It's not even Labor Day, and it seems like all the local drug stores have signs out that flu shots are now available on a walk-in basis--same copay as the doctor's office and a fraction of the wait. Although I'll have to put this off for a bit, everyone in my house is currently fighting the season's first bout of scratchy throats and stuffed-up noses. If one of these pesky colds should fester into an ear infection, however, we've got a variety of options for getting it checked out. More than once, I've even had the staff at my primary care physician's office tell me, "We're too busy. Please go straight to the walk-in clinic down the street."

If you're a primary care provider, have you been humming for the past few weeks with back-to-school physicals and vaccinations, or have you been losing this business to the 1,250 retail-based convenient care clinics now available to patients in the United States?

If that seems like a higher number since the last time you checked, it probably is. According to an article published this week in USA Today, CVS' MinuteClinic alone added 45 locations this year. The total number of retail clinics set up everywhere from drug stores to Targets and Walmarts to grocery chains has exploded seven-fold since 2006.

With convenience-clinic business already booming pre-health-reform, practices need to revisit how they'll compete and/or collaborate with these other providers. Though the specifics will vary by your practice's unique circumstances, there are three main steps to include in your action plan.

• Educate patients. If you are having trouble keeping up with the patients in your waiting room already, come right out and recommend to patients where they can more promptly be seen for minor ailments, such as poison ivy and pinkeye. By referring patients to quick-care providers you trust, you build goodwill on both fronts. Further, patients who do go down the street for that strep test will feel less like they're betraying you and be more likely to admit they've gotten treatment elsewhere, closing up some potential gaps in care. Perhaps most importantly, make sure patients know when retail care is not appropriate, such as for broken bones or any kind of chest pain (I have a relative who made the nearly fatal mistake of going to a retail clinic for what turned out to be congestive heart failure). If you don't want to sound self-promotional, link directly to articles such as the USA Today article on your website or social media feed, where physicians with no affiliation to your practice clearly spell out the differences.
  
• Offer better service. Internist Dr. David Winter, chairman of HealthTexas and Baylor Healthcare System, called the continued proliferation of retail clinics a "wake-up call for family physicians." He added, "We can get our act together and make it possible for our patients to get in sooner than six weeks." Timeliness is also critical, maybe more so. Once patients arrive for their appointment, waiting around is one of patients' top complaints about doctors worldwide.
  
• Coordinate care. Although "some clinics are good about giving patients a copy of their medical record or faxing or electronically sending a report to their doctor," as the article notes, this type of communication is not a given. Include clinics that come through in this area top-billing in the list you provide to patients. But also make a note of area clinics that don't promote well-coordinated care. Perhaps a stronger relationship with any offenders can help improve communication. Otherwise, it will be more important than ever that your practice educate patients to ask for their records or to have them sent.

How has your approach to working alongside retail clinics evolved since they began to emerge? What are your plans for the future? Please share your lessons learned with fellow readers of FiercePracticeManagement! - Deb