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Monday, March 23, 2009


Retail health clinics were designed to give patients access to fast, convenient, and affordable health care. But because the clinics are staffed by advanced practice nurses (APNs) or physician assistants (PAs), they do not provide the same level of care as physicians’ offices, urgent care clinics, or minor emergency centers. Medical services are limited to preventive care, such as immunizations, cholesterol screenings, and routine ailments. The clinics are not freestanding but operate in large discount retail stores, drug stores, or supermarkets.

TMA’s primary concerns focus on patient safety. TMA supports an integrated care model where the APNs and PAs staffing the clinics are appropriately supervised by a physician, refer the patient back to his or her regular physician to ensure continuity of care, refer patients appropriately for additional or follow-up care, and practice within their scope of practice.
During the 2007 legislative session, there was movement to free clinics from such patient protections, particularly to weaken physician oversight. TMA opposed the legislation on grounds that the changes would undermine patient safety and health care quality. Nevertheless, TMA has reached out to the retail health clinics to discuss a medical model that keeps the provision of care under the appropriate delegation and supervision of a physician but also allows innovations in the delivery of a limited set of services at these clinics.

Medicine’s 2009 Agenda
  • Retail health clinics — offering a limited set of services — must be subject to sufficient oversight to ensure patients receive safe, high-quality health care.
  • APNs and PAs in retail clinics must provide only services that are safely within their education, training, and skills and under the supervision and delegation of a licensed physician.

Medicine’s Message

  • Retail health clinics should be monitored closely to protect patient safety, ensure positive health outcomes, and make certain that patients with more serious illnesses are referred for appropriate follow-up care.
  • Retail health clinics are not replacements for a medical home, where a patient develops a relationship with his or her physician.
  • Retail clinics must share health records in a timely fashion with patients’ primary physicians and direct patients to their physician for follow-up care.
    Retail health clinics must adhere to state public health reporting and safety standards.

Check out the Doctor’s Orders video to get a more complete view of TMA’s 2009 legislative agenda. You can see all of TMA’s 2009 legislative issue briefs on the TMA Web site.

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