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From cottage industry to a dominant mode of primary care: Stages in the diffusion of a health care innovation (retail clinics)

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  • McKinlay, John B.
  • Marceau, Lisa D.

Abstract

Primary health care is essential to population health and there is increasing need for it, especially with an aging population with multiple comorbidities. Primary health care in the U.S. is widely considered in an ever-deepening crisis. This paper presents a detailed case study of the recent rise of a “disruptive innovation” – retail clinics – which have the potential to transform the face of primary health care in the US. We describe six stages in the diffusion of retail clinics, from cottage industry to a dominant mode for the delivery of primary health care, and consider sociopolitical influences that facilitate and impede their emerging potential. Retail clinics may provide a strategic opportunity to re-engineer the primary health care system, although they may also produce worrisome unanticipated consequences. Discussion concerning the potential threats and opportunities posed by retail clinics occurs in the absence of sound evidence concerning their comparative effectiveness and quality-of-care. This case study identifies the sociopolitical influences and processes that determine whether health care innovations rise or fall, and highlights critically important points along the pathway to health system change.

Suggested Citation

  • McKinlay, John B. & Marceau, Lisa D., 2012. "From cottage industry to a dominant mode of primary care: Stages in the diffusion of a health care innovation (retail clinics)," Social Science & Medicine, Elsevier, vol. 75(6), pages 1134-1141.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:6:p:1134-1141
    DOI: 10.1016/j.socscimed.2012.04.039
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    References listed on IDEAS

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    1. Susan L. Ettner & Jenny Kotlerman & Abdelmonem Afifi & Sondra Vazirani & Ron D. Hays & Martin Shapiro & Marie Cowan, 2006. "An Alternative Approach to Reducing the Costs of Patient Care? A Controlled Trial of the Multi-Disciplinary Doctor-Nurse Practitioner (MDNP) Model," Medical Decision Making, , vol. 26(1), pages 9-17, January.
    2. McKinlay, John & Marceau, Lisa, 2008. "When there is no doctor: Reasons for the disappearance of primary care physicians in the US during the early 21st century," Social Science & Medicine, Elsevier, vol. 67(10), pages 1481-1491, November.
    3. Marceau, Lisa & McKinlay, John B., 2008. "The blindness of those who will not see: On the replacement of primary care doctors in the 21st century. A response to Timmermans," Social Science & Medicine, Elsevier, vol. 67(10), pages 1497-1501, November.
    4. Timmermans, Stefan, 2008. "Oh look, there is a doctor after all: About the resilience of professional medicine: A Commentary on McKinlay and Marceau's 'When there is no doctor'," Social Science & Medicine, Elsevier, vol. 67(10), pages 1492-1496, November.
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    Cited by:

    1. Gagliardi, Dimitri & Ramlogan, Ronnie & Navarra, Pierluigi & Dello Russo, Cinzia, 2018. "Diffusion of complementary evolving pharmaceutical innovations: The case of Abacavir and its pharmacogenetic companion diagnostic in Italy," Technological Forecasting and Social Change, Elsevier, vol. 134(C), pages 223-233.

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