I wonder, does your local shopping mall or drugstore contain a so-called Retail Clinic -- a mini-health clinic where nurse practitioners provide walk-in treatment for very basic health issues? I haven't experienced one in my neighborhood, but I am told there are now more than 500 around the country, in stores like Target, Wal-Mart, and CVS, with forecasts of more than 1,500 coming by the end of 2008.
Some of the leading chains are MinuteClinic, MedExpress and Take Care Health Systems, recently acquired by Walgreens. They typically treat "common family illnesses, such as strep throat, bronchitis and ear, eye and sinus infections." But some clinics will also handle skin conditions, minor injuries, vaccinations, and annual physicals. Some advantages:
Extremely successful thus far, these retail-based health clinics "have captured the attention of the media, public, investors, and the medical establishment."
So what do you all think about a MinuteClinic concept for diabetes? Seems to me it would extremely helpful in particular for the millions of Type 2 patients who have trouble getting the treatment and guidance they need -- usually due to access issues.
At least one revered expert in diabetes education agrees. Check out this glowing feature on Dr. Linda Siminerio of the University of Pittsburgh Diabetes Institute. The article specifically points out:
"Centers for diabetes education and management could be established based on the MedExpress model, where people can walk in for service when needed. Such centers could be placed in malls or Wal-Mart stores... Pharmacists and nurses could serve as educators and answer questions about medications, testing equipment, diet and exercise. Nurses could be trained to adjust medications and suggest lifestyle changes for people struggling with control. For now, doctors must make those decisions."
Dr. Siminerio rolls this up with her overall campaign to get healthcare plans to put more money into diabeates educational resources.
Speaking of doctors currently calling all the shots (bad pun unintended), I was chatting lately with David Kibbe, MD, head of the American Academy of Family Physicians (AAFP) Health IT Center, about the sad state of diabetes education among primary care physicians, who end up treating most patients diabetes in this country by default.
Kibbe says: "Seven minutes with your primary care physician isn't going to cut it. The doctor needs at least 2-3 minutes to figure out what's going on with that patient and why they're there. And the doctors who take time with patients for diabetic counseling sacrifice income, because they're not compensated for this."
So what about a new business model in which specialized convenience clinics offer low-cost diabetes care? There sure would be quite a market for it, with estimates of 50 million Americans with diabetes by the year 2020 (!) Who is going to help all these people manage their disease?!
And wouldn't it be great to have a one-stop shop for basic diabetes tests (A1c, lipids, microalbumin) and medication and nutritional advice, conveniently located right there where you do the rest of your shopping anyway? Sounds like a good option to me.