Thursday, April 3, 2008

Physician Practicing Nursing??

Just when I thought that I've seen it all: An article appears about a physician and his 'new' practice, Wellnessmart. This is a retail-based practice where "...people walk in and get what they need."

The article goes on to say:

"The store doesn't sell vitamins or medication but markets preventive health services like screenings that may tell a 33-year-old man he has a 17 percent chance of a heart attack over 30 years. It sells annual checkups, weight management, vaccinations and travel immunizations."

Hmm, screenings, weight management, vaccinations, health education?? Sounds a lot like nursing interventions to me. Would anyone accuse this physician of practicing nursing without a nursing license (as NPs are routinely accused of practicing medicine without a [medical] license)?

If this seems similar to retail health, its because it's clearly lifted from that model: transparent pricing, no appointment necessary, vaccinations - just not episodic care. Oh, but here's where it differs: it is physician-staffed and insurance is not accepted. All the arguments folks make about retail health such as lack of continuity of care, not accepting private insurance (thus driving up health costs) and being profit-driven are missing from this article. It even appears from their website that patients can "obtain prescriptive authority for any ultrasound screening exams" and get any blood test that they choose. My questions are: who is following up on the benign abnormalities often found on these tests. Are they being turfed back to their PCPs? Will this drive up health costs even more?

I am a proponent for anything that attempts to increase access to quality health care. Retail clinics are popular because they are widely accessible, focused in scope, are built on evidenced-based outcomes and most accept health insurance. The same rules need to apply to this hybrid conglomerate as to the retail health model (staffed predominately by NPs & PAs).

1 comment:

Nurse Practitioners Save Lives said...

Cash and carry practices are becoming the rage because the insurance companies are calling the shots regarding what they deem the proper amount to pay for our services. What other business lets others determine what we charge for our hard work. This is making it difficult for MDs and NPs alike. I don't think that anyone will complain that he is practicing outside his scope of practice. God forbid that we practice within ours while stepping on an MD's turf. At least it's not as bad here as it is in the UK. They seem to be having difficulty determining what is the proper training and what the right practice constraints should be in place.