The difference between Immediate Care and Retail Care

In the past few years a phenomena known as retail care has arrived at pharmacy chains, and big box stores. Retail Care has some of the touches of Immediate, or Urgent Care, but their are significant differences you should be aware of.

Understanding the Immediate Care Medical Clinic

Immediate Medical Care is the delivery of ambulatory care in a facility dedicated to the delivery of care outside of a hospital emergency department, usually on an unscheduled, walk-in basis. Immediate or Urgent care centers are primarily used to treat patients who have an injury or illness that requires immediate care but is not serious enough to warrant a visit to an emergency room. Often immediate care centers are not open on a continuous basis, unlike a hospital emergency room that would be open at all times. They do however have extended hours and are usually open weekends so patients can use them without waiting to see their primary care provider. Much of the growth of these centers has been fueled by the significant savings that immediate care centers provide over the care in a hospital emergency department.

Urgent Care and Immediate Care are the same thing. Different states have regulations requiring the branding of these clinics so that patients in life threatening situations do not become confused and avoid going to an Emergency room at a hospital. For example in the State of Illinois they are known as Immediate Care Clinics.

Positives of an Immediate Medical Care Clinic

1. Staffed by Board Certified Physicians
2. Extended hours and days of operation
3. No Appointments Necessary
4. X -Ray Facility on site
5. Lab Facility on Site
6. Care for simple lacerations such as cuts requiring stitches and cleaning of the wound.
7. Treat Non urgent illnesses that can become more serious if not treated withing 24 hours.
8. Commonly have Occupational Medicine facilities on site
9. Commonly have on site medication dispensing.
10. Follow up is available if needed, and the clinic forwards records to your primary care giver.
11. Affordable cost for treatment, much less than an emergency room for a non-urgent illness.

Understanding the Retail Clinic

In 2000, medical treatment began to be offered at small offices in retail stores with on site pharmacies. These centers are generally staffed with nurse practitioners not true physicians. Prices are generally posted in public view and patients can do shopping while waiting. These retail clinics are not true urgent care centers, because of the limited level of care that can be provided without a physician nor x-ray, and lab facilities on site. Concerns about conflict of interest and incentives to over-prescribe medications in a facility rented from a pharmacy have yet to be fully addressed by organized medicine or governmental agencies.

Let say you visit your neighborhood retail clinic with a sore throat. It is common for a doctor, or medical assistant to take a strep test. At an Immediate Care Clinic with an on site lab you will know within twenty minutes whether you have strep or not and should be prescribed an antibiotic. At a retail clinic they have to send the culture out over night to lab for analysis. So if they prescribe you an antibiotic you may not need it. It is the same thing with something as simple as the flu. A clinic with an on site lab can make a true diagnosis while you wait, and treat you accordingly while a retail clinic has to send the culture out to be tested.

The limited scope of the Retail Clinic

1. Patients are seen by a Nurse Practitioner, not a Physician
2. Extremely limited scope of treatment and diagnosis
3. No X-ray or lab facilities on site to speed, or give a correct diagnosis
4. Patients are commonly referred back to their primary doctor for diagnosis, and follow up.
5. Patients are referred to the expensive emergency room at a hospital for costly X-rays.
6. Concerns about incentives which could lead to over prescribe medications

Comparing the costs of Immediate Care versus Retail Care

Surprisingly the total costs of going to an Immediate Care Clinic is about the same, or less than going to Retail Care Clinic once the bill is totaled up. The initial cost of seeing physician rather than a nurse practitioner may cost on average $10-$20 more on a visit, but is worth the small increase because of the much wider range of diagnosis, and care. However the advantage of having an on site lab, and X-ray facility to provide almost immediate diagnosis firmly gives the Immediate Care Clinic an advantage when the total bill is compiled.

Obviously an on site lab can give a much better rate, and quicker results than a specimen being sent out to a third party provider for overnight testing. Obviously an on site X-Ray facility will cost less than being sent out to an emergency room or having to wait till the next day to see your primary care provider who may, may not have an X-Ray facility on site.

Obviously a real Physician can provide a broader range of services than a medical assistant or Nurse Practitioner.

Why don't Retail Care Clinics have Physicians working at their clinics?

It is simply a matter of cost. A retail clinic can hire a Nurse Practitioner for less than a third, and maybe even a quarter of the cost of a MD. They are able to scale their costs, and increase profits by hiring a single MD to supervise the Nurse Practitioner's from a remote location at multiple facilities. The advantage to the retail clinic of course is higher profits, and the ability to provide a perceived less expensive health care option to the public.

Perception is almost everything to the public. Even though the care you receive is more comprehensive, faster, and overall less expensive at a true Immediate, or Urgent Care Clinic, patients are often lured in by the convenience a retail clinic can offer, and of course the large marketing campaigns which promote them at the major chains they reside in.

Conclusion

Both models can work depending on the scope of treatment needed, but a true Immediate, or Urgent Care Clinic has significant advantages over a simple Retail Clinic for the average consumer. Since the costs are about the same, and both have convenient locations and hours, the consumers best choice is always to be seen by a true physician at a site that provides for on site lab, and X-Ray.