Increased access to healthcare service is changing the role of the traditional primary care physician, and it can too easily lead to fragmented care.
CVS Pharmacy is stepping up its healthcare offerings by rolling out 1,500 “HealthHUBs” by the end of 2021. While the company’s 1,100 MinuteClinics focus on low-acuity services, these “HealthHUBs” will provide for more everyday needs with a special focus on chronic disease management while offering services like blood draws and sleep apnea assessments.
Then, there are the nearly 9,000 urgent care centers in the United States, according to the Urgent Care Association, and more than 550 freestanding emergency rooms, according to a report from UnitedHeath Group.
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For traditional primary care clinics, increased services from these clinics shouldn’t dampen the financial bottom line much—after all, primary care physician shortages lead to many clinics being understaffed and overbooked—although rural clinics in small towns may feel a pinch.
“People who have colds, flu-like symptoms, ear infection, sinus infections, maybe even need basic immunizations, may just decide it’s easier to go to their local CVS or equivalent in-store healthcare provider because they can seek care without an appointment and potentially get in more quickly,” says Andrew Hajde, assistant director of association content at the Medical Group Management Association (MGMA). “In most cases, though, traditional clinics are going to see more chronic patients who need ongoing care or have more complex issues where they need the constant attention of a physician on an ongoing basis.”
The evolving role of primary care physicians
The big separator between traditional primary clinics and retail and urgent care clinics is going to be how acute the patient’s health is, Hadje says. That offers a differentiation for traditional primary care clinics.
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According to MGMA Provider Compensation and Productivity Reports, the median total number of encounters in family medicine clinics without obstetrics services decreased 9.9 per cent between 2015 and 2018. The median relative value units (RVUs), though, decreased just 0.3 per cent.
Those numbers indicate that while doctors are seeing fewer patients, they’re seeing more complex patients and cases, Hajde says. “I think most people want a relationship with a physician who will really manage their care closely,” he says. “When you go to a MinuteClinic or someplace like that, you probably won’t have a relationship with those providers, and you might see a different person every time you go. It’s not to say that you’re going to have a bad experience, but they may not be as familiar with your medical record. They may not be able to treat you in the same way as with somebody who you have built a longstanding relationship.”
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