Let me start by saying how much I love nurse practitioners (I’m married to one!). I think they are well trained and I think they can do an excellent job. However, providing healthcare in a retail based clinic setting (those located in pharmacy, grocery and department store chains) can be less than optimal for many reasons. Besides the fact that patients seen there have no medical record to go by and the providers are not familiar with patients’ backgrounds because they are outside of their usual medical home, I have concerns about the multiple conflicts of interests associated with these centers.
It seems to me that every patient walks out of there with medications, and often MULTIPLE medications. This doesn’t happen in our office because it is not in the patient’s best interest. Yes, it can be hard to have a sick child with an illness that has to run its course, and as parents we just want to give them something to help them out. And this time of year we see coughs and colds that can seem to drag on forever. But sometimes there is nothing you can do but give the child tender loving care and time. When children are seen in retail based clinics – who make more money when selling both prescription and over-the-counter medications – they are more likely to receive medications.
I also recently heard something even more disturbing. I have heard that the salary for providers giving care in these clinics can be affected so much by customer satisfaction surveys that providers will “give patients what they want” when they come for an appointment. They do this so as not to jeopardize their income potential. I am all for letting a parent be part of the treatment team, but for many problems that come into the office, a treatment can be worse than the natural course of the disease.
I do my best when patients see me in the office. I try to supply them with tools to live a healthy life and fight disease. I may not always make parents happy, but even at the risk of parent dissatisfaction, I will put the health of the child first.