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ADVANCE Voice: NP

Retail Clinic Strategery

Published October 26, 2007 8:22 AM by Jill Rollet
 

Opening my Providence (Rhode Island) Journal this morning (OK, online), I saw yet another report on physician objections to retail or convenient care clinics. The same article, but with different names, has been showing up about once a week somewhere in the country for the past 3 years.

The article always cites physician charges that NPs aren't capable of treating the range of conditions that might present in the clinics. A variation of the following is always the clinics' response:

"The nurse practitioner, guided by a checklist, diagnoses and treats a limited menu of simple health problems, such as sore throats, urinary tract infections, ear infections, and rashes. ... If the problem looks serious or complicated, the patient is referred elsewhere."

I've always wondered whether this is the best strategy for answering the objection. I understand that it's a quick and easy answer (and at least superficially true). But how about a response citing NPs' education and experience treating far more complicated conditions? Does the retail party line sell NPs short?

8 comments

I would like to comment about health care and the role of Advanced Nurse Practitioner in the retail setting. I have worked

serving the uninsured in a free clinic and now am employed as a ARNP in a clinic in retail drug store.  People come to  a retail clinic for a service that is not being answered by their Primary Care MD

and the convienence of the clinic.  Many people cannot afford to take off work to be SICK. Many that have insurance do not even know their provider because they cannot get in to see them

Dolores Martin, , ARNP Retail Clinic February 7, 2008 5:53 PM
Tampa FL

I am currently recruiting NPs for a convenient care center opening in a major retail chain in Cleveland, OH.  NPs in the this area are so happy to talk with us because they have been working 60-70 hours per week with no overtime, no career path and no autonomy.  My client's centers are offering great hours, opportunity for advancement and the chance to use their educations and experience!

Shelly Gross, Convenient Care - NP Recruiter December 3, 2007 4:25 PM
Cleveland OH

A few weeks ago I posted a blog entry opining that retail health clinics sell NPs short when they emphasize

November 28, 2007 8:59 AM

I am working in retail clinic, just opening in Houston.  I have 12 years experience, mostly in ED and love the opportunity to actually spend time with the patient, teaching and listening to them.  Everyone I've seen could not get into their physician's office, and greatly appreciated the quality of their care, the time the NP spent with them making sure they understand what the problem is and including them in the care process.  We accept most insurances, which they like and very reasonably priced for those without insurance.  This has opened up the market for NP's.  For years I've had to prove the usefullness of NPs and we are slowly making headway.  I agree with above statement, if MDs really want their patients to see them, make arrangements for open slots, bring in NP to assist in seeing work in patients.  The pay in retail clinics is good and improving and benefits are excellent.  I work autonomously and my collaborating physician spends 20% of his time in clinic reviewing charts, discussing care options and inservices.  I have a lot less stress and I LOVE IT!

Nancy, retail clinic - FNP-C, TakeCare Health November 13, 2007 10:28 AM
Houston TX

Quite frankly, MD objections to convenience clinics sounds like whining. It is time to put up or shut up. Either respond to your patients by anticipating seasonal visit increases with more flexible office hours and maintaining several daily 'work in' slots or move over and let willing NPs provide the care your patients need. Even the most loyal of patients will seek care elsewhere if their needs are not being met.

Wilma, FNP November 12, 2007 10:46 PM

I just had to add my 2 cents to this one.  Although I am not an NP yet,  one day I will be and this topic seems to be hot right now.  The topic of retail clinics is not going away too soon.  Where I work, a cardiology office, the NP there has recently interviewed for one such clinic that will be opening in town.  She told me they pay WAY more than the hospital she works at PRN on weekends and she keeps getting cancelled there.  She is excellent at what she does and inspires me!

The December 2007 issue of The Wall Street Journal Magazine: Smart Money comments on these clinics.  The article entitled "10 things your primary-care physician won't tell you" lists walk-up clinics as number 5.  It comments that there are 460 such clinics today with projections up to 4,000 by 2009.  If you can be in and out WITH prescription in your hand why not?  If they will come, build it, stock it and NP staff it!

Terri, MSN/NP student November 12, 2007 8:56 PM
Grafton OH

I have read the articles about the new convenient clinics and the descriptions of the type of patients who present for evaluation. I can appreciate the physicans attempt to minimize our knowledge base and ability to assess patients, intergrate the findings and come up with a plan. Those physicans who make these concepts do not work with a np in a collaborative role nor are they comfortable with their role. I have worked in an emergency room setting for many years in a collaborative setting. I see patients who range in various levels of acuity. I would not have any expectation that some MD's are threatened by this new concept. Perhaps it is a financial issue?

stephanie, er - family nurse practitioner, Multiple Emegency departments November 9, 2007 1:07 PM
suffolk, norfolk, virgina beach VA

I happen to be an FNP who works at one of those retail clinics, I am not sure how to answer the objections to our practice other than we are providing a much needed service, customers love the concept, and we are not practicing rocket science (but it still takes skill to recognize when it is something other than what we can treat. We also practice evidence based medicine, our collaborative MDs are constantly reviewing our note for QA. %0d%0aSo what is the real issue with the MDs? Is it money? are they afraid we are taking business from them? there are many days when I have done mor referring out than actually treating patients. One last thing Dr. Oz was on XM radio this week fully supporting the retail medicine industry!!! One for us.

Sharon October 27, 2007 12:03 PM

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