Weighing in on the Supreme Court Decision
Amer Kaissi: National trend takes health clinics to retail centers.
By Susie P. Gonzalez
January 2012 - Health care providers are beginning to face the reality that people do not get sick only between 8 a.m. and 5 p.m. on weekdays. To make treatment more convenient, retail clinics are opening in grocery and drug stores, a trend studied by Amer Kaissi, associate professor of health care administration at Trinity University.
The concept behind retail clinics is convenience, Kaissi said, adding, "This is a national trend of taking health care to the consumer rather than the consumer going to a health care clinic." Such clinics began in Minneapolis in 2000, when Kaissi was attending graduate school. The clinics now number about 1,300 across the nation, and in Texas, they can be found inside some H-E-B grocery stores and also at select Target, Wal-Mart, CVS/pharmacy, and Walgreens outlets.
People already go to such stores once or twice a week, and if they have a suspected sinus infection, for example, they can walk into the retail clinic, without an appointment, and be seen relatively quickly by paying a flat fee or insurance co-pay under a "menu pricing system." If their condition warrants, they leave with a prescription, Kaissi said. Patients are seen by a nurse practitioner or a physician's assistant but are referred to a doctor if their condition is serious.
In the early years of operation, retail clinics were met with skepticism from doctors who feared inferior care and no follow-up. But Kaissi's research has discovered that the concerns were unfounded. In San Antonio, the RediClinics located at five H-E-B's opened in partnership with the Methodist Health Care System, thus boosting consumer confidence, he said.
"My research focuses on how hospitals get involved with the trend," he said. Most hospital emergency rooms are overwhelmed with patients, and about half of them "don't need to be there" because they have minor conditions. Other patients, for financial reasons, might delay care when their health condition is minor but may be forced to go to the ER when they get seriously sick, he said, explaining that an earlier retail clinic visit could prevent a costly ER trip.
Kaissi stressed that patients are happy with the care they receive at retail clinics and trips to the emergency room for non-threatening conditions have dropped. "This is not going to solve the health care crisis, but for minor conditions, it is one way to reduce costs while providing a service that patients really value," he said. "People with insurance are not doing this to save money; they are doing this to save time."
In the classroom, Kaissi teaches an undergraduate elective on Management of Health Care Organizations along with graduate students seeking a master's degree in health care administration. He has adapted television game shows such as "Who Wants to be a Millionaire" and "Jeopardy" as an ice-breaker to determine how much students know about his class material or as an exam review. Students are put in teams and compete to provide the answers. "They take it seriously, but most of the time, it's a fun teaching tool" used sparingly to keep it fresh.
When not on campus, Kaissi is one of several Trinity professors who have organized soccer games at the International Children's Shelter in San Antonio, which is operated by Baptist Children and Family Services. Trinity soccer-playing faculty and students have not only visited the shelter but also sponsored fundraisers to supply soccer balls and jerseys to the boys. Once, the shelter residents visited the Trinity campus to frolic on a lush soccer field that was a welcome alternative to the dusty and barren recreational area at the shelter. Such an encounter, no matter how brief, was an attempt to make a difference in the lives of the young children.
- Institutional Health Care Management (Graduate)
- Health Care Strategic Planning and Marketing (Graduate)
- Health Care Human Resource Management (Graduate)
- Management of Health Care Organizations (Undergraduate)
- The American and French Health Care Systems (Undergraduate, in French)
- Kaissi, A. "Hospital-Affiliated and Hospital-Owned Retail Clinics: Strategic Considerations and Operational Challenges." Journal of Health Care Management. September-October 2010.
- Kaissi, A., Parchman, M. "Organizational Factors Associated with Self-Management Behaviors in Diabetes Primary Care Clinics." Diabetes Educator, 35(5), 843-850, September-October 2009.
- Kaissi, A., J. Begun. "Strategic Planning Processes and Hospital Financial Performance." Journal of Health Care Management. 53(3), 197-209. May-June 2008.
- Kaissi, A., Kralewski, J., Dowd, B., Heaton, A. "The Effect of the Fit Between Organizational Culture and Structure on Medication Errors in Medical Group Practices." Health Care Management Review. 32(1):12-21. January-March 2007.
- Kaissi, A., Parchman, M. "Assessing Chronic Illness Care for Diabetes Care in Primary Care Clinics." Joint Commission Journal on Quality and Patient Safety. 32(6):318-23. June 2006.
- Kaissi. A. "Manager-Physician Relationships: An Organizational Theory Perspective." The Health Care Manager. 24(2), 165-176, April-June 2005.