Feature articles by: Dean Q. Lin, FACHE, Pat Pollert, RN, Darla Dobberstein, RN, and Ronald Wiisanen, MD
EDITORIALDuring holidays filled with family, I took a moment out of the bustle and picked up a popular magazine that was lying in my sister’s living room. There it was again! Between the ubiquitous cake recipe, answers to “relationship questions,” and instructions on how to exercise in style, was tucked an article on how to “Skip the Doctor’s Office.” I zeroed in on it and was virtually transported to a “walk-in clinic.” The article told me in a few sound bites all about “the latest trend in healthcare,” about what I had spent the past months intellectually and professionally exploring with the authors in this issue.
Whatever we, who sit on the healthcare provider side of the table, think of retail clinics or walk-in clinics, we as consumers are optimistic about their offer of quick solutions to those natty little ailments that beset each of us at one time or another. We won’t, after all, have time to make an appointment, spend days in minimized productivity distracted by discomfort or pain, wait for the appointment, wait again in an outer office, and, finally, get that precious bit of paper with a prescription. We are busy!
I put down the magazine and quickly popped into my editor of Frontiers role and thought “but it’s not so simple!” The questions that surfaced when we started working on this issue flooded back: What about the impact of these clinics on our physicians, who have so much clinical knowledge and investment in their practices? What’s the impact on our hospitals? How can we know that there won’t be some major error? How will these clinics fit into a continuum of care? (as Scott Fenn asks in his commentary.) Will these clinics succeed financially and compete for our patients? On and on…..
We must admit that the rapid rise of mini-clinics is another strong message from the consumer about the need for financially affordable and convenient access to basic medical services. While generally for-profit, non-hospital investors have seen and responded to this demand, some health systems have also gotten in front of this movement and have made a strategic move to establish their own mini-clinics. Conveniently located in grocery and retail stores,,staffed with advanced practice nurses, offering simple pricing schedules (and keeping those prices comparatively low), these clinics are making basic healthcare services available to our friends and neighbors who don’t want to wait to have that little ailment treated, and to those who are tired of the other side of the “consumer movement,” which reaches deeper into their pockets in the name of “consumer driven healthcare.”
In planning this issue of Frontiers, we reached out to some of the health systems that have ventured into the development of mini-clinics and asked them to share their experience in establishing and operating those clinics. They address this phenomenon against the backdrop of the need for improved access to care, the lack of primary care physicians, the cost impact of the use of ERs for primary care, the consumer demand for “after hours” availability of services, and the relentless increase in the cost of healthcare. They share details of their organizations’ initiatives and of what has worked for them, and they offer cautionary suggestions for other health systems that are contemplating a similar strategy.