Something Powerful

Tell The Reader More

The headline and subheader tells us what you're offering, and the form header closes the deal. Over here you can explain why your offer is so great it's worth filling out a form for.

Remember:

  • Bullets are great
  • For spelling out benefits and
  • Turning visitors into leads.

DiversityNursing Blog

New Clinics Fill a Niche for Routine Health Care

Posted by Alycia Sullivan

Fri, Nov 30, 2012 @ 03:10 PM

By Kristine Crane

minuteclinic

describe the imageNurse 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."

Topics: minute clinic, CVS, nurse practitioner

Nurse Practitioners Offer Effective, Low-Cost Care

Posted by Alycia Sullivan

Fri, Nov 30, 2012 @ 03:04 PM

Health care reform is one of the most significant public policy issues facing the United States. The debate frequently focuses on government policy and programs, often to the exclusion of non-government solutions. In this article, part of an occasional series, Sean Parnell reports and comments on how individual citizens, associations, and for-profit companies are solving health care problems through markets and voluntary action rather than government.

Getting access to health care can be difficult for many people, even for individuals or families with comprehensive health insurance. Doctors' offices are not always conveniently located, requiring a special trip to see the doctor. Many patients cannot see their doctors the same day, or even the same week, they call to schedule an appointment. And most patients are familiar with long waits in a reception area until their doctor can see them.

In addition, visiting a doctor for relatively minor symptoms or ailments can be expensive, even with comprehensive insurance coverage.

To address such concerns, nurse practitioners have begun to set up shop in locations more convenient for patients, typically a busy retail store like Target or CVS Pharmacy, or in a shopping center. These clinics offer a low-cost alternative to doctors' offices. No appointment is required.

Convenient for Minor Ailments

MinuteClinic, based in Minneapolis, is the biggest operator of these types of clinics, with 22 locations--15 in the Twin Cities area and another seven in Baltimore. FastCare operates two clinics in Louisville, Kentucky, both in Kroger's grocery stores. Other clinics with names like Quick Care and MEDspot also have opened, and further expansion is expected.

The nurse practitioners staffing these clinics have a four-year bachelor's degree in nursing as well as a two-year master's degree. A nurse practitioner is allowed by most states to prescribe medication and perform basic health care functions without direct supervision by a doctor.

At these clinics, nurse practitioners commonly treat such ailments as ear and eye infections, strep throat, allergies, bladder infections, and flu. They also administer vaccinations and perform routine screenings such as pregnancy and allergy tests.



Prices Low, No Waiting

Prices at clinics staffed by nurse practitioners are typically far less than what a doctor's office might charge. The average cost for a visit is roughly $38 at a FastCare clinic, according to an October 14, 2004 CBSMarketWatch.com article. MinuteClinic's Web site lists the cost of a visit at about $44.

The February 1, 2004 issue of Fortune magazine compared costs between MinuteClinic and local doctors for several common medical problems. Forbes reported an ear infection treated at MinuteClinic would be $44, while a visit to a doctor's office would typically cost about $85.

Lower cost is not the only advantage the nurse practitioner clinics offer. Their biggest advantage, according to many in the industry, is the minimal waiting times. There are no appointments: Patients simply walk in to the clinic and are seen almost immediately. The typical visit takes about 15 minutes.



Doctors Concerned

The arrival of clinics staffed by nurse practitioners has drawn mixed reaction from the medical community. Some doctors have expressed concern nurse practitioners will miss the signs of more serious illnesses that require attention from a physician or even a hospital.

Dr. Bob Hamilton, a retired general surgeon in Godfrey, Illinois, says nurse practitioners simply don't have the extensive medical training needed to identify and treat patients who may appear to have a simple condition but in fact are much sicker and need a doctor.

"Long years of medical training for doctors are spent learning the intricacies of human diseases and their management," said Hamilton. "The breadth of medicine can be almost overwhelming, but it's necessary to properly diagnose and treat patients. I'm afraid nurse practitioners simply don't have that needed training."



Nurses Well-Trained

MinuteClinic's Linda Hall Whitman disagrees. "The doctors expressing these concerns do not appear to be familiar with the depth of the extensive training, credentialing, and national certification required of nurse practitioners," she said.

"Every MinuteClinic patient assessment and treatment follows evidence-based clinical practice guidelines that are embedded in our electronic medical records system," noted Dr. James Woodburn, chief medical officer for MinuteClinic, in a company news release. "Individuals with illnesses outside our scope of services or who exhibit signs of a chronic condition are referred to their doctor or, if critical, the nearest emergency room."

Some critics are also concerned that competition from clinics run by nurse practitioners will affect the finances of physician practices. Lou Giancola, president and CEO of South County Hospital Healthcare System in Rhode Island, recently wrote in a column posted on its Web site, "MinuteClinics ... add to the financial strain already felt by hardworking practices."

Giancola continued, "MinuteClinics cannot provide the continuum of care that your family doctor can, but it can chip away at his or her ability to maintain a practice in this community."



Clinics 'Fill a Need'

Other doctors are more comfortable with the role these clinics play. Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons and an internist in Tucson, Arizona, sees a place in a market-driven health care system for standalone clinics run by nurse practitioners, although she has concerns about quality of care and the possibility that better-qualified doctors may be driven out of the market by lower-cost nurse practitioners.

"Things work well in a free market, so I'm fine with patients going to see a nurse practitioner," Orient said. "Some nurse practitioners are excellent and do a better job than a lot of doctors."

Linda Gorman, director of the Health Care Policy Center at the Independence Institute, a Colorado think tank, also supports the idea of independent nurse practitioner clinics. "These clinics fill a need for people who know what is wrong with them," Gorman said, although she also noted, "They aren't suitable for people with complex medical problems."

Gorman recounted the story of a friend, a teacher in a school in which nearly all of the students came down with pink eye. "Then the teacher's eyes turned pink. It was blindingly obvious that she, too, had pink eye. She was not happy having to pay $75 for a visit just to get the prescription. A nurse practitioner clinic would have been perfect for her."



Nearly All Patients Satisfied

Independent clinics run by nurse practitioners are unlikely to be a "silver bullet" for health care. As many doctors note, the training and experience of nurse practitioners is simply not equivalent to that of a doctor.

However, as Hall Whitman of MinuteClinic observes, treatment protocols at the company's clinics are reviewed and approved by physicians, and the clinics have a 99.9 percent patient satisfaction rate over four years of operation--treating more than 220,000 people. The firm never has been sued for malpractice, notes Whitman, which would seem to indicate its clinics are focused on ailments within their scope of care and are referring patients to doctors when more extensive diagnosis and treatment may be warranted.

Topics: cost effective, health care, nurse practitioner

Recent Jobs

Article or Blog Submissions

If you are interested in submitting content for our Blog, please ensure it fits the criteria below:
  • Relevant information for Nurses
  • Does NOT promote a product
  • Informative about Diversity, Inclusion & Cultural Competence

Agreement to publish on our DiversityNursing.com Blog is at our sole discretion.

Thank you

Subscribe to Email our eNewsletter

Recent Posts

Posts by Topic

see all