New measures encourage quality, safety at retail clinics

Access to care

According to a Harris Interactive poll, 78 percent of the public believes that store-based health clinics could provide a fast and easy way to receive basic medical services, but 75 percent are concerned about the quality of care these clinics provide.

The vast majority of respondents also were apprehensive about staff qualifications in a clinic not run by medical doctors.

“Patients want quick and easy access to health care services, but they shouldn’t have to worry about the safety and quality of care provided in these clinics,” said Dr. Rebecca J. Patchin, AMA board member, in a news release.

Safety principles

To enhance public confidence in the quality of care provided by store-based clinics, the AMA adopted these principles.

• Store-based health clinics must have a well-defined and limited scope of clinical services, consistent with state scope of practice laws.

• Store-based health clinics must use standardized medical protocols derived from evidence-based practice guidelines to ensure patient safety and quality of care.

• Store-based health clinics must establish arrangements by which their health care practitioners have direct access to and supervision by those with medical degrees as consistent with state laws.

• Store-based health clinics must establish protocols for ensuring continuity of care with practicing physicians within the local community.

• Store-based health clinics must establish a referral system with physician practices or other facilities for appropriate treatment if the patient’s conditions or symptoms are beyond the scope of services provided by the clinic.

• Store-based health clinics must clearly inform patients in advance of the qualifications of the health care practitioners who are providing care, as well as any limitations in the types of illnesses that can be diagnosed and treated.

• Store-based health clinics must establish appropriate sanitation and hygienic guidelines and facilities to insure the safety of patients.

• Store-based health clinics should be encouraged to use electronic health records as a means of communicating patient information and facilitating continuity of care.

Doctors agree

Physicians deliberating the new principles at the AMA’s policy-making meeting agreed with the public’s concerns, noting that intensive diagnosis and care should not be carried out at clinics staffed by less-qualified health professionals and equipped for basic services.

Physicians added that health care safety could be negatively affected if in-store clinics lead to fragmentation of patient care, inadequate follow-up and missed opportunities for preventive care of patients.

Insurers and employers

Health insurers and employers are reporting better control of health care costs as the result of in-store clinics, and retailers cite the clinics with helping to increase store traffic.

However, “the new AMA principles will help ensure these incentives do not override the basic obligation of store-based clinics to provide patients with quality care,” Patchin said.