Some parents with pediatricians also use retail clinics

About 23% of almost 1,500 parents surveyed while in the waiting rooms of 19 primary care pediatric practices reported that they had used a retail clinic (RC), such as those found at Walgreens and CVS, for their child’s care. Of those who had used such a clinic for pediatric care, 47.8% had done so more than once in the preceding year, with 13.9% using an RC 1 to 2 times; 1.3%, 3 to 5 times; and 32.6% more than 5 times during the year.

Of parents who had used RCs, 74.1% had first considered going to their pediatrician but decided on the RC because it offered more convenient hours, even though practices typically were open from 8:30 am to 5 pm weekdays and for 2 to 4 hours on Saturdays, when nearly half the visits to RCs occurred. While 36.6% of parents said convenience was their reason for choosing an RC, parents also cited no appointment being available at the pediatrician’s office (25.2%), not wanting to bother the pediatrician after hours (15.4%), or thinking the problem was not serious enough to bother the pediatrician (13.0%) as reasons for their choice.

Parents who used an RC for pediatric care were more likely than other parents to have used an RC for themselves, to have more than 1 child, and to be older. Parents who did not use an RC for child care most often cited as the reason a preference for having the pediatrician care for their child (60.7% of those surveyed). Only 2% of parents said that their pediatrician had advised them not to take their children to RCs for care.

Most often, visits to RCs were for acute upper respiratory tract illnesses and colds or flu. According to parents, the RC prescribed antibiotics to 85.2% of children with an ear infection, 78.6% of those with a sore throat, and 67.7% of those with a cold or flu. Only 41.8% of parents who sought care at the RC told their pediatrician about the visit and were more likely to do so if the RC advised it.

Most parents who used RCs were satisfied (61.7%) or very satisfied (32.8%) with the care their child received, and 53.4% indicated they would use such facilities for their children in the future (Garbutt JM, et al. JAMA Pediatr. 2013;167[9]:845-850).

COMMENTARY  Although this study was restricted to the Saint Louis, Missouri, metropolitan area, the growth of retail clinics is a national trend. Of the 23.2% of respondents who had sought care for their child at a retail clinic, nearly a third had done so more than 5 times in a year. And more than 90% of parents were satisfied with the care their child received (even though some of the care, such as prescribing antibiotics for colds and flu, might not be what you would want for your patient). Retail clinics are changing both the clinical and financial realities of pediatric practice. I am not sure what our response should be. Maybe, as a first step, we should ask our patients’ parents if they use this health care option and why. -MICHAEL BURKE, MD

MS FREEDMAN is a freelance medical editor and writer in New Jersey. DR BURKE, section editor for Journal Club, is chairman of the Department of Pediatrics at Saint Agnes Hospital, Baltimore, Maryland. He is a contributing editor for Contemporary Pediatrics. The editors have nothing to disclose in regard to affiliations with or financial interests in any organizations that may have an interest in any part of this article.