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The (Nurse Practitioner) Is In

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By MARY SHEDDEN | The Tampa Tribune

Published: February 15, 2008

Hewey Walker felt lousy.

The Dover man felt plenty sick — enough to miss a day at work. But not so awful that it was worth a full-fledged doctor's appointment.

"I just feel really bad," said Walker, who's called Buddy by his friends, one of whom suggested he visit one of the country's fastest growing areas of health care: a convenient care clinic.

It took Walker just a few minutes to check in and see a nurse practitioner at the Take Care health clinic inside a Walgreens drug store in Brandon. His ailment was minor, and it was treated quickly with a basic exam, diagnosis and simple prescription.

Most important, it cost less than the alternatives: a freestanding walk-in clinic, a doctor's office or the hospital.

"I would have gone to a walk-in clinic and probably been waiting still, and probably would have paid a lot more," he said.

The clinic Walker visited is one of an estimated 700 so-called retail health clinics that have opened across the nation during the past few years. The aim: to quickly offer treatment of minor ailments.

During the past 30 years, American health care has seen a dramatic evolution. Your fatherly family physician long ago saw his business beat a path to walk-in clinics, where patients are treated by a cadre of doctors they may never have met before.

The new retail or convenient care clinics, which rely on nurse practitioners, represent the newest generation. More than 20 different companies — under banners such as Little Clinic and MinuteClinic — operate within existing drug or grocery stores. In the Tampa Bay area, the number of these clinics keeps increasing at popular retailers such as Walgreens, CVS and Publix Super Markets.

You'll find the clinics tucked into store corners, providing little more than a tiny office for the nurse practitioner on duty. But they don't need much, as they conduct only a basic physical exam for minor sicknesses such as a sore throat, earache, rashes, and select vaccinations. Patients must be 18 months or older.

"It's a limited scope of practice here. We're not here to see everyone," said Michele Flanagan, lead nurse practitioner for Take Care Health System, which has 12 clinics in the Tampa Bay area.

There are critics of these retail health clinics. Both the American Medical Association and American Academy of Pediatrics have questioned the quality of the care for an industry that is still relatively new.

Convenient care advocates combat the concerns by pledging that patients needing more treatment than the clinics can address will be referred elsewhere. Flanagan said the convenient care services are offered as an alternative to increasingly expensive and hard-to-find health care.

The cost at Walgreens-owned Take Care clinics averages from $59 to $74 for a first visit. The Convenient Care Association told the Wall Street Journal recently that 40 to 50 percent of the treatment at the clinics is reimbursed by insurance, while the rest is care to people without such plans.

Walker, whose first-time experience left him feeling much better, said he never would have thought getting medical attention could be so simple.

"Who would have thought you would have a clinic in a drug store, much less with a practitioner who was knowledgeable?"

When Quick Care Could Work

Respiratory infection

Skin conditions

Diagnostic testing

Minor injuries

Vaccinations

Physicals (people ages 18 months and older)

Old School Medicine Might Be Best

Chest pains or shortness of breath

Abdominal pain/queasy stomach

Obvious muscular tears or skeletal fractures

Significant back pain

Major medical or gynecological exams

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