Nurse practitioner Denise Snyder likes to think of Gainesville's new MinuteClinic as a one-room schoolhouse. It has just about everything you'd find at a doctor's office: blood pressure cuffs, flu vaccines, strep tests, an eyesight chart, and even a stack of toothbrushes for people with strep throat, since they are supposed to use a different toothbrush within 24 hours of taking antibiotics.
The one-stop clinic -- Gainesville's first MinuteClinic -- opened two weeks ago inside the CVS at 3404 SW Archer Road, and another one will open next month in the CVS at 4354 NW 23rd Ave.
The clinics, numbering more than 600 in the U.S., specialize in treating minor illnesses and injuries, monitoring chronic conditions such as diabetes and high blood pressure, and doing routine physicals and vaccinations. Their intent is to fulfill a need in between an urgent care clinic and a primary-care doctor's office.
MinuteClinic is one of a few local clinics that in the dawn of health-care reforms is set to make health care more accessible. The University of Florida and Shands opened a Family Medicine Clinic at Jonesville on Nov. 1, which covers preventive care, immunizations, sports physicals, women's care and pediatric and adult care. And an Alachua County Health Department (ACHD) clinic will open next summer off Southwest 24th Avenue in southwest Gainesville to serve disadvantaged patients, the ACHD announced Tuesday.
Snyder, who is MinuteClinic clinical practice manager for Northwest Florida and Gainesville, said the goal of MinuteClinic is not to replace primary care practices but rather "to be an extension of that."
"We're out in the community and very accessible for minor conditions and basic care," added Dr. Nancy Gagliano, the medical director of MinuteClinic, which is a subsidiary of CVS and headquartered in Woonsocket, R.I.
"With health reform and just the general shortage of primary-care physicians, the country needs to be innovative at finding patients affordable care," said Gagliano.
Minor illness visits cost $79, and flu and strep tests $30. Overall services are estimated to cost 80 percent less than they do at the ER and 40-50 percent less than they do at primary-care clinics. MinuteClinic accepts most major insurance plans. According to some estimates, retail health clinics such as MinuteClinic, which launched in 2000, could reduce health-care costs by $350 million by 2020.
The clinic is mostly staffed by nurse practitioners, and because of that has a holistic approach to treatment, explained Tracie Mitchem-Green, a nurse practitioner at the Gainesville clinic. "We don't just throw a medicine at it. We're very evidence-based," she said, adding that if someone comes in who's had a cold for a day and wants antibiotics, they won't necessarily prescribe one. "We're all about educating patients."
An "Ask Me 3" brochure that patients get has three questions that patients should ask when they come in: What is the problem? What do patients need to do about it? Why is it important for them to follow through with treatments?
"We don't just give them a Z-pac and send them out the door," Snyder added. "If it's a virus, the body has to heal."
The clinics' location inside a CVS store is convenient -- since nurses can show people which medications to buy from an often overwhelming plethora of choices, said Snyder.
Since the clinic opened, Mitchem-Green has had a lot of patients with sore throats. That's why Kyle Johnstone wandered into the CVS where the MinuteClinic is on Tuesday. He was looking for cough syrup for his sore throat, which developed after he spent the weekend with a nephew who had strep throat. Johnstone said he couldn't get into his primary-care physician for another two weeks, so he decided to wait 20 minutes to be seen at the MinuteClinic instead.
The pharmaceutical representative squeezed in the visit between work appointments. "If I'm walking into a lot of offices, I don't want to spread germs," said Johnstone.
Kimberly Greenwood, a nursing student, also came to the clinic Tuesday with a sore throat and discovered she had an upper respiratory virus, so she stocked up on some Sudafed and was headed home after being seen.
A native of Ohio, Greenwood had been going to MinuteClinic there for several years. "If you're a student and constantly moving around, it's a really good thing to have," said Greenwood, adding, "I don't want to go to urgent care clinics and take care from people who need it."
And that's precisely MinuteClinic's mission. "We can free up the primary-care physician a little bit to take care of more patients and sicker patients," Gagliano said, adding that the clinics are convenient for people to stay on top of regulating their glucose or blood pressure. "With the aging of the population, there's just more care people are going to need ... this is almost a safety net in the community."
The ACHD clinic aims to be a safety net as well, in Gainesville's southwest neighborhoods. "We know that the area has tremendous unmet needs," said Diane D'imperio, director of program development at the ACHD. The area, known as the "southwest triangle," has the county's highest concentration of Medicaid births and babies of low birth weight. It also reports the highest number of ER visits per capita.
"We think (the clinic) will make a huge difference both in terms of reducing ER visits and improving overall health," said D'imperio.
One of the clinic's partners is SWAG, the Southwest Advocacy Group, which is right across the street from where the clinic will be. SWAG provides educational, health and community resources to people in the area.
"Having the SWAG clinic there is an automatic outreach," said D'imperio. "People might come there looking for food or clothes...the staff there will really be able to encourage people to come. They'll be able to function like an advisory group."