Retail clinics sound good. But if you need follow-up care, good luck.

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The truth is, I know it’s easy to go to the Minute Clinic.  I know the enticement of not needing an appointment, of being able to shop while you wait, of having the prescription ready to pick up by the end of your appointment.  Who doesn’t like convenience and a friendly smile to add?  Who doesn’t like the customer service offered at CVS, Target, or your local pharmacy?  I certainly do.  And I know that the doctor’s office can be a pain.  I also loathe the annoying phone tree that leads to a tired nurse or secretary, and possibly the hours of waiting to have the physician call you back and tell you to rest and drink fluids anyway.

Realize, though, that these clinics do not have your best interests at hand.  Of course, they can manage the typical medical problems that often don’t require much intervention in the first place: respiratory infections and minor rashes and such.  They can even treat your strep throat or urinary tract infection.  Until, of course, something goes wrong.  At midnight when your temperature soars and you are unable to swallow because of tonsillar swelling, there will be no one at Target to prescribe you steroids.  Or when your simple bladder infection turns into pyelonephritis, there will be no expertise available to guide your way.

You then will be stuck calling me, the beleaguered primary care physician.  I, however, am a vanishing breed.  Because I saw the writing on the wall years ago and became a hospitalist or concierge doctor, or departed from clinical medicine.  And those few of us who are left, certainly won’t want to clean up the mess of a pharmacy clinic at some ungodly hour when we would rather be sleeping.  You didn’t come to me in the first place, why should I now be responsible when taking care of you has suddenly become inconvenient?

Yep, now you’re getting it.  These clinics pickoff the easy, high margin care and then punt when push comes to shove.  They have less interest in your well being and more in your wallet.  Low acuity, high volume primary care can be very lucrative.  Don’t expect them to be there, however, when you really need them.

And don’t expect me either.

Because I’ll be long gone.  Forced to abandon my life’s work due medicine’s lack of convenience.

Looks like someone will be going to the emergency room.

Good luck!

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of The Empathic Physician.

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