In some respects, the healthcare scene is changing so rapidly that we may soon need a time machine to remind us in which era we are living. We are constantly challenged to create new systems that improve upon the current healthcare delivery system. The arrival of retail-based healthcare clinics seems to have done just that. Richard Bohmer, a senior lecturer in business administration at Harvard Business School, noted "[horizontal ellipsis] in-store clinics reflect a well-designed operating system in which all the elements- location, physical structure, information systems, staffing, clinical and business processes, and range of services-are aligned to meet a particular population's needs efficiently and effectively."1
An NP Opportunity
Retail-based healthcare clinics are one emerging solution to ease access to healthcare for insured, underinsured, and uninsured individuals. Nursing and medical services are provided by highly qualified health professionals in places where people frequent-retail stores-with hours to fit busy schedules and at an affordable cost.
Retail-based clinics provide an excellent opportunity for nurse practitioners (NPs) to practice independently in an advanced practice nursing role. Although some clinics may be staffed with several NPs and auxiliary personnel, many schedule only one NP for duty at any given time.
Catherine Wisner, a Senior Health Fellow in the Office of the U. S. Surgeon General, summed up the experience this way: "You do it all. You greet the patient, take all the insurance information, and collect the payment at the end of the visit, so you need an appreciation of both the business side and the customer-service side. You are the face of the company. Patients can choose to go somewhere else next time, and you want them to come back. It's a different mindset [than purely clinical]."2
The Future of NP Education?
Even though care in these clinics is guided by evidence-based protocols, the NP must have the requisite personal knowledge, confidence, and skills to comfortably and safely practice solo.
The American Academy of Nurse Practitioners (AANP) developed the AANP Standards for Nurse Practitioner Practice in Retail-Based Clinics,3 a nine-point list of standards that detail how management and NPs should establish an operation to ensure that the NP and the facility are equipped to deliver quality care to the public. Nursing educators would be wise to pay more attention to this other side of training future NPs; curricula and assignments could include practical applications of basic business aspects of service delivery.
Tine Hansen-Turton, executive director of the Convenient Care Association, noted that besides providing autonomy in practice and skills in business and management for advanced practice nurses, the retail clinic market offers the additional benefit of greater visibility of nursing as a viable profession and the recognition of innovative roles open to nurses with advanced degrees.1 The publicity given to NPs in retail clinics might encourage more young adults to choose nursing as a career.
Patients, however, are the real benefactors of retail clinics-reduced cost, highly trained NPs, immediate care, and convenient locations. Let us see what the future brings. Retail clinics may be the way of the future for basic primary care.
Jamesetta Newland, APRN, BC, FNP, FAANP, FNAP, PhD
Editor-in-Chief, [email protected]
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