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Real Life in Retail Health

Service Expansion in Retail Health

Published June 23, 2009 11:24 AM by Elizabeth Jones

Service expansion in retail health has created great concern for some members of the medical community. New service rollouts in retail health are not synonymous with new skill acquisition for nurse practitioners. Retail clinicians are highly trained nationally certified family nurse practitioners whose commendable evidence-based practice has been well established in the literature.

The convenient care model of health care delivery is primarily consumer driven which speaks volumes for the high quality and affordable services provided by retail health clinicians. Let's take a glance at the proposed new services ... infusion therapy for the treatment of postmenopausal osteoporosis is currently being piloted in some retail health clinics. These medications are safe efficacious treatments that are proven to improve patient outcomes and are commonly administered by nurses in various outpatient settings.

Common office dermatological procedures such as wart and skin tag removal using approved portable cryosurgical techniques are also proposed new service soon to be rolled out in the retail health setting. These simple low risk procedures are approved for administration by any licensed healthcare professional in outpatient settings.

Skin closure with topical skin adhesives is another common outpatient procedure performed by healthcare professional including nurse practitioners. This method of skin closure is comparable to suturing and is best suitable for small superficial lacerations. Again, the procedure is of low complexity, commonly used by many licensed healthcare professional and is preferred over suturing by patients especially children.

Now, let's take a closer look at the proposed new service roll outs for retail health. They have all been approved by the FDA as safe highly effective alternative methods of treatment in outpatient settings, they are preferred over traditional methods by most patients which means that there is a high demand for the service. Why not give patients what they want in a convenient affordable setting? Coincidently, they are all "procedures" that are reimbursed by most commercial insurers ... could this be the real basis of concern? Surely not ... so I'll dismiss that thought...

1 comments

As a NP in  retail health (have been employed with a major retail health provider since 2005)I have some major concerns about adding new services just "because the consumer wants it".  The consumer wants a lot of things, not all, necessarily are good for them.  And yes I know that NPs are more than qualified to provide some of the soon-to-be launched new services, but are they services we should be providing in retail health?  I'm not so sure.

For example, one of the new services the company I work for is launching is asthma.  While on the surface, seems simple enough.  But as an old ER nurse, I know how fast a simple visit for asthma can go "bad" in a hurry.  We will be administering breathing treatments, is this a good idea in retail setting?       What if after several treatments, the patient doesn't "clear", when working in the ER that was an automatic "admission" and treatment with IV steroids.

Some of these new "proposed" services typically take longer then the advertised "average 15 min. visit time".  Are we doing our other customers any favors by adding services that can take an average of 25-30 min?

Let's not lose sight of what it was that was the driving force behind the "retail health clinic".  We cannot and should not strive to provide services that are more appropriately treated in primary care.

name omitted June 24, 2009 1:28 PM

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