfather—a solo physician in Tacoma for four decades—he shared his dismay that home visits were no longer a routine part of medical care.  He admonished, “You will never be a good doctor if you don’t know the environment in which your patients live.”   He was probably right.

On the other hand, if you ask Walgreens, profit margins are prioritized over the art and science of health care.  And they are going all-in on comprehensive care for senior citizens. Jim O’Conor, senior vice president of Walgreens Neighborhood Health Destinations, said, “We are finding that seniors appreciate not just the high quality of clinical care, but also the social interactions, the personal attention, the convenience and the enhanced coordination between their pharmacist, physician and the health guides we have on-site.” Walgreens and Microsoft are developing a “seamless ecosystem” to connect consumers to providers, payers, and others. Approximately 200 retail clinics will operate through new arrangements with large health systems, to focus on complex issues and chronic conditions to make more money.

Such grand plans disregard the physician-patient relationship, which is a big mistake.  Rockwell’s painting still has relevance as today’s health care market is redefined.

Walgreens “seamless ecosystem” offers full-service primary care, pharmacy, nutrition, and wellness support.  Clinics will be staffed by physician-led teams, registered nurse ‘care coaches,’ behavioral health specialists, and social workers.  The retail giants believe seniors will flock to “convenient neighborhood health destinations” where they can get health care services where they buy their salad dressing.  Target is teaming up with Kaiser Permanente, CVS—of MinuteClinic fame—is partnering with Aetna, and Rite Aid is working with a telehealth service provider to expand “virtual care” services.

Is a MinuteClinic on every street corner really a panacea for the over-60 crowd?

One of the wisest women I have ever known was Millie, a neighbor, and friend who lived well into her 90s.  After her primary care physician retired, she asked for help to find a new doctor.  She was emphatic about having a physician who knew her name and cared to ask her opinion.

Millie was not willing to get a flu shot at a retail clinic, so there is no doubt she would not seek care at one when she was ill.  In fact, I visited her home to give her the influenza vaccine myself over the years.  She would often speak fondly about the doctor she had as a child.  It is during one of those home visits when I first learned Millie had lost her father to influenza during the epidemic of 1918.

It seems perverse to deliver health care services at a place called the MinuteClinic. The kind of physician-patient relationship that can be cultivated in a minute is not one to write home about.

While CVS and Walgreens see geriatric primary care as yet another untapped gold mine, for me, the relationship memorialized in Norman Rockwell’s “Physician” resonates as much today as it did 90 years ago.  Seamless ecosystems are no match for a “willingness to place professional expertise at the feet of childhood magic.”

The bond Millie and I shared was magical.  And every patient deserves a physician who knows their name.

Niran S. Al-Agba is a pediatrician and can be reached at her self-titled site, Dr. Niran Al-Agba.

Image credit: Shutterstock.com

Prev

A screenwriting dermatologist shares the importance of creativity in medicine [PODCAST]

August 8, 2020 Kevin 0
…
Next

COVID-19 adds a new health care gap: internet disparity

August 9, 2020 Kevin 1
…

Tagged as: Primary Care

Post navigation

< Previous Post
A screenwriting dermatologist shares the importance of creativity in medicine [PODCAST]
Next Post >
COVID-19 adds a new health care gap: internet disparity

More by Niran S. Al-Agba, MD

  • Is there hope for COVID with home visits?

    Niran S. Al-Agba, MD
  • A tale of two epidemics: COVID and obesity

    Niran S. Al-Agba, MD
  • The impact of economic inequality on the incidence of mass shootings

    Niran S. Al-Agba, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Why health care replaced physician care

    Michael Weiss, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care needs more physician CEOs

    Alexi Nazem, MD
  • Freestanding ERs and retail clinics: Do they create a more efficient health care system?

    Richard Young, MD
  • The health care system will cause its own physician shortage

    Advait Suvarnakar and Aashka Suvarnakar

More in Physician

  • The harmful effects of shaming patients for self-education

    Maryanna Barrett, MD
  • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

    Wendy Schofer, MD
  • Skydiving and surgery: How one doctor translates high-stress training to saving lives

    Alexandra Kharazi, MD
  • Don’t be caught off guard: Read your malpractice policy today

    Aaron Morgenstein, MD & Laura Fortner, MD
  • The dark side of medicine: an urgent call to action against greed

    Don Gaede, MD
  • Dr. Glaucomflecken for president!

    Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 39 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Abortion Is Not Murder in the Eyes of the Law
  • Introducing Allergenic Foods Early Tied to a Reduction in Later Allergies
  • Isotretinoin REMS Still Needed, But Its Burden Could Be Reduced, FDA Staff Says
  • Children Do Well With Fewer Opiates After Surgery
  • High Out-of-Pocket Costs Tied to Less Follow-Up After Initial Mammography

Meeting Coverage

  • Children Do Well With Fewer Opiates After Surgery
  • Advances in Diagnosis and Management of Severe Cutaneous Adverse Reactions
  • Orismilast Clears Skin in Moderate-to-Severe Psoriasis
  • New Combinations Promising in Advanced Urothelial Carcinoma
  • No Survival Benefit With CRT Versus Chemo for Locally Advanced Endometrial Cancer
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Surviving clinical rounds: tips and tales from a pediatric hematologist-oncologist [PODCAST]

      The Podcast by KevinMD | Podcast
    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Delivering health care at a retail clinic isn’t something to be proud of
39 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...