Observations Letter from New England

An inconvenient truth: urgent care is not primary care

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h1657 (Published 26 March 2015) Cite this as: BMJ 2015;350:h1657
  1. David Loxterkamp, medical director, Seaport Community Health Center, Belfast, Maine
  1. david.loxterkamp{at}gmail.com

Primary care is best at placing illness in context

In February 2014 the biggest seller of prescription drugs in the United States, CVS Caremark, announced that it would end the sale of tobacco and tobacco products. The decision would cost the company an estimated $2bn (£1.3bn; €1.8bn) a year, but that represented only a fraction of the $127bn in total sales.1 The company then changed its name to CVS Health, signaling its desire to become a healthcare company, not just a chain of retail pharmacies. In fact, the transformation of CVS was foreshadowed years earlier when it opened its first in-store medical clinic.

Today CVS is the largest operator of walk-in health centers in the US, with its MinuteClinics in more than 900 stores and 31 states. They are staffed by nurse practitioners and physician assistants who treat minor illnesses and accidents and carry out health screening and preventive examinations, tests, and vaccinations at roughly half the cost of a regular doctor’s visit. Andrew Sussman, president of MinuteClinics and a doctor, sees walk-in centers as filling a void. Half the patients who …

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