Go ahead and shop ‘till you drop. There’s a growing chance that there’s a doctor in the mall, or at least a Nurse Practitioner. The first Convenient Care Clinic (CCC) opened in 2000. Now there are over 200 of these small clinics located inside pharmacies and busy retail outlets like Wal-Mart. They are open to walk-in patients seven days a week, and boast extended hours. Most are busiest at lunchtime, in the evenings and on the weekends, suggesting that people really are using them at their convenience. Compare that to the typical weeklong wait for an appointment at the family doctor’s office.
CCCs aim to provide convenient, affordable care for a limited range of common ailments, such as colds or flu, minor burns or rashes, sprains, headache, ear infections, allergies and urinary tract infections. They also provide preventative care, including physicals, immunizations, and health screens. Besides the convenience of location, CCCs try to keep waiting times mercifully short and prices low. Treatment at one of these clinics costs from $40-70, plus any tests or immunizations. That can be half the price of a visit to the family doctor, and one-sixth the cost of going to an emergency room. Many insurance plans, as well as Medicare, will accept charges from a CCC, so that patients need only come up with their co-pay.
Costs are kept down in part by offering a streamlined menu of services, which in turn allows them to employ practitioners with less training (and lower salaries) than physicians. Most CCCs are staffed by Nurse Practitioners (NPs) or Physician Assistants (PAs). You may have noticed more of these around in traditional clinics and hospitals as well. An NP is a registered nurse who has advanced training and education (usually a master’s or doctoral degree in nursing), and is thus able to provide a broader range of health services. PAs are licensed to practice medicine under the supervision of a physician (who does not necessarily have to be on site). They typically have a bachelor’s degree in medicine. These health professionals are trained to deal with many ordinary health issues, and to refer to others with more advanced training when appropriate. They can diagnose and prescribe medications within the limits of their scope of practice. Patients seem to be pleased with the quality of service provided by these health care professionals.
If the expansion plans of the CCC chains are anything to go by, the clinics are a hit. The American College of Nurse Practitioners has registered its support of the convenient care industry. In fact, it seems remarkable that the pent-up demand for basic health services has not burst over the dam of limited availability before. But unsurprisingly, not everyone is pleased with the trend. Opposition to the CCCs is based on the possibility that their patients will receive lower quality care, or that the services rendered will not be integrated with the rest of the health care system (CCC patients are given a copy of their records when their visit is completed so that it is available to other providers). There is also concern that NPs are not qualified to work without direct supervision by a physician. The American Academy of Family Physicians, American Medical Association and American Academy of Pediatrics, are lobbying for increased regulation of the industry.
This is a common tactic of physician supported organizations to limit non-physician treatment options. Perhaps with enough regulation, CCCs can be made as inefficient and expensive as the physician-run clinics they are competing with. Clinicians need to have enough knowledge and training to know when referral to a more specialized expert is appropriate. One concern is that a less knowledgeable practitioner will miss a clue about a serious underlying disease. But that is true at any level in the medical field. Do we really need a physician with 6 years of training to treat an acute sprain? Does waiting several days to see the family doctor for a sore throat constitute quality care? When basic healthcare is provided more efficiently, the lower costs make it available to a wider range of patients, and can reduce insurance claims – the processing of which leads to even higher treatment costs.
Healthcare Economist author Jason Shafrin writes that “Many studies have claimed that Nurse Practitioners (NPs)–as well as Physician Assistants (PAs)–are adequate substitutes for primary care physicians. Researchers claim that NPs can perform a great majority of the tasks currently carried out by primary care physicians, and should be used more frequently since NP and PA salaries are usually half of primary care physicians.”
Despite the concerns of the traditional medical and insurance industries, it appears that CCCs do not increase the overall demand for services. Instead, they make appropriate care more easily available to more people at more affordable prices. This has been the model followed by chiropractors, acupuncturists, physical therapists and other independent health care professionals for years. There are shortages of family practitioners in America, especially in rural areas. Apparently, family practice holds little allure anymore for medical school graduates, compared to more prestigious and better paying specialties. So be it. But it is time then, to let other willing and qualified practitioners address the common health needs of patients in a way that is accessible and affordable.
Go ahead and shop ‘till you drop. There’s a growing chance that there’s a doctor in the mall, or at least a Nurse Practitioner. The first Convenient Care Clinic (CCC) opened in 2000. Now there are over 200 of these small clinics located inside pharmacies and busy retail outlets like Wal-Mart. They are open to walk-in patients seven days a week, and boast extended hours. Most are busiest at lunchtime, in the evenings and on the weekends, suggesting that people really are using them at their convenience. Compare that to the typical weeklong wait for an appointment at the family doctor’s office.
CCCs aim to provide convenient, affordable care for a limited range of common ailments, such as colds or flu, minor burns or rashes, sprains, headache, ear infections, allergies and urinary tract infections. They also provide preventative care, including physicals, immunizations, and health screens. Besides the convenience of location, CCCs try to keep waiting times mercifully short and prices low. Treatment at one of these clinics costs from $40-70, plus any tests or immunizations. That can be half the price of a visit to the family doctor, and one-sixth the cost of going to an emergency room. Many insurance plans, as well as Medicare, will accept charges from a CCC, so that patients need only come up with their co-pay.
Costs are kept down in part by offering a streamlined menu of services, which in turn allows them to employ practitioners with less training (and lower salaries) than physicians. Most CCCs are staffed by Nurse Practitioners (NPs) or Physician Assistants (PAs). You may have noticed more of these around in traditional clinics and hospitals as well. An NP is a registered nurse who has advanced training and education (usually a master’s or doctoral degree in nursing), and is thus able to provide a broader range of health services. PAs are licensed to practice medicine under the supervision of a physician (who does not necessarily have to be on site). They typically have a bachelor’s degree in medicine. These health professionals are trained to deal with many ordinary health issues, and to refer to others with more advanced training when appropriate. They can diagnose and prescribe medications within the limits of their scope of practice. Patients seem to be pleased with the quality of service provided by these health care professionals.
If the expansion plans of the CCC chains are anything to go by, the clinics are a hit. The American College of Nurse Practitioners has registered its support of the convenient care industry. In fact, it seems remarkable that the pent-up demand for basic health services has not burst over the dam of limited availability before. But unsurprisingly, not everyone is pleased with the trend. Opposition to the CCCs is based on the possibility that their patients will receive lower quality care, or that the services rendered will not be integrated with the rest of the health care system (CCC patients are given a copy of their records when their visit is completed so that it is available to other providers). There is also concern that NPs are not qualified to work without direct supervision by a physician. The American Academy of Family Physicians, American Medical Association and American Academy of Pediatrics, are lobbying for increased regulation of the industry.
This is a common tactic of physician supported organizations to limit non-physician treatment options. Perhaps with enough regulation, CCCs can be made as inefficient and expensive as the physician-run clinics they are competing with. Clinicians need to have enough knowledge and training to know when referral to a more specialized expert is appropriate. One concern is that a less knowledgeable practitioner will miss a clue about a serious underlying disease. But that is true at any level in the medical field. Do we really need a physician with 6 years of training to treat an acute sprain? Does waiting several days to see the family doctor for a sore throat constitute quality care? When basic healthcare is provided more efficiently, the lower costs make it available to a wider range of patients, and can reduce insurance claims – the processing of which leads to even higher treatment costs.
Healthcare Economist author Jason Shafrin writes that “Many studies have claimed that Nurse Practitioners (NPs)–as well as Physician Assistants (PAs)–are adequate substitutes for primary care physicians. Researchers claim that NPs can perform a great majority of the tasks currently carried out by primary care physicians, and should be used more frequently since NP and PA salaries are usually half of primary care physicians.”
Despite the concerns of the traditional medical and insurance industries, it appears that CCCs do not increase the overall demand for services. Instead, they make appropriate care more easily available to more people at more affordable prices. This has been the model followed by chiropractors, acupuncturists, physical therapists and other independent health care professionals for years. There are shortages of family practitioners in America, especially in rural areas. Apparently, family practice holds little allure anymore for medical school graduates, compared to more prestigious and better paying specialties. So be it. But it is time then, to let other willing and qualified practitioners address the common health needs of patients in a way that is accessible and affordable.