Tuesday, August 10, 2010

Minute Clinics - Destruction or Inspiration

A poster at The Health Care blog recently pointed out that Minute Clinics (and similar) are seeing increasing number of visits while Americans are going to their doctor less... and wondered if this was the dawning of a new age (and sun-setting of an old one).

Here was the comment I posted:

What is old is new again... "quick care clinics" have come and gone many times over the past few decades - are they really the be-all and end-all answer this time? I think they have a role, but certainly don't solve everything - and their major benefit may be in making doctors think more innovatively about how they deliver their care for low complexity cases.

More specifically - let's start with the clinical perspective: there will be anecdotal stories of great convenience, but also those of horribly missed diagnoses. From an efficiency perspective, there will be wonderful stories of quicker access vs. going to the standard practice... but two things are critical to understand:
1. There are not enough NPs and quick care clinics to truly handle all the demand out there.
2. Practices aren't going to stay standard forever. Many are now doing virtual visits via phone or the web - and hey, that's even easier and more convenient than having to find a clinic with an NP and register there. So boom... the efficiency rod strikes right back at them.

Of course, the truth is that there is PLENTY of DEMAND right now, and not nearly enough supply, so everyone will be busy for awhile. But this is an important time for care providers to start rethinking how they deliver care, especially to the "easy, highly structured" cases (e.g. URIs, UTIs, as well as stable Htn, DM...) and hopefully we will start seeing more innovation in this model - thus freeing up doctors to have more time for the more complicated cases as well!

I wrote a more thorough review of all this back in 2007 when the same questions were coming up... check it out:
A Time of Change: New technology-enhanced care models may change everything. Will you be able to adapt?

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