Convenience leads many parents to retail clinics instead of PCP

Despite established relationships with pediatricians, parents are still likely to take their children to retail clinics for care because of convenient access, according to recent study findings.

“In our study population with an established relationship with a [primary care physician] about one in four families had used a [retail clinic] for pediatric care at least once, and many reported multiple visits, double that of prior estimates (10% for children and 19% for adults), likely reflecting increasing use of [retail clinics] by families with children,” Jane M. Garbutt, MBChB, of the Washington University School of Medicine in St. Louis, and colleagues wrote in the study published in JAMA Pediatrics.

The cross-sectional study included 1,484 parents who completed surveys from 19 pediatric practices in a Midwestern practice-based research network.

Researchers found that parents who used retail clinics (RCs) for pediatric care (23.2%) were more likely to report RC care for themselves (OR=7.79; 95% CI, 5.13-11.84), have more than one child (OR=2.16; 95% CI, 1.55-3.02) and be older (OR=1.05; 95% CI, 1.03-1.08). Participants also reported first considering going to the pediatrician (74%) but chose an RC because it had more convenient hours (36.6%); office appointment was not available (25.2%); they did not want to bother the pediatrician after hours (15.4%); of they did not believe it was serious enough (13%). Forty-seven percent of RC visits occurred between 8 a.m. and 4 p.m. on weekdays and 8 a.m. and noon on weekends.

Acute respiratory tract illnesses (sore throat, 34.3%; ear infection, 26.2%; and colds or influenza, 19.2%), and physicals (13.1%) were common reasons for a visit to an RC. Seven percent of participants said the RC indicated it would inform the pediatrician of the visit and only 41.8% informed the pediatrician themselves, according to the study abstract.

“Pediatricians can address concerns about quality of care, duplication of services and disrupted care coordination by working to optimize communication with the RCs themselves, as well as with their patients regarding appropriate management of acute minor illnesses and the role of RCs,” researchers wrote. “They also will need to directly address parents’ need for convenient access to care.”

In an accompanying editorial, Edward L. Schor, MD, of the Lucile Packard Foundation for Children’s Health in Palo Alto, Calif., wrote that RCs reflect “systemic changes occurring within the health care industry to which pediatric practices must adopt.”

“Public and private payers are trying to cut or cap physicians’ payment while increasing 24/7 access, assuring quality, and improving the overall health of the population,” he wrote.

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Disclosure: The study was funded in part by the National Center for Research Resources and National Institutes of Health Roadmap for Medical Research.