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Old 11-24-2009, 08:20 PM
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Default Retail Clinic Medical Care, Here to Stay?

The first in-store medical convenient care clinic (retail health clinic) was opened in the metropolitan St. Paul/Minneapolis area in 2000. Since that time, the number of companies providing this new form of quick, inexpensive, and convenient healthcare has rapidly increased.

Usually staffed by nurse practitioners (NPs), the clinics do not claim to provide comprehensive primary care but offer a limited menu of nonemergent screening and routine treatment services. Common conditions that are treated include allergic reactions, upper respiratory infections, rhinitis, sinusitis, bronchitis, strep throat, otitis media, influenza, insect bites, urinary tract infections, and conjunctivitis. Patients use the clinics for routine immunization; pregnancy testing; school, sports, or work-related physical examinations; and preventive health screening for diabetes, tuberculosis, and hypertension. The healthcare providers use their clinical judgment to diagnose common acute health problems, order diagnostic tests, prescribe medications, and refer patients needing additional care.


Findings:
  • 62% of the respondents indicated that they learned about the MediMin clinics either from a sign at the store or from a friend.
  • Patients chose to obtain healthcare at a MediMin clinic because of convenient location, no appointment necessary, short waiting times, low cost, and friendly competent care. Only 13% of patients selected MediMin because of the presence of a pharmacy.
  • If they had not come to the clinic, 40% of respondents said they would have waited to see their doctor, 35% said they would have sought care at an urgent care center, 16% would have visited an emergency room, and 12% would not have sought care.
  • 96% of respondents said they did not have to wait at all or waited less time than expected; 67% did not wait at all.
  • 95% of respondents indicated that they were very satisfied or satisfied with the MediMin experience.
  • 67% of those who responded in Spanish indicated that they always shopped at the host store, whereas only 21%-23% of those who responded in English indicated that they always shopped at the host store.
  • 98% of respondents who visited the clinics said they would visit MediMin again for healthcare needs.
The researchers found that clients with varied incomes and different ethnicities valued the same attributes of retail health clinic care that are valued in other research studies on this topic: convenient location, no appointment necessary, short wait time, and low cost.
The high degree of patient satisfaction with retail clinic healthcare suggests that this type of entrepreneurial primary healthcare is meeting the needs of individuals. These clinics will likely continue or increase in number. Retail health clinics might be a viable source of employment for NPs.

Retail health clinics seem to be here to stay. As a "disruptive innovation" (a change in the way something is typically done that is well received and creates new markets), retail clinics survive because they meet the needs of the public. That they are dominated by NP and physician assistant healthcare providers is an added testimony to the effectiveness of this group of providers. For NPs in particular, who see their roles very much as health educators, these clinics allow them to do what they have always done well: teaching, counseling, and advocating. Although other segments of the healthcare professions may try to emulate these clinics, NP-driven clinics in convenient locations seem likely to continue.

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Old 11-24-2009, 08:24 PM
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My family has used the MinuteClinic at CVS or as I call them "the doc in the box" two times. I have not been at all pleased with the care or the practioner. Maybe I just need to try a different location.

I did take my Dad one Sunday to the one at Walgreens and they refused to see an 83 year old man with a fever. I think that was smart. The NP said he wasn't as qualified as the ER when it came to the elderly with a fever. Dad hadn't wanted to go to the ER but after that he did. I was impressed with that NP.
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Old 11-24-2009, 08:55 PM
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Our occ health NP just left about a month ago to staff a Kroger clinic closer to her home. I would see her in a heartbeat. She was always spot on, though, in her diagnostics for the occ health clinic, well schooled and you could read her writing (and sometimes her mind--I always knew where she was coming from). SO I probably would use her clinic.....otherwise I am skeptical.
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Old 11-24-2009, 10:42 PM
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You'd better have insurance and/or money. They wouldn't help me when I was uninsured.
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Old 11-25-2009, 06:59 AM
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I've used whatever it is Walgreen's is calling their clinics. I had a horrendous case of bilateral pinkeye, and I probably would have ripped my eyes out had I had to wait for an appointment. I thought the NP was thorough, maybe a little too much so, even checking for abrasion/ulcer (in both eyes? really?)
The cost was around 80 bucks, which is important to a healthy gal like me with a high insurance deductible. I would use it again for a minor issue like that, but when I had that fun with the recurrent bronchitis last year, I used a traditional urgent care clinic/occ health clinic...I was concerned about PNA, and I didn't want to have to be seen (and pay) twice.
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Old 11-25-2009, 09:10 AM
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I've been to the CVS Minute Clinic twice. Both times upper respiratory infections which both times were diagnosed as a "virus"

The first time I ended up in the ER the next day (Sunday) with pneumonia and the second time ended up at the doctors the following day (Monday) with a severe sinus infection. I'm not the type who wants antibiotics for the sniffles. I despise taking antibiotics and avoid them like the plague. I explained that and the fact that I know when I need them or wouldn't have come to the clinic in the first place but that was totally discounted. My dd went once and had the same experience. I don't remember what she went for but was told it was nothing. Then went to the doctor and it was something. I'll try Walgreens if I ever have to go again. It's a great idea if you can find a good NP.
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Old 11-25-2009, 09:14 AM
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Quote:
Originally Posted by Poliopioneer View Post
You'd better have insurance and/or money. They wouldn't help me when I was uninsured.
There's many people here that go because they do not have insurance and can't afford the ER or walk-in-clinic. I think the charge is $79.00. But I mean what can they do? If you have high BP they're not going to treat you, if you have diabetes, they're not going to treat you, etc...I think very simple maladies are the only things they are willing to treat such as pink eye, in other words, obvious conditions that you and I could treat could we write a script.
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Old 11-25-2009, 10:59 AM
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We don't have any of these type of clinics where I live. I think it is a decent idea.

I went to a new urgent care for likely strep about 1 month ago and it was a joke. This urgent care prided themselves on speed and I guess it showed. A PA came in listened to right lower lobe and left upper lobe, wrote me a script for Augmentin and left. He was literally in there 3-4 minutes and they charged .00 to my insurance after I paid 15 dollars. My other urgent care experiences were really good although I always saw a doctor.

Yeah get the flamethrowers out but I only want to see a DO. We have an awesome DO school in our state--every doctor I have seen from there has been great. MDs have been about half/half in my experience. PA and NP probably about the same.
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Old 11-25-2009, 11:10 AM
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The doctor I go to is a DO. I don't know that I understand what the difference is? Having worked with him in the hospital for years I never saw any difference other than the staff couldn't stand him, I was always the only one who got along with him and they always put me up to calling him with problems. He is what I consider a real doctor in the fact that he really cares about his patients and they love him. He gives out his cell phone number to patients so they can call him directly and my favorite thing about him is that he absolutely insists that the girls in his office only refer to themselves as medical assistants. The are wonderful MA's, everyone in the office is polite and does what they say they will do. A real rarity. The last doctor I went to was great but his office was a "nightmare" and he didn't care so I said toot-a-loo!
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Old 11-25-2009, 11:39 AM
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Flamethrowers, Noryn?
Maybe if the forum were "Just us MDs."
I don't think there's anything wrong with having a preference regarding a specific clinician. Your right and option as a patient. Hell, my (crunchy, tree hugging, granola eating RN who should KNOW better) big sis uses a Naturopath for her primary care.
Find the care that meets your needs and wants. Anyone who doesn't like it can find their own damn doctah.
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