Nurse practitioner Desiree Ang treats UW student Mikaella Sutich, of Sammamish, in the Bartell Drug Store MinuteClinic in Bellevue, where patients drop in without an appointment for minor problems. Mikaella was seen for a bladder infection.
SEATTLE (The Seattle Times), April 19, 2006:
On one side, a frozen-food case holds ice cream and waffles. On the other, a magazine rack displays PC World and Teen Prom magazines.
In the middle, in a little office squeezed into the Bartell Drug Store in the Bellevue Crossroads area, Mikaella Sutich, 19, recounts the symptoms of her bladder infection to advanced registered nurse practitioner Desiree Ang.
It didn't take long, because Sutich was quite sure about what she had, but Ang went through a series of questions anyway, making sure it wasn't something more serious. With an insurance co-payment of $25, Sutich, a satisfied customer of MinuteClinic — motto "You're sick. We're quick." — walked out in a few minutes with a prescription.
"It's really quick — I was in and out," she said. In a few more minutes, she'd filled her prescription and taken her first dose. "I'm on a roll!"
A UW student, Mikaella got a ride to the clinic from her sister, Brittany, 22, who works in Bellevue. She could have gone to her regular doctor, but the office is in Issaquah, and Mikaella doesn't have a car. The deciding factor was being told she'd have to wait a week for an appointment. She was uncomfortable and didn't want to wait. Plus, she said, "I don't really need to see a doctor. When you've had something before, you know what it is. You just want to get the meds for it."
The MinuteClinic in Bellevue is one of many in-store clinics popping up around the country in groceries, drug stores, even department stores. They're the for-profit world's answer to patients' increasing frustration with the current system's long waits and inconvenience Some critics worry that the clinics will make mistakes and further fragment care because they have no access to patient records showing drug allergies, medical history and current medications that could interact with new drugs.
Patients, despite worries about quality of care, seem to be interested in this new "fast-food" health-care delivery system. It's certainly not for everyone or every ailment, but when your child has a sore throat or a painful earache, it may be a way to get care quickly.
It was a bad sore throat on a weekend, in fact, that spawned MinuteClinic: One weekend in 1999, a businessman named Rick Krieger tried to get a strep-throat test for his son. Convinced there had to be a better way, Krieger and some partners founded QuickMedx in three Minneapolis-St. Paul grocery stores. That company became MinuteClinic, a for-profit company headed by a former Arby's Restaurant CEO, with more than 80 clinics nationwide.
So far, only MinuteClinic has established a beachhead in Washington, with four clinics: in addition to the one in Bellevue, they're also in Bartell stores in Renton, Sammamish and downtown Seattle. All but Seattle are open on weekends.
There are other companies running in-store clinics around the country, and most have ambitious plans. Take Care Health Systems, for example, is working with several drugstore chains, including Sav-On and Rite Aid, and plans to open nearly 200 centers over the next year.
Like the others, MinuteClinic emphasizes quick visits, convenient locations, and limits its scope to relatively minor ailments that can be quickly diagnosed and treated, tests for various conditions and vaccinations. The list includes not only allergies and ear infections, but bronchitis, strep throat, sinus infections and chlamydia, for example. The clinics are staffed by advanced registered nurse practitioners, who work from evidence-based protocols and are authorized in this state to diagnose and prescribe medications independently of physicians.
For some illnesses, MinuteClinic limits treatment to patients of a certain age. With bronchitis, flu or bladder infection, for example, they won't treat anyone older than 65, since those patients run a higher risk of complications.
For other conditions, there are lower age limits (sinus-infection patients must be at least 5, allergy patients at least 6).
The clinics will do a limited number of lab tests — for example, an overnight test for strep throat — but have no X-ray or other diagnostic equipment.
"We want to be able to give very high quality care for about 20 of the most common family-practice illnesses," says Terry Keene, a family nurse practitioner and manager of Seattle-area operations for MinuteClinic. "We don't want to do anything in the clinic that could become a real potential problem. We do a lot of triage."
Clinics have limits
In-store clinics aren't for everyone. Because they're new, says Dr. Jane Potter, an internal-medicine specialist who is president-elect of the American Geriatric Society, they don't have much of a track record, and patients have little experience with them. "They might not be the best for older people with chronic problems," says Potter. "We want to make sure they know the clinics' limitations."
A Wall Street Journal Online/Harris Interactive Health-Care Poll last year found that while a large majority surveyed thought in-store clinics might be convenient, accessible and cost-effective, a similarly large majority had concerns about quality of care.
The American Academy of Family Physicians, which has worked with both MinuteClinic and Take Care, says such clinics should have a well-defined, limited scope of practice, evidence-based services and treatments, formal connections with local physicians, systems for referring patients they can't treat and electronic-record systems that communicate with patients' regular doctors.
Potter notes that patients with many complex issues — including those taking many medications — may get into trouble in such a clinic, even when it does a good job.
"A person can be seen and be given a medication that would interact with something they're already taking," she says. "If you are a person that has a number of chronic conditions, approach these clinics with a great deal of caution."
Some insurers linked
Although Premera Blue Cross, Aetna, Cigna, United Health Care and Medicare have contracted with the chain, Regence Blue Shield has declined, said spokeswoman Jodi Coffey.
"We have some concerns about continuity of care," she said. "The clinics don't have ready access to a patient's history, and we're concerned about information from those visits not getting back to people's primary-care physician."
Keene, the regional manager, says the clinics keep fax numbers for local primary-care doctors and offer to send a report to the patient's doctor.
MinuteClinic doesn't hesitate to refer patients out and has an on-call medical doctor for consults.
Cost is key
For many patients, cost of care is an issue. A visit to an emergency room or hospital-based urgent-care center can run up large bills even for a simple problem. Equally worrisome, especially for patients without insurance, is never knowing how large the final bill will be.
At MinuteClinic, a price list is posted outside the clinic area. Most services are $59 or an insurance co-pay; tests are extra.
For Jeff Richardson, whose insurance covered the visit with a co-pay, it was the "quick service" that brought him back to the Bellevue MinuteClinic for the fourth time; this visit was for the earache hurting his 9-year-old son, Kevin.
"It's the convenience," said Richardson, who took about a half hour off from his work with a local builder. Like the Sutich sisters, he did a little shopping while he waited for the prescription to be filled. "This fit my schedule."
Information: www.minuteclinic.com
By Carol M. Ostrom
Seattle Times staff reporter
Copyright © 2006
The Seattle Times Company
April 19, 2006
USA: Sick Of Waiting? Visit the Local MinuteClinic!
Nurse practitioner Desiree Ang treats UW student Mikaella Sutich, of Sammamish, in the Bartell Drug Store MinuteClinic in Bellevue, where patients drop in without an appointment for minor problems. Mikaella was seen for a bladder infection.
SEATTLE (The Seattle Times), April 19, 2006:
On one side, a frozen-food case holds ice cream and waffles. On the other, a magazine rack displays PC World and Teen Prom magazines.
In the middle, in a little office squeezed into the Bartell Drug Store in the Bellevue Crossroads area, Mikaella Sutich, 19, recounts the symptoms of her bladder infection to advanced registered nurse practitioner Desiree Ang.
It didn't take long, because Sutich was quite sure about what she had, but Ang went through a series of questions anyway, making sure it wasn't something more serious. With an insurance co-payment of $25, Sutich, a satisfied customer of MinuteClinic — motto "You're sick. We're quick." — walked out in a few minutes with a prescription.
"It's really quick — I was in and out," she said. In a few more minutes, she'd filled her prescription and taken her first dose. "I'm on a roll!"
A UW student, Mikaella got a ride to the clinic from her sister, Brittany, 22, who works in Bellevue. She could have gone to her regular doctor, but the office is in Issaquah, and Mikaella doesn't have a car. The deciding factor was being told she'd have to wait a week for an appointment. She was uncomfortable and didn't want to wait. Plus, she said, "I don't really need to see a doctor. When you've had something before, you know what it is. You just want to get the meds for it."
The MinuteClinic in Bellevue is one of many in-store clinics popping up around the country in groceries, drug stores, even department stores. They're the for-profit world's answer to patients' increasing frustration with the current system's long waits and inconvenience Some critics worry that the clinics will make mistakes and further fragment care because they have no access to patient records showing drug allergies, medical history and current medications that could interact with new drugs.
Patients, despite worries about quality of care, seem to be interested in this new "fast-food" health-care delivery system. It's certainly not for everyone or every ailment, but when your child has a sore throat or a painful earache, it may be a way to get care quickly.
It was a bad sore throat on a weekend, in fact, that spawned MinuteClinic: One weekend in 1999, a businessman named Rick Krieger tried to get a strep-throat test for his son. Convinced there had to be a better way, Krieger and some partners founded QuickMedx in three Minneapolis-St. Paul grocery stores. That company became MinuteClinic, a for-profit company headed by a former Arby's Restaurant CEO, with more than 80 clinics nationwide.
So far, only MinuteClinic has established a beachhead in Washington, with four clinics: in addition to the one in Bellevue, they're also in Bartell stores in Renton, Sammamish and downtown Seattle. All but Seattle are open on weekends.
There are other companies running in-store clinics around the country, and most have ambitious plans. Take Care Health Systems, for example, is working with several drugstore chains, including Sav-On and Rite Aid, and plans to open nearly 200 centers over the next year.
Like the others, MinuteClinic emphasizes quick visits, convenient locations, and limits its scope to relatively minor ailments that can be quickly diagnosed and treated, tests for various conditions and vaccinations. The list includes not only allergies and ear infections, but bronchitis, strep throat, sinus infections and chlamydia, for example. The clinics are staffed by advanced registered nurse practitioners, who work from evidence-based protocols and are authorized in this state to diagnose and prescribe medications independently of physicians.
For some illnesses, MinuteClinic limits treatment to patients of a certain age. With bronchitis, flu or bladder infection, for example, they won't treat anyone older than 65, since those patients run a higher risk of complications.
For other conditions, there are lower age limits (sinus-infection patients must be at least 5, allergy patients at least 6).
The clinics will do a limited number of lab tests — for example, an overnight test for strep throat — but have no X-ray or other diagnostic equipment.
"We want to be able to give very high quality care for about 20 of the most common family-practice illnesses," says Terry Keene, a family nurse practitioner and manager of Seattle-area operations for MinuteClinic. "We don't want to do anything in the clinic that could become a real potential problem. We do a lot of triage."
Clinics have limits
In-store clinics aren't for everyone. Because they're new, says Dr. Jane Potter, an internal-medicine specialist who is president-elect of the American Geriatric Society, they don't have much of a track record, and patients have little experience with them. "They might not be the best for older people with chronic problems," says Potter. "We want to make sure they know the clinics' limitations."
A Wall Street Journal Online/Harris Interactive Health-Care Poll last year found that while a large majority surveyed thought in-store clinics might be convenient, accessible and cost-effective, a similarly large majority had concerns about quality of care.
The American Academy of Family Physicians, which has worked with both MinuteClinic and Take Care, says such clinics should have a well-defined, limited scope of practice, evidence-based services and treatments, formal connections with local physicians, systems for referring patients they can't treat and electronic-record systems that communicate with patients' regular doctors.
Potter notes that patients with many complex issues — including those taking many medications — may get into trouble in such a clinic, even when it does a good job.
"A person can be seen and be given a medication that would interact with something they're already taking," she says. "If you are a person that has a number of chronic conditions, approach these clinics with a great deal of caution."
Some insurers linked
Although Premera Blue Cross, Aetna, Cigna, United Health Care and Medicare have contracted with the chain, Regence Blue Shield has declined, said spokeswoman Jodi Coffey.
"We have some concerns about continuity of care," she said. "The clinics don't have ready access to a patient's history, and we're concerned about information from those visits not getting back to people's primary-care physician."
Keene, the regional manager, says the clinics keep fax numbers for local primary-care doctors and offer to send a report to the patient's doctor.
MinuteClinic doesn't hesitate to refer patients out and has an on-call medical doctor for consults.
Cost is key
For many patients, cost of care is an issue. A visit to an emergency room or hospital-based urgent-care center can run up large bills even for a simple problem. Equally worrisome, especially for patients without insurance, is never knowing how large the final bill will be.
At MinuteClinic, a price list is posted outside the clinic area. Most services are $59 or an insurance co-pay; tests are extra.
For Jeff Richardson, whose insurance covered the visit with a co-pay, it was the "quick service" that brought him back to the Bellevue MinuteClinic for the fourth time; this visit was for the earache hurting his 9-year-old son, Kevin.
"It's the convenience," said Richardson, who took about a half hour off from his work with a local builder. Like the Sutich sisters, he did a little shopping while he waited for the prescription to be filled. "This fit my schedule."
Information: www.minuteclinic.com
By Carol M. Ostrom
Seattle Times staff reporter
Copyright © 2006
The Seattle Times Company
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