A History of Retail Clinics (Abridged)

Written By Editor-in-Chief, AJRM

Retail Healthcare. What is it?

Simply defined … according to a Research Brief by RAND and its related (cited below, [2]) authors in 2016, entitled “The Evolving Role of Retail Clinics“, Retail clinics are medical clinics located in pharmacies, grocery stores, and “big box” stores, such as Target and Walmart.

RELATED STORY | RESEARCH | AJM
Volume 129, ISSUE 2, P134-136, February 01, 2016; Retail Clinics: A Shift From Episodic Acute Care to Partners in Coordinated Care; By James E. Dalen, MD, MPH; Published: September 09, 2015DOI.

Doctors Express describes is as … A retail clinic is a category of walk-in clinic located in retail stores, supermarkets and pharmacies that treat uncomplicated minor illnesses and provide preventative health care services. They are sometimes called “retail-based clinics,” “convenient care clinics,” or “nurse-in-a-box.” Retail clinics in the United States are usually staffed by physician assistants (PAs) or nurse practitioners (NPs) and do not necessarily have a physician physically available onsite.[8]

Services They “Typically” Provide

Most retail clinics in the United States treat adults and children over the age of 18 months. Retail clinics treat common family illnesses, such as:

Some retail clinics in the United States provide physical therapy with a specialist. Retail clinics also provide preventative care, including health screenings, vaccinations, and physical exams. They may serve as sample collection points for blood, urine and feces for laboratory tests, which are then sent to external labs. By definition, retail clinics offer a more narrow range of services (usually limited to 25 – 30 of the most common diagnoses) than are offered in traditional primary care offices.[3] This limited scope of services is seen in both nurse practitioner and physician-staffed retail clinics, and is an integral part of the retail clinic model.[4]

Staffing

Retail clinics in the United States are usually staffed by Physician Assistants (PAs), Nurse Practitioners (NPs) or other advanced practice nurses.[11] Some retail clinics are staffed by Physician Assistants (PAs).[5]

Physician Assistants are health care professionals licensed to practice medicine. Physician Assistants may or may not be required to collaborate with physicians depending on the legislation in the jurisdiction in which the Physician Assistant practices.[6] With appropriate training and supervision, PAs provide health care that is similar in quality to that of a primary care physician.[7]

Nurse Practitioners are registered nurses with advanced education and training who provide a defined scope of health care services. NPs engage in health promotion, patient evaluation, treatment, diagnosis, education, counseling, case management and coordination of care. One study found that patients of advanced practice nurses had close outcomes to patients of primary care physicians and physician assistants.[15]

A History

To understand retail healthcare first and foremost, we must understand that the way we access our healthcare and healthcare providers has changed dramatically in the past ten years (circa 2010).

According to a National Association of Community Health Centers (NACHC) guide, strong consumer response to retail clinics has even Federally Qualified Health Centers evaluating retail health from a care and economic perspective. The retail model, suggests the NACHC, enables community health centers to offer patients such benefits as customer awareness, friendliness and perceptions of quality.

One might further understand how retail healthcare has increasingly evolved since the early 2000’s by asking these questions … ‘Why does healthcare somehow get a pass or is considered exempt from meeting customer service expectations, ease of access, provide consumer-friendly experiences and price transparency … when it is expected in all other areas of our lives?’

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Gensler.com recently wrote about this exact issue plaguing the increasingly impatient, patient or consumer.

People expect convenience, quality and transparency when choosing how to spend time and money – and increasingly they seek the same from healthcare providers. Retail health is emerging as a means of delivering quality, convenient care to millions of consumers, as well as a model for healthcare systems to consider when providing services to new and existing patient populations.

For a closer look at “The Doctor’s Office of the Future,” read Sarah Bader’s Fast Company blog post.

A litany of reasons and novels of frustration have given rise to such consumer-patient friendly healthcare delivery models in the U.S., today that quite frankly: are convenient for the consumer; cost-effective to the patient; driving down pharmacy costs to the consumer; enabling pharmacy and big box pharmacy retailers to help their communities; provide career opportunities for healthcare providers [of multiple specialties] when the shortages of healthcare providers continues to be promoted as a chronic problem in our country and communities large and small.

Simply defined … according to a Research Brief by RAND and its related (cited below, [2]) authors in 2016, entitled “The Evolving Role of Retail Clinics“, Retail clinics are medical clinics located in pharmacies, grocery stores, and “big box” stores, such as Target and Walmart.

RELATED STATS | 23 February 2021 | Key Findings | J.D. Power
Consumers’ growing comfort with retail health could prove critical to vaccine effort

  • Nearly half (48%) of retail pharmacy customers used at least one health and wellness service in 2020, up significantly from 2019 (43%)
  • One in five (20%) customers spoke to a pharmacist during their visit, up from 16% in both 2018 and 2019
  • When customers use two or more health and wellness services, overall customer satisfaction and brand advocacy increases, and average customer spending doubles

Fast forward to present day (eg. 2021) … Consumerism Is Transforming Business Models and Delivery Channels ~HealthTrust, The Source

“There’s a general sense that consumers are shopping for healthcare the same way they do for other items,” says Ben Umansky, practice manager for research and insights at The Advisory Board Company. “They’re looking at online reviews from other patients and the price of a procedure before choosing a facility. That is retail behavior.”

According to the Convenient Care Association (CCA) the Convenient Care, a more generalized, at-large term used to describe a growing industry which may include Urgent Care and Retail Healthcare, began in 2000. CCA noted on their web site that the first CCCs appeared in Minneapolis-St. Paul, operated by QuickMedx. These first [retail] health clinics initially saw a very limited number of illnesses and accepted only cash for services. When QuickMedx was acquired by a major pharmacy retailer in 2005, it marked the beginning of several similar acquisitions by major retailers and healthcare systems.

CCA notes that today there are over a dozen companies across the country that have formed to provide health care services, to individuals and families, for the treatment of common illnesses. The clinics have progressed to forming contracts with health insurance companies, while also accepting cash payments for a visit. To date, there are more than 1,800 CCCs throughout the United States. CCA Members’ clinics are located in convenient locations such as drugstores, food stores and other retail settings. Our clinics make it easier and more convenient for patients to get the right level of care, in the right place, at the right time.

How Are Retail Healthcare Clinic Environments and Urgent Care Clinics Different From One Another?

It’s easy to confuse the ‘convenience’ of both Urgent Care and Retail Healthcare Clinics and get them mixed up.

Similarly, it’s just as easy to confuse Concierge Medicine with its familial companion subscription-based healthcare delivery model, Direct Primary Care (DPC) with one another.

But each are unique and different in their structure, payments and care delivery.

Wikipedia describes Urgent Care as … Urgent care is a category of walk-in clinic in the United States focused on the delivery of ambulatory care in a dedicated medical facility outside of a traditional emergency department (emergency room). Urgent care centers primarily treat injuries or illnesses requiring immediate care but not serious enough to require an emergency department (ED) visit. Urgent care centers are distinguished from similar ambulatory healthcare centers such as emergency departments and convenient care clinics by their scope of conditions treated and available facilities on-site.The United States is seeing a rapid increase in the number of urgent care centers. In the United Kingdom, similar services are called urgent treatment centres. While urgent care centers are usually not open 24 hours a day, 70% of centers in the United States open by 8:00 a.m. or earlier and 95% close after 7:00 p.m.[9]

Furthermore, the majority of urgent care centers are owned by physicians or physician groups, however, more corporations and investment banks are acquiring urgent care centers and creating regional and national brands in the industry.

Conversely, larger organizations and some smaller companies like Walmart, CVS, Walgreens, Take Care Clinics, Minute Clinics, Remedy, etc., run and operate retail healthcare clinics. Wikipedia further describes “retail healthcare clinics” as a retail clinic is a category of walk-in clinic located in retail stores, supermarkets and pharmacies that treat uncomplicated minor illnesses and provide preventative health care services.

Hopefully that helps clarify the differences and similarities between Retail Healthcare Clinics and Urgent Care Clinics. Similar, but different.

Clear as mud right?

The shift from volume-based to value-based reimbursement that is spurring tremendous growth in accountable care organizations and bundled payment models is also driving healthcare consumerism, says Doug Ghertner, president of Change Healthcare. And when consumers are behaving in a retail-oriented fashion, providers and facilities must respond. As a result, business models and delivery channels are transforming.

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Tiffany Parnell of MDNews wrote a helpful and educational piece recently writing … Mid-level providers, such as physician assistants and nurse practitioners, staff retail medical clinics, and the clinics’ scope of practice is fairly limited, focusing mainly on treatment of minor acute illnesses and on wellness. Since their development 14 years ago, retail medical clinics have experienced continued growth in both number and consumer popularity. For example, CVS MinuteClinic — the largest retail medical clinic provider in the United States — added 150 locations during 2013, and 1,500 clinics are expected to exist by 2017.

Parnell also noted that … Urgent care centers offer a broader array of services. Physicians generally oversee the care provided, and due to the availability of X-ray, sprains, strains and breaks are also managed at urgent care centers. According to the American Academy of Urgent Care Medicine, there are approximately 9,300 urgent care centers in America, with 700-800 clinics opening each year.

The American Academy of Family Physicians also weighed in on the management of chronic conditions and care for health concerns beyond minor, acute illness in a retail medical clinic setting. President-Elect of the American Academy of Family Physicians, Robert L. Wergin, MD, FAAFP, said at the time [February 20, 2014] “We understand there are times when a patient has a minor acute medical illness and needs attention and evaluation [outside of office hours]. Mid-level providers [at retail medical clinics] should use an evidence-based protocol. To avoid fragmented care, the care provider also needs to communicate with the patient’s family physician so they know what treatment was provided at the center.”

A 2009 study sponsored by the RAND Corporation and published in the Annals of Internal Medicine found that retail medical clinics offer outcomes for acute minor illnesses similar to those achieved in emergency departments, physician offices and urgent care centers — but at a lower cost.

There’s no doubt that Retail Healthcare Clinic environments are a popular, transparent, convenient and popular solution for millions of consumers in communities throughout the U.S. And, despite Primary Care and Family Physician negativity, they’re not going away.

In fact, during the COVID-19 Pandemic, their popularity surged and become a major solution and federal vaccine distribution partner.

The first retail clinic was opened in 2001 in Minnesota. Retail clinics are experiencing a commendable growth due to patient preference for convenient care options, cost effectiveness, easy accessibility, and multiple services offered. Furthermore, factors contributing to the growth of this market are increase in shortage of primary care physician, growth in health care expenditures, and rise in incidence rate of communicable diseases. Also, several retail clinics are providing treatment and management for chronic diseases such as asthma, diabetes, hypertension, and high cholesterol disorders. This factor is likely to propel the market growth during the forecast period. However, retail clinics are a secondary choice for many patients, which limits customer volume in these clinics. Low patient population visiting retail clinics and regulations in some countries are impacting the growth of the retail clinics market.

The retail clinics market can be segmented on the basis of location, types of suppliers, and geography. Based on location, retail clinics are further segmented into stores, malls, and other retail locations. Geographically, this market is further divided into North America, Europe, Asia Pacific, Latin America, and Middle East Asia and Africa. North America accounted for a significant growth rate due to factors such as large population base turning toward convenience care, adoption of electronic medical and chart records, and introduction of digital tools. According to Centers for Disease Control and Prevention (CDC), about 18 million adults suffered from asthma in 2012, which was one of the factors that had driven the growth of the retail clinics market. South East Asia, Middle East, and Latin America are projected to be the potential markets in the near future due to higher adoption rate of retail clinics, rise of disposable income, increase in disease burden, shortage of physicians, and ease of usage. Star Dental Care, a U.S. based institute, is aiming to open up retail dental clinics in India by 2017, which is estimated to enhance the growth of the market in this country.

Get accurate market forecast and analysis on the Retail Clinics Market. Request a sample to stay abreast on the key trends impacting this market.

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“You’re going to start seeing a very big blurring of lines between what has been a traditional retailer and what can become a healthcare provider,” according to Patrick Wisnom, global client leader for Johnson & Johnson at advertising agency WPP.

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Meeting the Needs of a Changing Practice

As the landscape of medicine continues to evolve, walk-in clinics may offer a useful adjunct for primary care physicians who are already operating at full capacity.

Scott Axonovitz, CRO at UPshow recently said “This unprecedented time is giving retailers a once-in-a-generation opportunity to redefine the retail  healthcare space. Retailers that recognize consumers’ changing healthcare needs and amplify their in-store environments through digital-first communication channels will be best positioned to succeed.”

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Credit: Advisory Board, (C) 2014 “There’s a general sense that consumers are shopping for healthcare the same way they do for other items,” says Ben Umansky, practice manager for research and insights at The Advisory Board Company. “They’re looking at online reviews from other patients and the price of a procedure before choosing a facility. That is retail behavior.”

According to the J.D. Power Healthcare Insight report, As of the middle of February (2021), the United States is averaging more than 1.6 million vaccine doses administered per day, with many states having set up mass vaccination sites at universities, stadium venues and parking lots. But the fulcrum to getting more shots quickly into the arms of Americans may just be retail health clinics. That’s what the Biden administration is betting on. The President recently announced that the federal government will begin directly distributing a limited number of vaccine doses directly to retail pharmacies across the nation. And considering Americans’ current love affair with these types of clinics, it could prove to be a well-designed strategy to break down a major barrier to mass vaccination.

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“You have to look at all the factors that are changing the landscape of medicine and putting a tremendous strain on our system,” said in February of 2014, Nancy Gagliano, MD, MinuteClinic Chief Medical Officer. “We have a severe primary care shortage estimated to be as many as 50,000 physicians by 2025. We have millions of newly insured patients coming into the system as a result of the Affordable Care Act who will be seeking care. We have an aging baby boomer population and a nationwide epidemic of obesity with associated hypertension, hyperlipidemia and diabetes conditions. I believe retail clinics, like MinuteClinic, are well positioned to help address these concerns and can be a significant part of the solution to increase access to high-quality, affordable medical care.”

In December of 2020, Benefits Pro writer, Michael Popke wrote … Misconceptions and wariness about retail clinics still abound among some consumers, as 47% of respondents said they are not confident in the quality of care provided at such clinics. The same story also stated that … New data reveals opportunities for retail clinics to redefine future of health care. However, if retail health clinics are to fully leverage an influx of new customers, they will need to make some adjustments.

A New Branch on the Family Tree of Retail Healthcare Has Developed, “Medtail”

Lisa Brown, editor for the south and west regions of GlobeSt.com who has 25-plus years of real estate experience, with a regional PR role at Grubb & Ellis and a national communications position at MMI wrote a story in late December 2020 and stated … Even before COVID-19, medical clinics in retail strip centers and large shopping centers, known as medtail, were commonplace. But this trend has only accelerated in recent months and will likely continue throughout 2021, according to Tether Advisors.

Today there is also a new interest among investors, venture capital and real estate investors in this space.

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The larger trends driving medtail that have been turbocharged by COVID-19 clearly have staying power, says Katie Killeen of Tether Advisors.

RAND also stated that convenience, accessibility after hours, and clear pricing appear to be the most important drivers of growth. The clinics treat a limited range of health conditions, such as minor infections and injuries, and provide vaccines and other preventive care. Care is delivered [typically] by a nurse practitioner or physician assistant. Consumers are relatively happy with their overall care experiences [Today] these clinics offer extended weekend and evening hours, walk-in availability, and short wait times. Many visits to retail clinics are in the evenings and weekends, when primary care offices are not available. Prices are typically fixed and transparent.

Examples of Retail Healthcare In Our Communities, Present Day, 2021

CVS Health is just one example of a pharmacy turned community healthcare organization redefining what it means to be a drug store operator — and carving out its place as a healthcare company.

“CVS Health is in a superior position to lead the change needed in the fragmented U.S. healthcare system,” Larry Merlo, president and CEO of the Woonsocket, R.I.-based retailer, said in the company’s year-end earnings conference call. “In short, 2018 was a milestone year both tactically and strategically as we successfully completed our transformational merger with Aetna.”

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Merlo also added in a story by Drug Store News (DSN), the HealthHub stores feature a care concierge — a newly created store position designed to help direct customers to the health resources they need, including in-store dietitians and an array of resources for patients seeking to manage such chronic conditions as diabetes, hypertension and asthma. More than 20% of the new store format is dedicated to health services, the company said, including new durable medical equipment and supplies, as well as new product and service combinations for sleep apnea and diabetes care. The stores also offer full-personalized pharmacy support programs and MinuteClinic services, with a focus on recommending next best clinical actions and driving medical costs savings.

Walmart is another example of a company in the retail healthcare space that seems to be getting quite serious about their shoppers and target audience and addressing healthcare costs.

“Walmart is launching new healthcare centers around the nation. And up-front pricing is making things more transparent. You can get urgent care, x-rays, counseling, dental, and optical services at these new and innovative health centers.” ~Clark.com

In a Tweet, Walmart has the resources in place to make crossing the divide from mass to class possible in its dream team of retail tech visionaries Marc Lore, Denise Incandela, Jenny Fleiss and Andy Dunn (bonobos.com). Walmart Has Now Launched a Pilot Primary Care Healthcare Clinic in suburb of Atlanta (Dallas, GA; Paulding County Store), the only one in the country is now in Atlanta. And, did you know … According to PYMTS.com, the average Walmart shopper is a white, 50-year-old woman with an annual household income of $53,125.

According to Business Pundit, Walmart might claim the biggest part of the retail pie.

Target is yet another.

Target beats out the company for shoppers who earn $50,000 or more. In fact, the chain derives a large chunk of its sales from shoppers who earn less than $25,000 per year … It isn’t until the 45 to 54-year-old group that Walmart shows its true demographic dominance. The generational gap at Walmart is troubling for investors looking to the long-term. Generation Y would much rather shop at Target or even Family Dollar, and Dollar Tree. Baby Boomers love Walmart but they are aging out of the market and will likely cause sales issues in the future if Walmart fails to grab the Generation Y crowd.

Walgreens also is a major part of the retail healthcare space, as are other organizations we didn’t mention, but have in other stories. For example, Walgreens and VillageMD to Open 500 to 700 Full-Service Doctor Offices within Next Five Years in a Major Industry First

“This rollout is a major advancement of one of Walgreens Boots Alliance’s four key strategic priorities, Creating Neighborhood Health Destinations,” said Stefano Pessina, executive vice chairman and CEO, Walgreens Boots Alliance. These clinics at our conveniently located stores are a significant step forward in creating the pharmacy of the future, meeting many essential health needs all under one roof as well as through other channels.”

The Future of Retail Healthcare Is Bright, Pending Consumer, Company and Community Interest In the U.S. & Abroad

Bain & Company’s Franz-Robert Klingan, Christoffer Precht and Giovanni Battista Miani recently wrote …

Healthcare systems around the world suffer from inefficiencies, and Europe’s healthcare systems are no exception. The rise of retail health is rooted in the desire to manage costs better, increase productivity and improve the quality of patient care. The fundamental appeal of consolidation is the ability to unlock value through efficiency, which benefits patients, physicians, payers and investors alike.

The trend toward retail health is supported by medical advancements that make it easier to shift services out of hospitals and into outpatient settings. This can offer greater convenience to patients, and payers are naturally keen to transfer patients to lower-cost outpatient environments.

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Common retail health clinics in Europe include dental clinics, ophthalmology and radiology clinics, and veterinary practice chains. As in the US, many European retail health clinics rely on patient self-payment for much of their revenue.

Retail health chains are also more responsive to physicians’ changing attitudes about ownership. They offer a more stable and flexible alternative to the risks of running a practice. And for physicians who are preparing for retirement and looking for a solid exit for their practice, retail health chains are welcome buyers. 

For investors, consolidation offers opportunities for value creation at the top and bottom line, and significant expansion of multiples. Revenues can be boosted by increased utilisation, category management, higher patient volumes, pricing sophistication, network optimisation, and improved branding and marketing. At the bottom line, there are scale-driven economies in such areas as purchasing and supply chain management, real estate management and the centralisation of administration.

The number of outlets is key to capturing better economies.

In Closing …

There are a number of ways to close this educational article about the history, present-tense and future of retail healthcare in the U.S. and it’s appeal abroad as well.

As American’s, we want things now. That’s built into our culture and inherent psyche.

There’s no doubt the appeal of retail healthcare to the consumer. The COVID-19 Pandemic also cemented their role in each of our lives, regardless of how you feel about the research, patient outcomes or data that has and or will come out of these centers of convenience.

These are some helpful and we think insightful industry voices that we hope will help you understand where retail heatlhcare has been, where it is today, and where it’s headed.

“The evolution of patients into cost-conscious healthcare consumers is already having significant implications for all players in the supply chain. Successful facilities will be those finding innovative products and services that yield increased transparency and give consumers greater control over their care.” ~HealthTrust, The Source

“We didn’t set out to disrupt healthcare. We set out to meet the needs of our customers at Walmart,” Walmart President of Health and Wellness Sean Slovenski said during a panel hosted by the American Telemedicine Association. “When we say it’s $20 to have your child seen with a primary care physician, and it’s really $20 … When you come in and walk out and get the bill and it’s still $20, that’s quite a disruption in the space.”

According to Business Pundit, Walmart might claim the biggest part of the retail pie, but Target beats out the company for shoppers who earn $50,000 or more. In fact, the chain derives a large chunk of its sales from shoppers who earn less than $25,000 per year … It isn’t until the 45 to 54-year-old group that Walmart shows its true demographic dominance. The generational gap at Walmart is troubling for investors looking to the long-term. Generation Y would much rather shop at Target or even Family Dollar, and Dollar Tree. Baby Boomers love Walmart but they are aging out of the market and will likely cause sales issues in the future if Walmart fails to grab the Generation Y crowd.

“CVS has pushed heavily into a vertical integration of health care, from the prior acquisition of Caremark to the merger with Aetna,” said Neil Stern, senior partner at Chicago-based consulting firm McMillanDoolittle. “This creates a different kind of company, particularly as it pertains to retail execution.”

Peter Francese, founded American Demographics magazine in 1979, which was acquired by Crain Communications in 2004 and folded into Advertising Age points to Walmart as a retailer that truly understands these demographic trends and has been planning for them for years. Walmart understands the financial constraints of lower-income shoppers, so they continue to double down on the “Save Money. Live Better” promise with easy access and affordable prices for better-quality goods. It understands the time constraints of lower-income, as well as two-income families, where long working-hours press into in-store shopping time. Online shopping, buy-online-pickup-in-store and curbside pickup are the solution.

(BELOW) Franz-Robert Klingan is a Bain & Company partner who leads the firm’s Healthcare Private Equity practice. He is based in Munich. Christoffer Precht is a Bain partner and a leader in the firm’s Private Equity practice, and is based in Stockholm. Giovanni Battista Miani is a Bain principal and a leader in the Private Equity practice. He is based in London.

The macroeconomic trends that are driving retail health consolidation will sharpen in the foreseeable future. Competition for acquisitions of single practices will intensify, particularly in easy-to-consolidate countries and specialties. Yet there is plenty of “white space” in most European countries and sectors. And any healthcare service that can be provided in an outpatient setting can be consolidated into a retail health chain, offering further potential for innovation and future growth.

Investors—whether they are entrepreneurial physicians or professional private equity funds—will need to carefully navigate the regulatory landscape of each country and ensure that incentive schemes do not conflict with medical ethics. They will also need to invest in initiatives selectively, balancing clinical improvements and efficiency gains against further acquisitions. This requires deep insights into the healthcare sector and retail growth models. 

With the right strategy in place, all stakeholders stand to benefit from retail health consolidation. Patients gain improved access to care, physicians have more flexibility and choice, and investors acquire long-term, stable returns. The outlook is promising for countries that foster the right conditions for retail health consolidation and growth.

Other Educational Links, Industry Stats and Insight Mentioned In This Podcast Included and Sourced (Below):

 
 

Citations & Sources Mentioned or Referenced Above

[1] https://pubmed.ncbi.nlm.nih.gov/24168869/; Kaissi A, Charland T. The evolution of retail clinics in the United States, 2006-2012. Health Care Manag (Frederick). 2013 Oct-Dec;32(4):336-42. doi: 10.1097/HCM.0b013e3182a9d73f. PMID: 24168869.

[2] https://www.rand.org/pubs/research_briefs/RB9491-2.html; The Evolving Role of Retail Clinics. Santa Monica, CA: RAND Corporation, 2016. https://www.rand.org/pubs/research_briefs/RB9491-2.html.

[3] W. Crounse, Microsoft and Health, “Healthcare goes retail,” June 28, 2006.

[4]“QuickHealth, “QuickHealth FAQ.””.

[5] “Convenient Care Association, “About Physician Assistants.””.

[6] American Academy of Physician Assistants, “What is a PA?”Archived 2006-10-28 at the Wayback Machine

[7] E. Sekscenski, et al., “State practice environments and the supply of physician assistants, nurse practitioners and certified nurse-midwives,” New England Journal of Medicine, 1994.

[8] “Attraction to Walk-in Clinics”. Doctors Express Urgent Care. Archived from the original on 15 July 2014. Retrieved 8 July 2014.

[9] “‘2012 Urgent Care Benchmarking Survey Results.’ Urgent Care Industry Information Kit. 2013” (PDF). Urgent Care Association of America. Retrieved 2015-06-26.

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