Provider Spotlight: Dr. Mandel, ER Maverick & Locum Tenens Physician

Dr. Ken’s Corner: Is Health Care By Appointment in Jeopardy?

Patients seem to be fed up with having to adapt their own schedules to fit in with what’s convenient for the doctor. “Cost-conscious patients facing higher health plan deductibles have helped make walk-in clinics one of the fastest-growing sectors in the health care market. With no appointments required and most insurance accepted, advocates say, “the clinics bring a patient-first consumerism to the nation’s outmoded health care delivery system” (

Some 20,000 physicians currently staff the nation’s 9,300 stand-alone urgent care centers, according to the American Academy of Urgent Care Medicine. The AAUCM reports that each center handles about 14,000 patient visits a year and projects that the number of urgent care centers will grow by 20 percent for the next several years.

Retail clinics, on the other hand, are usually staffed by nurse practitioners and physician assistants and are located in hundreds of pharmacies, supermarkets, and “big box” stores. Although immunizations are the number one reason patients visit retail-based clinics, some have also taken on patients with chronic illnesses such as diabetes and hypertension. “This kind of foray into chronic disease management is problematic because it really fragments patient care,” says Dr. Wanda Filer, president-elect of the American Academy of Family Physicians.  Retail-based clinics have also drawn the ire of pediatricians.  According to the American Academy of Pediatrics, “these clinics do not provide children with the high-quality, regular preventive care children need.”  But Dr. Andrew Sussman, president of CVS MinuteClinics, counters that retail clinics provide a valuable service: “The reality is there’s a lot of people who are medically homeless. So when they  get sick, even when they get sick with a relatively minor problem, they don’t have someone they can easily go to.”

The growing popularity of walk-in clinics is making doctors change the way they practice. According to the AAFP’s Dr. Filer, “the vast majority of American Academy of Family Physician members now offer same-day appointments, and some have expanded their hours of operation” ( Pediatricians are responding in a similar fashion, a trend that appears to be here to stay.

Ken Teufel, M.D., M.A.