Retail Clinic Check-up
I'm what you might call "doctor phobic." I haven't had a check up since 2001, and that was required to get into college. After high school, I moved to the Philadelphia suburbs from quiet nook upstate in a rural area lovingly referred to as the "Polish Poconos." Where I grew up, you knew your doctors. We had one doctor who took care of my mom's side of the family, and one who took care of my dad's side. I've been to both.
I've been in the ‘burbs for 8 years now, and besides a few visits to the college health center for pinkeye and a bout of bronchitis, along with two visits to a regular primary care physician for bursitis, I've avoided the cool comfort and aged Time magazines of doctors' waiting rooms. I dislike the waiting, can't find a doctor I adore and frankly, get all around nervous when it comes to doctor visits. Even calling to make an appointment gives me the heebies.
Then, a week and a half ago, I started getting these pounding earaches. A lot of my job involves interviewing folks over the phone or listening to transcriptions of said interviews. An earache seriously cramps my style.
The other night, when trying to recount symptoms related to the earache to my boyfriend, I listed off a few: earache (obviously), nausea, lower teeth pain, muscle aches, fatigue. I asked him if there was anything he'd noticed since the earache surfaced. "Well, you have been irritable lately," he noted.
Telling me my butt looks big in a dress would've been less of a blow to the psyche. It was time to make an appointment. Last time I tried to get a few minutes with my primary care provider (PCP) about an annoying rash, his staff basically told me to buzz off. He'd see me in 3 weeks or so, no sooner. Frustrated, I slathered on calamine and oatmeal lotion, changed laundry detergent and cut my fingernails so I wouldn't scratch. My rash disappeared before the 3 weeks it would've taken to get an appointment.
My choices with the earache were to either find a new PCP, try my luck with the old one or look into a pretty new option, a drug store retail clinic. I reasoned that for $62, I could get my ear infection diagnosed, walk in without an appointment and not have to confront my phone call with the doctor phobia.
I chose the last option. Yesterday afternoon, I took my aching ears (and the rest of me) to my local MinuteClinic, less than a mile from work. Nervous as usual when it came to doctors, I used the computer kiosk to sign in, and a friendly nurse practitioner (NP) sat patiently by. She put me at ease at once, smiling and telling me that I'd be taken care of.
MinuteClinic uses a proprietary EHR system and is Joint Commission accredited.
I took my seat in the tiny office and the NP clicked away at the EHR, asking the usual questions about my earache and symptoms. I was pleasantly surprised to find that the clinic takes my insurance, meaning the $62 would be chopped down to just my $40 specialist co-pay. After a brief examination (I have high blood pressure, a slight fever and ears that are "sucked in," not to mention a middle ear infection in both ears, turns out), the practitioner sent over two orders to the pharmacy using the EHR's e-prescriber.
The benefits to this type of care are numerous, particularly to a doctor-phobe like me. Clinics like this may help the burden on PCPs and stunt the use of emergency rooms for routine problems, like my otitis media squared. MinuteClinic touts the use of its EHR as a quality control device and one that lends to the efficiency of the clinics.
I eyed the EHR system and watched many prompts pop up on the screen. At one point, my friendly NP sighed as she clicked, saying, "Ah, we have a new EMR, I'm sorry."
At the kiosk where I signed in, I opted to receive a copy of my medical record from the visit via e-mail, and at the end of my visit, the NP gave me a paper copy, as well. I could've also chosen to send a copy to my PCP.
The record listed my penicillin allergy, noted the pain I was having and listed follow-up recommendations. Checking over the record after my visit, and noticed two teeny mistakes. My weight was entered as 98,102 pounds (yes, my butt does look big in that dress). Also, my temperature was recorded as normal, at 98.6 degrees, when it was really a little higher than that. I was so happy to be getting antibiotics and ear drops for the pain that I let the mistakes slide and traipsed over to pick up my prescriptions. I've never seen a copy of my records right after a visit, and it kind of made me wonder what mistakes existed in past records that I didn't have a chance to correct.
While there are definite advantages to this type of clinic, I don't think many people know about them yet, but more retail clinics are on the way. Wal-Mart plans to open more of its own in-store clinics powered by an EHR, and our local Walgreen's also boasts a retail clinic.
When it comes to HIM at retail clinics, it's completely dependent on the EHR, as the clinics are a one-man (or woman) show, not counting those behind the scenes, with the NPs administering care and taking care of the records. No MTs transcribe an account of the visit, no coders seek out the right codes and, as patients pay right then and there, no biller works out the logistics. With baby boomers aging, health care in the spotlight of the government and EHRs cropping up across the country, I don't think HIM professionals have anything to worry about when it comes to retail clinics sloughing off HIM jobs.
Overall, my first ever retail clinic experience was a good one. I take my antibiotic (which smells like Easter candy, strangely) twice a day, put in ear drops as needed for the pain and hopefully, I'll be feeling much better by the weekend, all for the bargain price of $40 plus my prescription co-pay, which I took out of my health savings account.
Have you visited a retail clinic? What's your take? Do you think these clinics will have any major implications for HIM?