March 27, 2013

Retail Clinics and Nurse Practitioners Instead of Doctors

I wrote favorably yesterday (below) about my first visit to a CVS Minute Clinic. After researching these clinics... and the function of nurse practitioners, I realize this CVS model offers a solution to the looming shortage of primary care doctors.

There is plenty of evidence that well-trained nurse practitioners can provide routine services every bit as good as -- sometimes even better than -- what patients receive from their doctors. That was certainly my experience.

Popularity of Retail Health Clinics 
CVS has its Minute Clinics; Walgreens has "Take Care Clinics." Similar walk-in clinics are springing up in other pharmacies, superstores and workplaces.

In a Harris-Interactive poll conducted in December 2012, 27% of all adults surveyed said they had used either walk-in retail clinics or work-based clinics for medical care in the past two years. That's a big jump from just 7% in 2008.

Younger adults were more likely to have used these facilities -- not surprising, since older adults have more chronic, complex health problems. The drop-in clinics are better at resolving acute or sudden health issues.

The survey found that people were most likely to visit a retail or work-based clinic for run-of-the-mill complaints, like colds, flu-like symptoms, minor cuts and wounds. Others use the clinics for routine needs like getting flu shots, obtaining prescriptions, and checking blood pressure or cholesterol, as I did.

Not surprisingly, fewer respondents were willing to use the clinics for more serious concerns.

According to the Convenient Care Association, the first retail-based convenient care clinic in America opened in 2000. Now there are more than 1,350 such clinics operating across the country.

CVS Minute Clinics have served 14 million patients since 2000. About 100 new clinics open every year.

"When the Doctor Is Not Needed"
That was the title of a NY Times editorial last December that explored the current shortage of primary care doctors in many parts of the U.S. The problem becomes much more pressing next year, when millions of uninsured Americans will be covered under the Affordable Care Act ("ObamaCare").

A sensible solution to this crisis, the Times suggested, is "to rely much more on nurse practitioners, physician assistants, pharmacists, community members and even the patients themselves to do many of the routine tasks traditionally reserved for doctors."  The editorial considered several initiatives that use non-doctors to provide medical care with very promising results.

Here's what the editorial said about retail clinics:
Hundreds of clinics, mostly staffed by nurse practitioners, have been opened in drugstores and big retail stores around the country, putting basic care within easy reach of tens of millions of people. The CVS drugstore chain has opened 640 retail clinics, and Walgreens has more than 350. The clinics treat common conditions like ear infections, administer vaccines and perform simple laboratory tests. 
A study by the RAND Corporation of CVS retail clinics in Minnesota found that in many cases they delivered better and much cheaper care than doctor’s offices, urgent care centers and emergency rooms.
Based on my experience, the retail clinics get my vote.

1 comment:

T&D said...

Those Clinics are the answer to routine use of emergency rooms!