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AMA Got it Wrong: Inconvenience, Not Retail, is the Enemy


A recent policy adopted by the AMA sends the wrong message to physician practices about the so-called threat of retail clinics.

Welcome to Editor's Corner. Here, the editors of Physicians Practice will share their thoughts on the happenings in healthcare and look at the industry from a broader viewpoint.

This week, the AMA is holding its annual meeting, announcing its positions and policy on the health issues of the day. For instance, in the past week, it has spoken out against the Medicaid cuts proposed in the American Health Care Act, voted to require pharmaceutical companies to include drug prices in ads, formally opposed discrimination against transgender people, and enacted a resolution that it would be proactive in creating a more diverse physician workforce.

But the one that really stuck out to me was this one aimed at retail clinics. In the resolution, the AMA said that retail clinics "should follow a set of principles designed to ensure continuity of care and support the goal of securing a primary medical home for patients."

This sounds fair enough, but when you get to the details of this policy, I'm afraid that the AMA comes across as antagonistic and territorial towards retail clinics. According to AMA Wire, in its policy, the AMA says retail clinics should only treat patients without a primary-care physician, must transfer records to the primary-care physician's EHR, should use local physicians as medical directors or supervisors, "should not expand their scope of services beyond minor acute illnesses," and have a "well-defined scope of service."

To be fair, the AMA has a salient point about ensuring the retail clinic encounters are connected to the patient's primary-care physician. But this should be standard any time you see an outside physician, whether it's a specialist at a hospital or a retail clinic.

My problem is with the last three requirements in particular, which read as the establishment telling the up-and-comer to stay in its lane and follow its lead. To me, it's the wrong message to send. They should embrace elements of the retail clinic, instead of telling them to get in line or get off its lawn.

Imagine if Blockbuster worked with Netflix, instead of laughing at them?

Regardless of whether you believe retail clinics are good or bad for patients, you have to appreciate their rapid rise in prominence. The AMA itself cited statistics that show there will be more than 2,800 retail clinics open in 2017, which is astonishing considering it really only started as a concept in the early 2000s. A 2016 report from firm Research and Markets, estimates the retail clinic market was worth more than $1 billion, an increase of 20.3 percent since 2010.

There are many reasons for this phenomenon, but more than anything though, retail clinics are convenient and many physician offices are not. Because of this, the AMA shouldn't be trying to treat the retail clinics as some kind of foreign invader, but rather use their rise to prominence as a way to guide physician practices forward. For instance, getting in to see a doctor shouldn't be a three-week endeavor, especially when the patient is sick and needs attention immediately. However, that's what has happened. Personally, I've been told "the doctor doesn't have anything open for at least a month" more times than I can count.

It's simple supply and demand. If you or your child needs to see someone immediately because of an illness and your doctor’s office can't take in you for a week, and there happens to be a retail clinic down the street, guess where you're going? Any hesitations you may have over your care being fragmented, the limited ability of your retail clinic physician, or anything else will go out the window pretty quickly.

This is something the AMA should understand and convey to its members. Convenience is king.

We live in a world where everything you need is at your fingertips. You can't expect people to wait for you for a prolonged period of time, whether you're a doctor or a pizza maker. That's just a fact of life in 2017.

I am sure there are executives at the AMA - as well as many members, including some of you - who will tell me it's not always possible to see patients at the drop of a hat. While this may be true, practices need to take measures to be more convenient. Use telemedicine. Hire a part-time physician or nurse practitioner to work off hours. Open a retail clinic of your own. Do what it takes.

As our Pearls contributor Lucien Roberts wrote a few months ago, "Convenience trumps great care most of the time…so adapt." This is the message physicians need to hear from the AMA, rather than telling retail clinics to stay in its lane.


Follow Gabriel Perna on Twitter at @GabrielSPerna or leave a comment below.

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