Is 'Quick' Enough?

The problem with this vision: It doesn't answer doctors' fears about RBCs' "encroaching on the economics of their business," as Kellerman puts it.

Kellerman is among those convinced that RBCs are here to stay and that traditional medicine will need to adapt to survive. Such adaptations are already occurring, he says, with doctors expanding office hours, opening on weekends and offering online scheduling.

The American Academy of Family Physicians has launched a national project ( http://www.transformed.com) to test new ways to improve care and make primary care practices more welcoming to patients.

"You can't stop the train," Corwin says. "Our colleagues are going to have to step up to the plate and change how they practice so that there's no reason not to go to your own doctor."

Van Vleck echoes the sentiment: "If you have a doctor that knows you, that you've been going to for years, there should be no reason to use retail-based clinics."

Pohnert continues to argue that it doesn't have to be a contest. She runs through the list of patients she sees whose circumstances, in her view, present no threat to traditional practice: "people who are traveling, visiting family in the area or here on vacations" -- not to mention people -- mostly young adults -- who don't have regular physicians. Or those without health insurance. "There are so many people and not enough providers," she says.

For now, she says, "we'll share. There's room for everybody. The consumers want to have choice, and we'll work together. We'll make it work for everybody." ·

Ranit Mishori, a family medicine resident at Georgetown University/Providence Hospital, recently wrote for the Health section about claims that you can improve your vision through exercise. Comments:health@washpost.com.