The
sign over the kiosk reads “You’re Sick, We’re Quick” and might be the motto for
a recent revolution in healthcare delivery, the
retail clinic. The brainchild
of entrepreneur Rick Krieger netted its owners $ 170 million last year when CVS
bought his company outright. Rick came up with the idea one frigid day when
his son needed a strep test before hitting the slopes. Since then a number of
companies have entered the fray for consumer-driven healthcare.
However, the idea has not been
well-received by all. Harvard Business Review described the retail clinic as a
“disruptive innovator of healthcare” and in an old-fashioned turf war the
American Medical Association has scrambled to protect the interests of primary
care physicians. Citing concerns over the quality of care, physicians groups
have lobbied at the Federal and State level to place stringent controls on the
clinics. In what sounds like a six-year-old defending his right to exclusive
use of a baseball diamond one doctor
opines: “Ear exams are not simple. There
is a reason for internship and residency training.” Wow, who knew?
Defenders of the quick clinic model stress
their utility for minor ailments and their effectiveness in reducing costs.
Furthermore, they argue it frees up both emergency rooms and primary care
physicians from dealing with the mundane so that they can focus their expertise
on the seriously ill. Nurse practitioners are hardly among the “superficially
trained.” The average Family Nurse Practitioner holds a Bachelor of Nursing
degree along with 5-15 years acute care nursing experience. To this is added
two years of advanced training including precepted clinical experience
resulting in a Masters of Nursing specialty degree and National Certification
as a Nurse Practitioner. In general, although admittedly having spent less time
in school, a Certified Nurse Practitioner has more clinical experience than a
newly graduated primary care physician.
Nonetheless, the quick clinic model maintains
focus on a very narrow group of easily diagnosed conditions – about two dozen
in all. Sophisticated software backs up the clinical skills of the NP and a
full report is faxed to the patient’s primary care physician for follow-up. The
real danger is that these highly-trained clinicians will become bored with the
spate of routine, uninteresting cases.
Is the quick clinic a force for positive
change or provender of evil? Only time will tell. However, this much is
documented. A telling study conducted by the Columbia University School of
Nursing and published in the Journal of the American Medical Association
randomly assigned 1,312 patients to nurse practitioner and general
practitioner physicians. The results were stated like this: "No significant differences were found
in patients' health status... No significant differences were found in health
services utilization..." whether treated by a physician or a nurse
practitioner.
Another study by Jan Towers of the American Academy of Nurse Practitioners (AANP) showed that the training and practice of Nurse
Practitioners that places a heavy emphasis on prevention – the vast frontier of
medical savings - can significantly reduce healthcare costs. These savings have not gone unnoticed by the Managed Care
sector 85% of whom have chosen to utilize Nurse Practitioners to cut costs.
Despite the controversy, the quick clinic
is clearly a win-win situation – consumer-driven healthcare is creating
patient-oriented clinicians while at the same time reducing health care costs. Since
its inception in 2006 when less than 100 existed, today, two years later
literally thousands are cropping up across the country resulting in the recognition
of the skills of advanced care professionals, particularly nurse practitioners,
and a new, recognized niche for their skills and passion.
At One Source Health Careers we herald the
success of the retail clinic as a much-needed innovation in healthcare
delivery. And if you are an advanced care professional who believes that the
future of healthcare is outside the current oligarchy why not give us a call.
We’d love to help you find your place in this cutting edge practice setting.
Further Reading:
“Nurse
Practitioners Inch onto the Field” (Managed Care Magazine)
http://www.managedcaremag.com/archives/0008/0008.turf.html
“The
Minute Clinic Movement: Model for the Future or 60 Seconds of Fame?” (California
Healthcare Foundation) http://www.chcf.org/press/view.cfm?itemID=123240
“Retail
Clinics: Disruptive Innovators of Healthcare,” (WSJ Healthblog)
http://blogs.wsj.com/health/2007/05/14/retail-clinics-disruptive-innovators-of-health-care/
