Nursing News

Growth in Retail Clinics Seen as Boon for Nurse Practitioners

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By Megan M. Krischke, contributor 

August 24, 2012 - Retail clinics, those small health clinics often found in drug and grocery stores, have seen a tremendous increase in patient visits in recent years. In fact, patient visits doubled from 2007 to 2008 and doubled again from 2008 to 2009, according to a new study conducted by the RAND Corporation and published online in Health Affairs.  Although visits to retail clinics still make up a small portion of the overall outpatient market, researchers estimated there were nearly 6 million retail clinic visits in 2009 alone.

The clinics, which focus on acute episodic care and basic preventive services, attract patients because of their ease of access, their weekend and evening operating hours and their affordability. These clinics are also offering unique venues for nurse practitioners (NPs) to practice independently, at the full scope of their education and training, and to learn about the business side of health care.

Retail Clinics and Nurse Practitioners
Paulette Thabault, ANP-BC, JD, sees retail clinics and the NPs who work in them as an essential part of meeting the increasing demand for health care services.

“I think the issues of access, cost and quality of health care are significant dilemmas we have in our country and they provide opportunities for CVS to pursue our mission of helping people on their path to better health,” remarked Paulette Thabault, ANP-BC, JD, chief nurse practitioner officer for MinuteClinic at CVS Caremark. “Our aim is not to replace the primary care medical home, but to support it and provide affordable access to health care at a time patients need it--when they are sick.”

CVS currently has 600 MinuteClinics in 25 states and Washington D.C. and is adding approximately 100 clinics a year.

“In a retail health setting, NPs work autonomously, individually assessing patients for whatever illness they come in for or providing immunizations or physicals,” she explained. “Many NPs find it professionally rewarding to work autonomously.”

“Retail clinics provide an opportunity for NPs to practice to the highest extent of their education and training,” remarked Susan M. Cooley, PhD, RN, CPNP, vice president of clinical services for Texas-based RediClinic. “The market is primary care, so family practice NPs, along with some physician assistants, are who we hire.”

“Nurses are very well suited to doing this job because they are expert case managers,” Cooley explained. “Our entire nurse training teaches us is to look at the whole patient. A patient may come in for an earache but they may also have other health care needs that need to be addressed and that is where NPs really do a good job of seeing the whole picture.”

Retail Clinics and Nurse Practitioners
Susan Cooley, PhD, RN, CPNP, says that retail clinics offer NPs the opportunity to practice to the full extent of their training.

“The research shows that about 70 percent of patients we see say they don’t have a primary care provider (PCP),” Cooley continued. “In many cases, we are considered by the patients as their PCP. Because of this we try to make sure they have what they need prevention-wise--offering referrals for services such as colonoscopies and mammograms.”

RediClinic, the largest independent retail health operator, has partnered with a grocery story chain to provide 30 clinics in Houston, Austin and San Antonio, Texas.

Both MinuteClinics and RediClinics offer patients who do not have a PCP a list of PCPs who are accepting new patients. The staff at MinuteClinics also make of point of contacting patients who come in with an illness 48 to 72 hours after their appointment to make sure that they are getting better and that they are following through with any referrals the clinician made.

“Before retail clinics, if someone had an after-hours medical need, their only choices were to go to urgent care or the ER.  One significant benefit of retail clinics is not only can they charge less because of diminished overhead, but the patients know when they walk in how much the visit will cost them,” explained Cooley.

MinuteClinics has established partnerships with schools of nursing across the country to provide clinical precepting experience to student nurses in NP programs, giving them the opportunity to experience practicing in the retail setting.

“There is a shortage of PCPs, and NPs are part of the solution for bringing health care to people who don’t currently have access. NPs working in a retail setting will be an important access point,” stated Thabault. “It is an exciting opportunity to develop an innovative career path as we see the number of clinics and the services they offer expand.”

Cooley sees working for RediClinic as a unique learning opportunity for NPs.

“We are very transparent with all of our employees so it is a great place to learn not only clinical medicine, but also about entrepreneurship and building a business,” she said. “We share our financials with our employees and encourage them to think about growing the business. They know how much money their clinic is bringing in, how many patients they have seen and they help with marketing.It is a great way to learn the business of medicine,” she said. “Clinicians that are most successful are the ones who go out and meet people. If you don’t have a patient you might as well be talking to people standing in the checkout line and telling them about the services the clinic offers.”

For more information about retail health, visit the industry’s professional organization, Convenient Care Association.



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