Retail clinics seek to move away from just treating minor maladies

Retail clinics have put the profession of nurse practitioner on the map, but now these convenient care clinics are evolving from just a place to go for minor ailments to one where primary care and chronic care can be obtained.

(Photo by Preston Keres/The Washington Post/Getty Images)

Retail clinics have revolutionized the healthcare industry in general and have elevated the nurse practitioner profession in particular.  Now, the evolution of retail clinics will see services provided in these facilities move from treating minor acute illness to delivering primary care and managing chronic disease.

That was the message coming from NPs in executive roles with three of the nation’s largest retailers who spoke at the American Association of Nurse Practitioners’ Specialty & Leadership Conference Friday morning in Rosemont, Ill.

“Retail clinics have put the profession of nurse practitioner on the map,” declared Sue Ferbet, Chief Nurse Practitioner for the more than 400 Walgreens Healthcare Clinics. Before retail clinics became part of mainstream healthcare delivery more than 10 years ago, NPs spent much of their time explaining who and what they were, Ferbet noted.

Later when retail clinics began to surge in popularity, they faced heated opposition from physicians who picketed outside stores or railed against convenient care providers in full-page newspaper ads.

In order to gain acceptance, retail clinics limited the scope of their services. But while the tactic worked, it created a barrier that nurse practitioners and physician assistants who work in the clinics now must constantly push back against.

Angela Patterson, chief nurse practitioner officer for the more than 1,100 CVS Health Minute Clinics, stressed how retail clinics have to move away from “sore throats and flu shots.” This requires moving away from just acute episodic care to treating patients holistically and to serving as a “safety net for primary care” in providing screening, monitoring and initiating treatment for chronic disease, she said.

Patterson noted the need for nurse practitioners to “practice at the top of their license,” and stressed the difference between “scope of practice” which is the legal limit on services they are allowed to provide and “scope of services” which are the limits provider organizations choose to place on themselves.

Patterson added that NPs in retail clinics have to make better use of technological advances so they are not just working in the isolation of their particular facility. She said they must also meet the patient-satisfaction challenge of delivering “an experience that delights” consumers.

The other major challenge panelists discussed was recruiting and retaining experienced staff. Nancy Zaner, chief nurse practitioner officer for Walmart Care Clinics, noted her company has particular trouble staffing its remote locations.

“I don’t see that as a challenge that’s going away,” Zaner said. She added that the profession must look into the future and develop the needed workforce pipeline, but she also noted that “the bulk of our work has to be spent on retention.”

They must do all this while also battling against a misconception that NPs and retail clinics are stealing patients from primary-care physicians.

“We filled a void,” Zaner said in describing how retail clinics had evening hours and were open on weekends when physician offices were closed.

 

Photo: by Preston Keres, The Washington Post, Getty Images

 

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