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RETAIL MEDICINE TREND: Wal-Mart & Kroger Fall Flat … New estimate says CVS, Walgreens 3,000 Nurse-in-a-Box clinics throughout the U.S. by the end of next year —

Easy Way To Save Money on Health Care

Pharmacy chains to roll out more nurse-in-a-box clinics — A few years ago, everybody wanted in to this market space, but nobody knew the business model.

“Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers and emergency departments. ($110 vs. $166, $156, and $570, respectively),” the journal reports.

By Clark Howard, ClarkHoward.com

MAY 28, 2014 – our access to health care is getting easier in America today.

I’ve talked in the past about “nurse-in-a-box clinics” at retail storefronts that offer care 7 days a week from nurse practitioners.

BusinessWeek reports 16 of 50 states allow nurse practitioners to practice as primary care providers without restrictions. In the remaining states, the local affiliates of the American Medical Association have supported anti-competitive laws that restrict nurse practitioners. But there’s a strong movement in those states too to give pushback.

This is one genie you can’t put back in the bottle. According to one new estimate I saw, there will be 3,000 nurse-in-a-box clinics throughout the country by the end of next year.

What kind of care can you get?

Just Released! On Sale Now $9.95I can’t speak to the quality of clinical care offered by nurse practitioners because I’m just an average guy with no training or knowledge. But a study by the Rand Corporation found zero evidence that they provide lesser care. The authors of another study were so impressed by nurse practitioners that they wanted to end the anti-competitive laws in a majority of states to better provide care for people.

The first law of being a doctor is do no harm. But these laws do harm. If you’re a physician and you think I’m wrong, go to Clark Stinks and tell me.

Meanwhile, some of the big pharmacy chains are looking to expand the number of nurse-in-a-box clinics they have on the ground. CVS is expanding from 600 clinics to 1,000 across the country. Walgreens plan to expand too.

A few years ago, everybody wanted in to this market space, but nobody knew the business model. So you had Wal-Mart boasting they’d have 2,000 clinics, but they fell flat on their face and haven’t figured out the business model yet. Ditto for Kroger too.

But the clinics are a natural outgrowth for the big pharmacy chains. So many people who don’t have a primary doctor come to their pharmacists looking for advice, essentially putting them in the difficult spot of being asked to practice medicine.

The nurse-in-a-boxes are a key solution to that problem, because in medical school, nobody wants to be a general practitioner, or a family practitioner, or a pediatrician. (All the income potential is in the specialties.) We need an alternate way to provide that care. And nurse practitioners are the unsung heroes of making it affordable in America.

Assessing the cost of care

A few year ago, the Annals of Internal Medicine published a study that examined the cost and quality of care people who had 3 common illnesses — otitis media (middle ear-infection), pharyngitis (sore throat), and urinary tract infection — received at a doctor’s office, at an urgent care center, and in an emergency room at a hospital.

The study was done by a team of PhDs and MDs from the University of Pittsburgh working in conjunction with two health-related research foundations, and the results didn’t surprise me.

“Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers and emergency departments. ($110 vs. $166, $156, and $570, respectively),” the journal reports.

And then there’s this conclusion statement from the study’s authors: “Retail clinics provide less costly treatment than physician offices or urgent care centers for three common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care.”

That last phrase — “with no apparent adverse effect on quality of care or delivery of preventive care” — tells me everything I need to know!

Source: http://www.clarkhoward.com/news/clark-howard/health-health-care/big-pharmacy-chains-roll-out-more-nurse-box-clinic/nPgGLEasy Way To Save Money on Health Care

1 reply »

  1. I noticed on Facebook the question “What Are Your Thoughts From This Recent Story about Nurse Practitioners … “The nurse-in-a-boxes are a key solution to that problem, because in medical school, nobody wants to be a general practitioner, or a family practitioner, or a pediatrician. (All the income potential is in the specialties.) We need an alternate way to provide that care. And nurse practitioners are the unsung heroes of making it affordable in America.”

    My thoughts in regards to Nurse Practitioners. These are nurses who want to be doctors! If a nurse wants to pursue her degree to become a nurse practitioner, I’m okay with that; however, I want an MD, NOT a NP or PA to be my health care provider. I am so glad that my doctor, upon changing to a concierge service, did not bring his nurse practitioners along with him. In my opinion, the cost of a concierge service is with your doctor, not a NP. It’s comical to me to read where concierge practices still have Nurse Practitioners or Physician Assistants as part of their practice. I would like to ask them “what changed in your practice if you still have NP’s or PA’s”?

    I have seen where NP and PA’s have misdiagnosed many people and the MD’s have to clean up after them. It happened with my son, I thought his appointment was with the doctor and it was with the NP. She sent my son along his way and he ended up having pneumonia. Thank GOD our doctor. Ever since then, I refuse to make an appointment with a NP or PA. Actually, another instance took place with my daughter when she needed her sports physical. I was unable to get her in with an MD and had to resort to a nurse practitioner. I was sorry that I did and I was sorry that I didn’t go instead of my husband. My daughter is healthy and a sports physical has always been listening to her heart, lungs, weight and BP and that’s about it. The last time she had a sports physical .. she walked out with having labs done and her tetanus shot. It was a year early for her tetanus shot (and she would have gone the following year for it), but labs were uncalled for. The reason given to my husband for labs was “she’s never had labs done before so we will do them now”. If I was there, I would have said “no you are not. Labs are not necessary”. We never received any call back in regards to the labs, but of course was charged for the unnecessary labs. After that, never again will a NP see any member of my family. She was playing “doctor”. “Throwing her weight around as a NP”.

    I’m sure not all NP’s are like that one, but still. In a concierge service, we are paying to see the MD, not a NP.

    It was my understanding that NP’s were under the MD’s. NP’s work under their own license, but MD’s had to go over all the patient’s records that the NP would see in a day and check off if the NP diagnosed correctly, etc. I don’t like the fact that NP are in CVS’s or Walgreens. I’m surprised the medical associations/state laws created a degree as a Nurse Practitioner.

    If a nurse wants to diagnose and treat people, they should become doctors. I’m hoping the medical students today will see that being a primary doctor with the help of being a concierge doctor would bring more students into this field. It’s the only way for healthcare today. Concierge practices!!!!

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