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September 19, 2014

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Time-starved or uninsured, you could find health care next to the snack aisle

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Retail clinics are on the rise in America, for convenience as well as low costs.

Driving down the 215, I noticed a billboard for a local ER. Apparently, my wait time would only be six minutes if I felt compelled to stop by for a check of my lymph nodes. But in the world I grew up in, emergency rooms were for emergencies, and they didn’t compete for patients in such overt ways. Then again, I have always been fortunate enough to have health insurance, so I never had to think about seeking care wherever I could find it.

In response to that growing and glaring need as well as greater demand from insured populations for basic care options, urgent care clinics have popped up all over the Valley, some inside a place I have only ever gone for passport photos and candy--Walgreens. The neighborhood drugstore launched its Take Care clinic model here in 2007, and the system of 13 walk-in facilities is part of a greater national trend toward retail health care.

A recent study by Rand Corp. published in the American Journal of Managed Care indicates that use of retail clinics is on the rise in America, mostly among busy adults with commercial insurance and median incomes of $59,000. They like the convenience of retail, though they get the ancillary benefit of costs that are “30-40 percent less expensive than similar care provided at a physician’s office, and 80 percent less expensive than care provided in the ER” for simple, acute conditions.

To find out exactly what’s on the Take Care menu, I caught up with Richard DiCarlo, a physician’s assistant with experience in hospital and other urgent care settings who now manages clinical operations for Walgreens health system in Vegas. He says he was drawn to the retail side by the opportunity to connect to his patients and community on a different level and to provide services that make their lives a little easier.

“The thing that really sets us apart ... is really just the convenience factor, the affordability factor for patients,” DiCarlo says, acknowledging that it’s not about convenience for some. “Many here in the Valley do not have insurance, so again, this is a great alternative for them. It’s a real, viable opportunity for them to seek care for things that they would, perhaps, unfortunately let go to the wayside.”

Such things, DiCarlo says, range from respiratory and bladder infections to flu symptoms and earaches. Take Care accepts most insurance, but if you don’t have a policy, your starting price to be seen by a board-certified physician’s assistant or nurse practitioner is $79, which DiCarlo says most patients find reasonable compared to what they would pay in another clinical setting. The services available to them break into two main categories: Prevent and Treat. Prevention options include a range of vaccines, physicals and wellness services such as flu testing and blood pressure screening. And treatments are available for common illnesses from mono to pink eye, minor injuries from sprains to burns, and skin conditions from acne to warts.

Patients can check online for Take Care locations and up-to-the-minute availability before scheduling an appointment or just dropping in for a checkup. Local clinics typically are open 8 a.m.-8 p.m., and if a patient comes in with a condition that is beyond their scope of service, DiCarlo says they’re referred to the proper facility within an established resource network. If a patient is new to the area and hasn’t yet found a medical home, he can use the same network to find a care provider. As DiCarlo says, Take Care is meant to support—not replace—primary care, but it can bridge gaps.

“This model is just so important moving forward, now and in the future, because I think those same barriers that we discussed—those that unfortunately don’t have the resources, the money, don’t have an established primary care doctor—I think all of those reasons will always exist,” he says. “It helps break down those barriers and really gives them an opportunity just to seek care they truly would not have.”

Do ERs mind the competition? DiCarlo says the mainstream medical community is embracing retail care as part of the system. "Really, the bottom line is just helping the patient,” he says. “That’s the ultimate goal.”

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