How will the 300 Minute Clinics in 2007 impact current medical practice?
According to a Reuter's report, CVS plans to open 300 new Minute Clinics in 2007.
Is this going to change the way doctor's offices fundamentally do business? In the long-term, I think so, because right now they can't compete with retail convenience. In multi-doc office, I expect to see doctor/NP/PA scheduling altering to have a more or less constant presence in the office. This will be particularly true with NPs and PAs who can handle more immediate issues — the things that will be diagnosed at Minute Clinics.
There's been lots of talk in the medical blogging community about how Minute Clinics are "bad" in the sense that a patient's medical history will be spread out over multiple locations. That the treatment prescribed by the NP at the Minute Clinic will be sub-par, or not what one's PCP would have chosen. These are valid complaints, so I expect to see doctors respond in the areas where Minute Clinic density is higher.
You don't need a large medical practice to cover a lot of hours. Lots of hours = lots of availability. Sure it's not as nice as a 7-7 medical practice, but it IS more convenient for the patients/customers. And it has unexpected benefits as well — 3 days weekends once a month and the like are not uncommon for pharmacists.
Realistically, a moderately-sized medical practice (3 docs, say) could easily cover 72 hours of availability per week. 8am-8pm Monday through Friday, and 9am-3pm on Saturday and Sunday. Start with one doctor in the morning, have the second come in later in the day, say around 11am or noon, and doctor #1 goes home around 4-5pm while his/her colleague stays until late. This is what retail pharmacists do, and I expect you'll see variations on this theme for doctors once they start feeling the pressure from retail clinician availability. Get an NP or a PA to see the urgent cases, and I think you could probably cut down on ER overuse in your area.
Are there problems? Yes. Are the insurmountable? No. Will it happen in the next five years? Probably. Think about it. 300 Minute Clinics in 2007 alone. If they become big hits, expect to see that number grow yearly. That's a lot of Minute Clinics. That's a lot of lost, easy revenue.*
*I think it was Flea(?) who said that these types of visits are the bread and butter of pediatricians because they're fast and easy. These are the types of visitors the Minute Clinics are catering to.
[tags]Medicine, pharmacy, CVS, Minute Clinic, retail medicine[/tags]
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I am not certain who wrote the aforementioned comment regarding the Reuters report, but I do take issue with some of statements. The reality of the health-care world in which we practice is such that NPs and PAs are currently seeing many complicated presentations in the office setting, along with the "fast and easy" presentations (much could be said about this conclusion also…another time perhaps). This is all with the blessing of the physicians in the office who collect a percentage of the billing after salary expenses/overhead costs for the NP or PA.
To now say that the care provided will be "sub-par" if provided by a NP is questionable at best. One is led to ask why is the NP an appropriate provider in the office setting (and those of us in practice know there is no physician involvement in the evaluation/treatment of nearly all patients…often the physician is not present) but a "sub-par" provider in another practice setting?
It seems many of these concerns regarding patient care are really smoke-screens for FINANCIAL concerns. Numerous studies have now documented that treatment provided by a Nurse Practitioner in no way comprises patient care. In fact, in some instances, it has been found to have more favorable outcomes.
Comment by Helen Featherston ARNP — May 3, 2007 @ 5:50 pm
[...] time I post about MinuteClinics here at OTP, because I think I've said enough already. I had mixed feelings on the concept of one-stop medical shopping so to speak, but some time has gone by, and my opinions [...]
Pingback by A final note on MinuteClinics :: OnThePharm — May 6, 2007 @ 1:01 pm
The answers for physicians will be quite simple and MeD thru within their offices will show that shortly. A patent pending on the easy scheduling system and more credible and visible than Ketchup Aisle medicine. Yes, the doctors can open these quickly and thousands of outlets are possible with very little build-out. Continuity of care is not the issue, and volume is not a problem as Retail has issues. The patients are loyal and the doctors have the patient charts. The service will be launched to and for physicians and I would not worry about the retail medicine chains no matter what the PR. Urgent care is at risk.
Dr. David B. Foy
President of MeD thru
Comment by Dr. Foy — June 26, 2007 @ 10:01 am
The comments above are inaccurate. I have many patients that use Minute Clinic and my profits have not decreased. They have increased because of referrals. The company has gone to great lengths to ensure best practice standards. My schedule is often extremely full and scheduling is difficult. The majority of care is covered by the patients insurance. I always receive a copy of the note and the patients are referred back to me for follow up. I’ve also received referrals from the clinics when a patient does not have a primary care physician. We as physicians let our ego get in the way. We need to be more focused on access and what is best for the patient.
Comment by Dr.. john — September 27, 2007 @ 12:32 pm
Thanks for your comments. I'm glad to hear they're not cutting into your business. Now if only the Ivory Tower types would get this into their heads…
Comment by RJS — September 27, 2007 @ 5:47 pm
I HAVE VISITED THE MINUTE CLINIC IN MY HOME TOWN 4 TIMES NOW, ALL FOR SINUS OR SORE THROAT ISSUES. I CONSIDER MYSELF LUCKY THAT I HAVE HEALTH INSURANCE AND ALSO HAVE A PRIMARY PHYSICIAN. MY INSURANCE COMPANY RECENTLY SENT OUT INFORMATION ON THE MINUTE CLINICS AND HOW ITS MORE COST EFFECTIVE THAN A DOCTORS OFFICE VISIT. THREE OF MY FOUR VISITS WERE PLEASANT AND FAST. HOWEVER MY LAST VISIT WAS VERY DISAPPOINTING. THE NURSE PRACTIONER WAS RUDE AND VERY UNPROFESSIONAL. I LEFT FEELING WORSE THAN I WENT IN AND AFTER SEEING THAT $100.00 WAS BEING BILLED TO MY INSURANCE COMPANY FOR NO SERVICE AND ACTUALLY HORRIBLE SERVICE, I NOW HAVE TO MAKE AN APPOINTMENT TO SEE MY PRIMARY PHYSICIAN AND THIS IS JUST MORE OF A WASTE OF MY TIME AND MY INSURANCE DOLLARS. THIS ONE EXPERIENCE WILL NOT DETER ME FROM GOING TO A MINUTE CLINIC AGAIN AS IT IS A COST EFFECTIVE CONVIENANT MEANS FOR A QUICK CHECK ON MINOR HEALTH ISSUES. THIS N/P MAY HAVE SUFFERED FROM THE SAME STRESS THAT YOUR FAST FOOD WORKERS FEEL AS THIS IS ALMOST EQUIVILIENT TO DRIVE THRU MEDICINE.
Comment by CHRIMICH — March 19, 2008 @ 10:32 am