Retail clinics increasingly popular option

This issue covers topics such as retail clinics, management of heart failure, and optimizing human papillomavirus vaccination.

Retail clinics have become a growing part of the U.S. health care landscape over the past few years, with a projected number of 3,000 nationwide this year. Some of the attractions for patients include convenient hours, lower copays than EDs, and easy access. Primary care physicians, however, worry about the quality and scope of the care provided, as well as potential effects on care continuity and the patient-physician relationship. Staff writer Mollie Durkin talks to experts about potential reasons behind the clinics' surge, research on outcomes, and ways in which primary care physicians can address this avenue of care with the patients in their practices.

Managing heart failure is a complicated clinical area that is only likely to get bigger as the number of patients with the condition continues to increase. Our story outlines the challenges and looks at what internists need to know about the condition, including the latest on guidelines, newly available drugs, and the best time to refer to a cardiologist for optimal comanagement. Telemedicine may hold some promise in this area, too, but as yet its benefits remain more of a goal than a reality, the story explains.

A third vaccine for human papillomavirus (HPV) was approved in late 2014, but more availability doesn't necessarily mean higher vaccination rates. Our story examines some of the barriers, including HPV's status as a sexually transmitted disease and the fact that the recommended age range for vaccination can span adult and pediatric practices. Physicians can help improve rates by utilizing electronic medical records to track doses and by keeping conversations with patients and families simple, experts say.

Our conference coverage is from the American Epilepsy Society's annual meeting, held in Philadelphia last December. At the meeting, an international expert in the field addressed the use of valproate in women of childbearing potential, discussing recent European regulations, stricter than the FDA's, that prompted development of a European task force on the issue. While valproate's teratogenic properties require women and their doctors to proceed with caution, overregulation could in some cases mean denying patients their only effective treatment, the expert said. One key, as always, is ensuring that patients and doctors are on the same page regarding risks and benefits.

Do many of your patients visit retail clinics? How, if at all, are they affecting your practice? Let us know.


Jennifer Kearney-Strouse