Can a pharmacy be your only doctor?

You go to a local chain drugstore to buy shampoo and find that the in-store health clinic offers flu shots and there’s no waiting time. You’re overdue for that shot, so get it — and accept the doctor’s offer of a blood pressure screening.

You’re done just 15 minutes after walking in and satisfied that you’ve effortlessly received good care with little or nothing out of pocket as the clinic accepts Your insurance.

Is there a catch? Perhaps. With your complete medical history, would your GP interpret your blood pressure readings differently than the retail clinic nurse? Did the clinic even send your blood pressure data to your doctor? If you don’t have a GP, should you accept the nurse’s nonchalant comment that your blood pressure is “a little high”?

Similar questions may arise for any service you receive at a retail clinic.

But there’s no denying that these clinics — typically located in pharmacies, supermarkets, and other large stores — offer something too many Americans lack: convenient access to some basic, quality health care services, often at a lower cost than in a traditional doctor’s office, medically staffed emergency center or emergency room.

Bottom Line: If you’re thinking about getting health care from a retail clinic, it’s wise to consider how that type of health care will serve you in the long run—not just how quickly you can get your tasks done.

“We now have a wealth of care options,” says Dr. Ateev Mehrotra, professor of health policy at Harvard Medical School and resident physician at Beth Israel Deaconess Medical Center in Boston. “Choice is a good thing, but it creates new problems — for example, patients need to “triage themselves” to determine which care setting is best suited to diagnose and treat their minor illness or injury.

“There are also tradeoffs between cost, quality and convenience, and navigating all of these is complicated,” he adds.

A popular entry point, retail clinics have become a major force in American healthcare. CVS, with more than 1,100 MinuteClinics, treats a sore throat, may be able to remove sutures or surgical staples, and so on. Walgreens has hundreds of clinics that can treat back pain, headaches, UTIs, and more. But what value can consumers expect from a for-profit clinic with no on-site doctor?

Typically, you can find good care at a competitive price, researchers have found.

“For a select group of conditions, retail clinics provide equivalent quality of care compared to other facilities,” concluded a Rand Corp report. from 2016.

And researchers at Northeastern University reported in the journal Medical Care in 2019 that clinics are small, on average charge less than other care facilities for similar services.

Whether retail clinics are a good option for you depends, at least in part, on your age and general health.

“People who go to these clinics tend to be younger, healthier, and less likely to have a family doctor,” says Dr. moreotra. “For what we looked at in our research — things like UTIs, sore throats, sinusitis — the care this demographic receives at a retail clinic is equivalent or in some cases better than what they might receive in an emergency room or clinic an emergency center.”

But for older patients, especially those with multiple chronic diseases, “continuity of care is really important — knowing their history and medications,” says Dr. moreotra. “It might not be the best option for them.”

Physicians are concerned about the long-term effectiveness of healthcare provided in a retail environment only by mid-market providers such as nurses. And according to the Rand report, only about a third of retail clinic users reported having a GP.

The research of dr. Mehrotra has shown that “retail clinic visits have a negative impact on continuity of care — seeing the same doctor over and over again,” he says. “And many studies show that greater continuity of care is associated with better outcomes.”

Medical associations agree. “GPs build long-term relationships with patients and take a holistic view of their health,” Rebecca Beeler, a spokeswoman for the American Academy of Family Physicians, said in an email. “This uniquely positions our providers to provide proactive, preventative care that prioritizes long-term patient well-being.”

“Unfortunately, over the past 10 or 15 years, people in the United States have been going to primary care less often,” says Dr. moreotra. “In our research, most patients told us, ‘I don’t have a doctor.’ But for patients, coming to a GP practice is easier said than done.”

According to an analysis by KFF, a nonprofit health policy organization, more than 97 million Americans live in regions where there is a shortage of primary care health professionals.

Despite the shortage of doctors, major retail players are beginning to offer a wider range of healthcare services, collaborating with healthcare systems and even taking over primary care chains.

CVS, which has partnered with the Cleveland Clinic and added the HealthHUB brand to 900 of its MinuteClinics, provides services like chronic disease management for people with conditions like diabetes. And Walgreens is working with VillageMD to open full-service, physician-staffed primary care practices alongside some of its drugstores.

Regardless of the type of retail clinic, it is important for patients to ask how information about their health status and care is communicated between the clinic and other provider organizations. Even for the minority of healthcare systems that own or work with retail clinics, it’s difficult to track patients’ personal health records over time, according to 46% of healthcare executives and clinicians surveyed by the Massachusetts Medical Society’s NEJM Catalyst in 2022 have been asked.

“Ideally, you want to have your medical records in one place – all of them,” says Kenneth Hertz, principal consultant at KTHConsulting, which provides consulting on managing physician offices. “Because your records are fractionated into different locations, it’s difficult to get the full story.”

Hertz and his wife have experienced fragmentation of their own medical records.

“At our local clinic, which is staffed by physician assistants and nurses, they have medical records for my wife and I, but they don’t send information to our GP,” says Hertz. “But my wife is the person who always gets printouts and takes them to our doctor’s office for them to scan. It serves as its own healthcare communications network. So the integration of datasets is clearly an issue.”