PhotoYou may know that health care in the U.S. is making some big changes as the Affordable Care Act goes into effect next January. But where you get your health care may also be changing.

As many as 30 million people who do not have health coverage are about to get it. Private practices already have full patient loads and fewer new doctors are coming on board to replace those who are retiring.

Many patients, especially those who find they have little time to plan doctor appointments around busy work and home schedules, may turn to the same place they buy their prescriptions for routine health care needs.

Walk-in health clinics are springing up everywhere, often inside a drug store. Three of the major players in retail pharmacies – Walmart, CVS and Walgreens – have walk-in health clinics at select stores. Staffed by a nurse practitioner, these clinics usually treat minor ailments and offer preventive care.

Open seven days a week

In Walmart's case, the clinics are independently owned by medical providers who agree to operate under Walmart's terms. The services have to be provided on a walk-in basis, seven days a week. The treatments must be reasonably priced and, unlike your doctor's office, the fees must be clearly posted.

PhotoCVS operates MinuteClinic, a walk-in medical service provided at some stores since 2000. According to CVS, it has some 650 locations in 25 states. CVS says its health care providers have carried out more than 15 million patient visits and boasts of a high customer satisfaction rating.

Walgreens operates Take Care Clinics, located inside select Walgreens stores. It, and its competitors, treat coughs and colds, flu and other routine illnesses. But the scope of care at these walk-in clinics appears to be growing.

Walgreens has just announced that it is going to treat chronic conditions at its more than 350 walk-in clinics. In addition to a runny nose, you can be treated for high blood pressure, elevated cholesterol, asthma and even diabetes. It's possible other walk-in clinics will follow suit as the Affordable Care Act takes effect.

Filling the gap?

“The existing gaps in patient care and demands on an already overburdened health care system are all projected to worsen with an influx of new patients under health care reform,” said Heather Helle, divisional vice president, consumer solutions group, Walgreens. “Walgreens is stepping up to be part of the solution.”

PhotoWhile some patients will continue to find comfort in receiving all their health care needs from their family physician, others undoubtedly will be drawn to the idea of walking into a clinic and receiving treatment, without having to make an appointment. The growth of these clinics, a study suggests, could interfere with the existing relationship between a patient and her primary care provider.

In October 2012, Rand Corporation researchers found mixed evidence on the question. They discovered that the consumers who use retail walk-in clinics are less likely to go back to their family doctor, resulting in a disruption in the continuity of their health care. But they didn't find that necessarily to be a bad thing.

Quality of care

While the patients might see a different provider on each visit, and might be less likely to return to their family doctors as often, the researchers said they didn't find evidence that the walk-in clinic patients got worse care than they would have otherwise.

"The interpretation of our findings depends on one's view about the relative importance of different aspects of primary care," said study author Rachel Reid, of the University of Pittsburgh School of Medicine. "Retail clinics are still in their infancy and over time we may or may not observe a more negative impact of retail clinics on preventive care or continuity of medical care."

The researchers also found the number of these retail health clinics is growing. Last October researchers counted more than 1,300 in the U.S. The growth of these clinics will only increase, they predicted, with the expansion of health care to every person in the U.S.

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