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ADVANCE Voice: NP

Jumping on the Retail Health Bandwagon

Published January 29, 2008 11:02 AM by Jennifer Ford

Retail health clinics, and NPs staffing them, provide convenient, affordable health care, even for the uninsured. But it's been common lately to see health insurance companies covering services in retail health clinics. Most retail clincs work with insurance providers so that patients can use their insurance and pay only their regular office-visit copay. "All the major health insurers have contracts with our members," says Tine Hansen-Turton, executive director of the Convenient Care Association. Among the insurance companies who offer coverage at clinics are CIGNA, Aetna, BlueCross BlueShield, Humana, and UnitedHealth Group. And these providers are continually expanding their networks to include many of the growing retail clinic chains. CIGNA, for example, recently added The Little Clinic (located in Kroger and Publix stores in Kentucky, Florida, Georgia, Ohio, Arizona and Tennessee) to its network, which includes MinuteClinic, RediClinic, and Take Care Health Systems.  

Insurance providers and hospitals, recognizing the benefit of these clinics to the public and the health care industry, have begun opening their own clinics. CIGNA Medical Group owns its own retail clinics, called CMG CareToday, and the Mayo Clinic recently announced that it will be opening several clinics of its own in Wisconsin and Minnesota in 2008. This is good news for NPs, because as these clincs continue to open at a breakneck pace, new jobs are being created for NPs just as quickly. And the involvement of respected key players from the health care industry will promote the good work NPs do. 

4 comments

Ruth,

I'd like to offer you another perspective on your view of "...limit[ing] me essentially to sore throats and runny noses."

There are thousands of NP's that have selected a specific specialization of practice and are fine with that. For example, do you think that FNP's practicing at a Planned Parenthood have limited their scope of practice to "only" women's health? Would you consider this pigeon-holing? Other examples of NP specialized practice include pain management, coumadin clincis, critical care, etc. Retail clinics are focused on high-quality evaluation and treatment of routine episodic illnesses. I see no difference in this than any other specialty.

One of the most important things that I see for NP's practicing in retail clinics is the chance to interact with thousands upon thousands of potential patients/customers/consumers of healthcare and educating them on the NP role. There is no other setting where one has the potential to reach as many people to spread the word about NP-driven care than in the retail setting. We all know that patients are sold on NP-driven care once they have the opportunity to experience it.

In addition, retail clinics offer NP's the chance to pursue a career ladder as there are many management/recruiting/leadership opportunities.  

I'll admit, retail-clinics aren't suited for all NP's just as all NP's aren't suited for these clinics. I just can't understand why some may take that same "limiting" view as to the benefit of the clinics, our profession and our patients.  

Stephen Ferrara, FNP February 17, 2008 1:20 PM
NY

Mr. Marks is missing the point.  Our focus in the nursing profession is to reach the community and open the portals for entry into the healthcare system.  Retail clinics offer an opportunity for the uninsured to be educated on health and wellness, get care for minor health problems that they may not otherwise receive, and be "plugged into" community resources to help them with their medical problems.  So many patients I have treated either cannot afford a doctor visit or end up in the ER for minor, easily treated illnesses because they know they won't be turned away. I have had many patients who are simply intimidated by the medical community, who will come to our clinic because we are so easily approachable.  Our patients do not look at us as "merely midlevel providers".  Instead, they tell us every day how glad they are that we're here and how much more we have taught them than they have learned through their own doctors.  My patients lead me to believe that we are, indeed, promoting our profession in a positive light, and more importantly, we are giving them the care they need and deserve.

Becky, family - ARNP, The Little Cliinic February 9, 2008 10:15 AM
Louisville KY

  The first time I heard of clinics in grocery stores and drug stores I was horrified.  How could any NP think about reducing their scope to cookbook low level decision-making??  I tried to educate myself about what it was really all about and keep an open mind after the initial shock wore off.  I agreed to talk to a recruiter who contacted me for this type of position and find out exactly what the role included.  

  I was so relieved to find the article written so well by Michael Marks, as all the information in your journal sounds like it was written by the ad campaign managers for Minute/Quick/etc clinics.  After I obtained factual information about the role of the NP in these clinic settings, I told her honestly I could not even think about taking a position that would limit me essentially to sore throats and runny noses.  Why would I spend so much time advancing my knowledge base and applying knowledge based on the experience of 40+years in the nursing profession only to have my ability to function reduced so badly??

  I came up through the diploma school program when doctors were never to be questioned, patients were not informed in order to participate in decisions affecting their lives, and the nursing role was incredibly limited.  On up through the BSN and finally the MSN and Family NP program, now with almost 10 years of NP experience, I am glad the NP role is continuing to expand.

  "The Front Page" portion of your latest journal cites a 1 year study at MinuteClinic with the amazing news of "exceptionally high quality care " from NP's and PA's treating patients with sore throat complaints.  What did they think they would find, and why do they give the majority of credit to the "clinical support tools" built into MinuteClinic EMS system?  The implication is NP's/PA's would not be able to decide if an antibiotic should or should not be given without this kind of help.

  I sincerely hope these clinics will evolve into a more expanded role for NP's who will be able to follow patients with hypertension/diabetes/CAD/PAD and other complex problems and do more of what we have learned to do so well.

Ruth Scott, Family - MSN, ARNP-BC February 7, 2008 10:19 PM
Auburndale FL

Mr. Michael Marks had a Back Page essay on retail clinics in the most recent issue of Advance For NPs. He complains that NPs staffing retail clinics are taking the profession backwards. I would submit that retail clinics are enabling NPs to provide care in a way that consumers seem to desire. NPs ought to be more concerned about meeting the healthcare needs of our communities than promoting the profession. We won't have to worry about the latter if we take care of the former.

Kevin Schaller February 5, 2008 4:42 PM
LaCrosse WI

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