The emergence of the Convenient Care Clinic
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Image Gallery ( 8 images )April 4, 2007 An interesting development in the health system in the U.S. of recent times has been a new type of health facility that is beginning to pop-up at local drug stores, discount stores and various supermarkets. In the store's local pharmacy, many establishments have set up mini-clinics. Operating specifically in high-traffic retail outlets with accessible pharmacy services, these clinics provide routine, non-emergency services to walk-in patients at affordable prices seven days a week. These mini-clinics cost half of what patients typically pay for a regular doctor's visit and are roughly one-sixth the cost of an emergency room visit. Patients who visit these mini-clinics are treated by a family nurse practitioner or a physician's assistant – both of whom can write prescriptions and perform a full exam. Although mini-clinics do not handle chronic illnesses, they are ideal for ailments like strep throat, sinus infections or common colds and with no appointment necessary, extended hours, and seven days a week, the approach is more in keeping with modern business practices than the unyielding, inefficient and expensive traditional health system. As Charles Darwin said: “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.”
Mini-clinics accept insurance co-pays, Medicare and Mdicaid, they’ll send a report to your primary care doctor and if you don’t have one, they can recommend one in your neighborhood.
Since the first Convenient Care Clinic opened in 2000, the Convenient Care industry has grown quickly. Today there are over 200 such clinics operated by over a dozen companies across America. In September 2006, the Convenient Care Association (CCA) was founded to represent this new form of healthcare facility. The CCA's mission is to strengthen and advance the Convenient Care model of health care.
The need for accessible, affordable, quality health care has never been greater. The CCA has a white paper on the role of the Convenient Care Clinic (CCC). The following two chapters from the white paper are below. The full white paper is available here.
Introduction
Over the past year, the media has extensively covered the emergence of retail-based CCCs. Many have written about the expectation that retail health clinics will “profoundly affect health care delivery by providing an alternative site for basic medical needs.” CCCs have been called a “disruptive innovation” because they are consumer-driven and they serve as a response to many health care patients who “are frustrated with the conventional health care delivery system,” which often provides little access to basic health care services when people need it the most. While the CCI still has yet to fully establish itself, the clinics have shown tremendous potential in providing affordable, accessible and quality health care to consumers who otherwise would have to wait hours, days, or even weeks for the care they deserve. Other alternatives include seeking costly, time-consuming emergency room care for illnesses that could have been prevented if basic health care services had been accessible. Ownership of convenient care clinics varies. Some of them are privately held, and others are run through health systems, or non-profit organizations. Most have a medical director involved at the highest level of the organization and some have nursing leadership. Several of the leading CCCs have both a medical and nurse practitioner officer who work collaboratively overseeing the medical scope of practice and quality care of the organization.
In addition to highly qualified PAs and physicians, CCCs are usually staffed by Family Nurse Practitioners (FNPs), who provide high-quality health care services for episodic, common family ailments. Services include diagnosis and treatment of the most common health problems experienced by patients, including: sore throats, immunizations, and preventive health care screenings. Evidence to date has shown that “clinics do not increase overall demand for medical services, an initial concern expressed by the medical and insurance community; rather, they offer an alternative for consumers [at all socio-economic levels] facing access problems within the conventional health care system.” To date, consumers have expressed high levels of patient satisfaction with the services provided by NPs, PAs and physicians and the convenience of using a CCC. The CCI plans to expand across the nation, rolling out thousands of clinics over the next few years and ultimately increasing access for all Americans. However, CCI leaders, dedicated to providing the highest quality care, are determined to ensure that the convenient care movement is recognized as one of high quality and integrity. Thus, in the summer of 2006, leaders and stakeholders of the new and emerging retail-based CCI convened a Summit to shape the future of this new industry. The information, data and input from the Summit participants have resulted in this CCI White Paper. The purpose of this paper is to provide background and historical information on the industry along with education about the largest group of providers in the CCC, NPs, as the care providers, to describe the role of the new consumer-driven model of care and to lay out future directions for the CCI. History & Background of the Convenient Care Center Model
While the convenient care centers are a relative new provider type in the U.S., the concept of highly trained nurses as accessible health care providers dates as far back as the 1890s when visionaries like Lillian Wald founded the Henry Street Settlement. CCCs began in 2000, when the first in-store clinics appeared in Minneapolis-St. Paul, operated by QuickMedx. These first health clinics initially saw a very limited number of illnesses and accepted only cash for services. Today there are over a dozen companies across the country that have formed to provide health care services, to individuals and families, for common illnesses. The clinics have progressed to forming contracts with health insurance companies, while also accepting cash payments for a visit. A 2005 Wall Street Journal Online Interactive Health-Care Poll showed that 83% (N=2245) of adults strongly or somewhat agree that companies can provide onsite health services at retail stores, and that 78% (N=2245) of people felt strongly that retail-based clinics provide a convenient way for people to get basic medical services.
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