minute clinics

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Has anyone hear of the minute clinics that are going to start showing up in Wal-Marts and Grocers with NP's running them? What will this do to FP as we know it?

It depends on what kinds of cases they will be taking and what they will be charging. The idea of anytime medicine wouldn't be too big of a draw where I'm from as you can often call and get an appoitment the same day with a fp. I can see it being a big factor in areas where you have to wait a week or more to see a physician.

These would be equivalent to an urgent care clinic. It will be interesting to see how things pan out.

I hate to be a downer, but FP's future as a specialty is limited. On one of the FP listservs that I subscribe to, someone posed the question of NPs replacing FPs. One of the FPs stated that with the current crop of residents not wanting to do call, procedures, or OB, he had rather hire an NP over a newly minted FP.

Food for thought.

Originally Posted by FMbound

These would be equivalent to an urgent care clinic. It will be interesting to see how things pan out.

I hate to be a downer, but FP's future as a specialty is limited. On one of the FP listservs that I subscribe to, someone posed the question of NPs replacing FPs. One of the FPs stated that with the current crop of residents not wanting to do call, procedures, or OB, he had rather hire an NP over a newly minted FP.

Food for thought.

I think that FPs must be more willing to see walk-ins and stop leaving the hospital. There is a trend now for hospital rounds to be handled by hospitalist. FPs must dintinguish themselves from NPs. I have said in the past that FP should reduce residency positions and increase the quality of the remaining programs. Too many people find themselves in FP because nothing else "worked out."

CambieMD

Originally Posted by allendo

Has anyone hear of the minute clinics that are going to start showing up in Wal-Marts and Grocers with NP's running them? What will this do to FP as we know it?

Why go to an FP's office when you can go to Walmart to be seen. Hey, you can pick up six pack and cold cuts at the same time. This sounds like drive through medicine. This appeals to a lot of people. I am working in an urgent care facility. It is amazing how many pcps send over patients to have small lacs closed. They just don't want to be bothered. Many specialists work hard to accommodate their patients. I do not see this with your more establishes FPs at least not where I practiced. Patents will go to Walmrt because of the convenience .


CambieMD

Originally Posted by CambieMD

I think that FPs must be more willing to see walk-ins and stop leaving the hospital. There is a trend now for hospital rounds to be handled by hospitalist. FPs must dintinguish themselves from NPs. I have said in the past that FP should reduce residency positions and increase the quality of the remaining programs. Too many people find themselves in FP because nothing else "worked out."

CambieMD

Very true but for some reason the specialty is going in the opposite direction. It is too bad FP is the specialty of last resort.

Originally Posted by FMbound

I hate to be a downer, but FP's future as a specialty is limited. On one of the FP listservs that I subscribe to, someone posed the question of NPs replacing FPs. One of the FPs stated that with the current crop of residents not wanting to do call, procedures, or OB, he had rather hire an NP over a newly minted FP.

Food for thought.

Why in the world would a fp not want to do procedures? Isn't that the big money thing for fps? And no call? Maybe I'm missing something being just a MS2 but I thought most specialties outside of Derm had call.

Originally Posted by raidermedic

Why in the world would a fp not want to do procedures? Isn't that the big money thing for fps? And no call? Maybe I'm missing something being just a MS2 but I thought most specialties outside of Derm had call.

Procedures double the insurance rates (at least in Oklahoma). Many pediatricians aren't even doing circs anymore for this reason.

I know a lot has been said about hosptialists and how they are somehow "taking over" hosptial admissions, but here is an interesting point that I have noticed in my private practice in a LARGE EAST COAST CITY....Things that make you go hmmmmmm......

At first, hosptialists come on like gangbusters acting like they are taking over the inpatient hospital scene...Fast-forward a few months later and these same hospitalists who were talkin all that smack CANNOT handle all the work and start looking for help...So who do they ask for help with admissions??? The SAME commmunity FP/IM docs. There are 4 major hospitalists groups in town (3 private and one run by the county hospital). I personally have been approached by all 3 private groups to help out with cross coverage. I currently provide cross coverage for 2 of the groups. The hospitalist group run by the county hospital is always looking/begging for docs (FP and IM) to share the on-call duties. Even when I was in training in the midwest, and the hosptial hired 3 hospitalists, they STILL could not handle the load and had to ask the residents for help. So in a nutshell, the "hosptialist" concept is not the Be-all-and-end-all solution that it was meant to be. Just food for thought...something to make you go hmmmmmmmmmmm..

And I'm OUT.....CHUUUCH!!!!

-Derek

Originally Posted by CambieMD

I think that FPs must be more willing to see walk-ins and stop leaving the hospital. There is a trend now for hospital rounds to be handled by hospitalist. FPs must dintinguish themselves from NPs. I have said in the past that FP should reduce residency positions and increase the quality of the remaining programs. Too many people find themselves in FP because nothing else "worked out."

CambieMD

We had these popping up in NE TN during my training. The company opening them put them in grocery stores and charged $35.00 a head. It didn't matter if you had insurance or not if I am correct. They could screen with Strep, UA and maybe a couple of other things. Staffed by NP's and often near the same location as their urgent care offices where I would moonlight. It was too early to tell how they would do, but 35 bones is close to a lot of people's co-pays and more affordable if you are self-pay. Most NP's are going to be able to handle 85% of what comes through (colds, allergies, poison ivy) the McClinic at Wal-Mart.

FM near the end? I doubt it as there will likely be a new demand for PCP's in the future. Our system cannot handle the top heavy specialist lean we have now. Sure, our no call, no procedures, no hosp may hurt us in the long run so we better define (and not be wrong) where the specialty needs to develop in the future. You will continue to see an influx of lower priced practitioners into the system (even in specialties).

Much of the new FM doc no call, no procedure, no hosp is not derived from laziness but from the poor return, increased liability and time these factors involve. When I round at the hospital, I may see 1-7 patients (usually 2-3) and it will take an extra 20 minutes drive time and multiple calls from the hospital each day. I like it and I do it for my patients but the time vs worth it (like I could have had breakfast with my kids) goes through my mind.

Originally Posted by CambieMD

Why go to an FP's office when you can go to Walmart to be seen. Hey, you can pick up six pack and cold cuts at the same time. This sounds like drive through medicine. This appeals to a lot of people. I am working in an urgent care facility. It is amazing how many pcps send over patients to have small lacs closed. They just don't want to be bothered. Many specialists work hard to accommodate their patients. I do not see this with your more establishes FPs at least not where I practiced. Patents will go to Walmrt because of the convenience .


CambieMD

I agree. It was only a matter of time. I frequent my 24 hour Wal-Mart Super Saver and they have optometrists, hairstylists and a chiropracter. I have never heard of a minute clinic but I knew it was only a matter of time before Wal-Mart start doing this.

My question is how will they handle the threat of malpractice. I'm sure they still have to have a physician on site in case someone threatens to sue.