Your Patients Are Online, Why Aren’t You?

Posted on April 6, 2012 by

The internet is the perfect medium to deliver health education campaigns. Unlike traditional media, the internet provides interactive, multimedia and customizable content for the user. However, the inherent advantages of such health educational campaigns have not been fully understood or measured. There is no question that individuals will continue using the internet as a source for health information and to build a sense of community. The issue for health care providers to ponder is not whether patients will use this medium, rather what aspects of on-line participation produces the best outcomes for improving specific health conditions. For example, health professionals on Twitter, might be able to recognize incorrect health information tweeted by others and can broadcast evidence-based facts to the community. If enough followers read the valid information and retweet it to their followers, potentially thousands of people will see the message. This has tremendous power to reach many people with a single brief message. Of course, a health professional must be cautious providing specific recommendations to “patients” via this medium for fear of patient confidentiality and liability issues. An additional challenge is safeguarding privacy while making the content user-specific.

Health education and information were among the primary factors for my pursuit of an advanced practice nursing degree. There is a vast amount of health information available on the internet. Unfortunately, some of this information is inaccurate or wrong.  As a primary care provider, nurse practitioners hold a unique perspective and the potential to positively impact patient attitudes, beliefs and knowledge base about their health. The dissemination of evidence-based information can be extremely difficult. Conflicting recommendations and inconclusive data are among the challenges of incorporating evidence-based methods into practice. For-profit advertisers and special interests further complicate the health information landscape by claiming their product’s dramatic results under the guise of valid research.

Health care doesn’t only take place in medical facilities or institutions – it happens every single minute of every day as patients must constantly make choices about what they should eat, if they should exercise, and whether to take that medication or not. Therefore it is imperative to provide patients with culturally specific and evidence-based information to support the decisions and choices they make. On-line social communities and networks are empowering for patients and provide opportunities to seek individuals with similar diagnoses or prognoses. It is an outlet for patients and can aide as a coping mechanism to ultimately allow better self-care and health decisions. Therefore, the potential power of this medium is vast.

As technology continues to evolve and new forms of communication are introduced, clinicians must be familiar and comfortable with these methods.  The availability of health information on the internet has changed how clinicians care for patients. In general, access and interaction with information creates a more engaged patient and is a sign of patient empowerment. Perhaps the greatest sign of this is the website, Patients Like Me, a networking site dedicated to sharing real patient data. Their goal is to “…enable people to share information that can improve the lives of patients diagnosed with life changing diseases.” The website relies on patient entered data to generate new knowledge about a specific condition in the hopes of creating wisdom that the health care community can utilize to better care for these conditions. The data (without any specific patient identifiers) is available to researchers and clinicians for analysis.

Online support communities and health education are areas that are very popular with patients. It is important for clinicians to be aware of these sites and appropriately recommend them for their patients who are good candidates for this medium.

Posted in Education, Health, Health Care, Nurse Practitioner, Resources | Tagged , , , , , | Comments Off

Achoo! Tips for Treating Seasonal Allergies

Posted on April 4, 2012 by

Allergy season is definitely upon us here in the Northeast. A mild and relatively dry winter has made pollen counts abnormally high and start very early in the spring season. As I type away, battling the seasonal allergy symptoms of allergic conjuctivitis, rhinitis, post nasal drip and sneezing, I thought I’d share some of my allergy treatments and resources.

One of the best resources I use for current pollen counts and forecasts is Pollen.com. During allergy season, I check the site daily based on my zip code to get a sense of what symptoms I might expect to see with my patient’s episodic visits. In addition the actual pollen counts, the site also identifies the predominate types of pollen for the day.

Treatment of allergies usually involves some form of antihistamine. The newer generation of now drowsy antihistamines include Claritin, Zyrtec, and Allegra (now all available over the counter) and are once daily dosing. The newer prescription antihistamines include Clarinex (a re-worked version of Claritin)  and Xyzal (a re-worked version of Zyrtec). The tried and true older generation Diphenhydramine (Benedryl) works very well on allergy symptoms but can cause drowsiness and requires dosing throughout the day. Remember to counsel against alcohol consumption with antihistamines as it can have an additive effect and cause drowsiness and sedation.

I believe eye symptoms are often overlooked (no pun intended!) Treating the eye symptoms may ease the severity of the rhinitis and post nasal drip as we think of a “drop down” effect from the eyes. Patanol and Pataday are my go to drops as well as Naphcon A.

Intranasal steroids are another class of medications that help treat allergic rhinitis. One of the issues with these medications is that they don’t work immediately. It can take up to 10 days before they start to work and oftentimes, patients may stop using them since they don’t work right away. (Nose bleeds [epistaxis] are another potential side effect of intranasal steroid use). Some of the more popular steroids are Flonase, Nasonex, and Rhinocort.

I also try to focus on the nonpharmacologic aspects of treatment. I am a proponent of nasal saline spray. When we think about the purpose of the nose, it is designed to filter and warm the air we breathe. It usually does a great job but that “stuff” essentially stays in the nose and thus we have an allergy-mediated response to it. Saline helps to cleanse the nasal cavity and moisture the tissues of the nose. Two spays to each nostril 4 – 5 times a day.

Staying indoors during high pollen counts with the windows closed and air conditioner on will also help to reduce allergy symptoms for those affected by Spring allergies. (Indoor allergies are also a problem for many people and something to be cognizant of).

Allergy testing and desensitization may be needed for severe allergy symptoms as long as patients are willing to get weekly allergy shots.

So allergy sufferers hang in there and for those treating patients with allergies, I hope you find these tips helpful! And as always, practice good hand hygiene to help prevent the spread of infection.

Posted in Disease, Doctors, Health, Health Care, Nurse Practitioner, Resources | Tagged , , , , | Comments Off

What Nurse Practitioners MUST Know About ACOs

Posted on March 30, 2012 by

With all the recent discussion on the Affordable Care Act (ACA) being heard before the Supreme Court, I wanted to discuss one of the programs that was borne from the ACA. The Centers for Medicare & Medicaid (CMS) define Accountable Care Organizations (ACOs) as “… groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.”

Wow, this sounds great so far, and seems to be congruent with nurse practitioner-partnered care, what could be wrong with this model? Read on.

The “ACO Professional” is defined, “…as a physician (as defined in section 1861(r)(1) of the Act) or a practitioner described in section 1842(b)(18)(C)(i) the Act (that is, a physician assistant, nurse practitioner or clinical nurse specialist (as defined in section 1861(aa)(5) of the Act)).”

Wow, a win-win all around – a new model of care that is coordinated to reduce waste and duplication, utilizes nurse practitioners and is part of federal legislation. What’s the catch?

It is embedded here in the Federal Register:

Thus, although the statute defines the term ‘‘ACO professional’’ to include both physicians and non-physician practitioners, such as advance practice nurses, physician assistants, and nurse practitioners, for purposes of beneficiary assignment to an ACO, the statute requires that we consider only beneficiaries’ utilization of primary care services provided by ACO professionals who are physicians. The method of assigning beneficiaries therefore must take into account the beneficiaries’ utilization of primary care services rendered by physicians. Therefore, for purposes of the Shared Savings Program, the inclusion of practitioners described in section 1842(b)(18)(C)(i) of the Act, such as PAs and NPs in the statutory definition of the term ‘‘ACO professional’’ is a factor in determining the entities that are eligible for participation in the program (for example, ‘‘ACO professionals in group practice arrangements’’ in section 1899(b)(1)(A) of the Act). However, assignment of beneficiaries to ACOs is to be determined only on the basis of primary care services provided by ACO professionals who are physicians.

Did you catch that? Yes, that’s right, while NPs are included as “ACO Professionals,” if a Medicare patient utilizes a nurse practitioner as their provider, they are not eligible to participate in the ACO unless the beneficiary is assigned to a physician. If that seems non-sensical to you, that’s because it is.

So what can NP practices do who want to participate in this money saving model of care (where half of the savings are reaped by the practice)? Unfortunately, the public comment period has closed on this issue. Right now, if an NP-owned practice wanted to participate in a similar type of shared savings model, they would have had to apply for a grant under the CMS Innovation Program and hope to get a similar award for what an ACO would bring. That deadline was due in January and the actual awards should be announced any day.

This is where NPs get shut out of the system. Yes, NPs may participate in an ACO, will improve care, reduce costs and duplication, but the only party benefitting is the physician or hospital-owned ACO. Doesn’t seem fair, does it? We must let our representatives know how backwards this is.

 

Posted in Career, Health, Health Care, Nurse Practitioner | Tagged , , , | Comments Off

What You Need to Know About NP Certification

Posted on March 29, 2012 by

Awhile ago, I commented about the APRN consensus model and the implications it will have on the offering of NP programs. Now, we are seeing the two certifying bodies, the American Nurses Crendentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Program (AANPCP), aligning their certifications with the consensus model.

According to the ANCC, “the certifications listed below will be retired when their current National Commission for Certifying Agencies (NCCA) accreditation period expires in 2014. Retiring certifications are:

  • Acute Care Nurse Practitioner
  • Adult Nurse Practitioner
  • Adult Psychiatric & Mental Health Nurse Practitioner
  • Gerontological Nurse Practitioner
  • Adult Health Clinical Nurse Specialist
  • Adult Psychiatric & Mental Health Clinical Nurse Specialist
  • Child/Adolescent Psychiatric & Mental Health Clinical Nurse Specialist
  • Gerontological Clinical Nurse Specialist”

According to AANPCP, “in anticipation of implementation of the Consensus Model, the Gerontologic examination will be retired as an entry-level certification exam in 2013. We anticipate the phasing out of the Adult examination by 2014. As long as you maintain current certification with AANPCP as an ANP or GNP through continuing education and clinical practice hours, and do not allow your certification to lapse, your credential will not be affected.”

So what does all of this mean?

The NPs already certified may keep their already attained credential by continuing to renew on time, using professional development activities and maintaining the correct practice hours. However, these exams will no longer be offered and thus retired. It will affect nearly every new NP going for certification in 2015. Therefore, it is extremely important that the school/program that you graduate from is aligned with the APRN consensus model so that you will be eligible to take the correct exam.

Also according to the ANCC, “… ANCC will be creating new certifications to meet the role and/or population foci requirements:

  • Adult-Gerontology Acute Care Nurse Practitioner [expected launch 2013]
  • Adult-Gerontology Primary Care Nurse Practitioner [expected launch 2013]
  • Adult-Gerontology Clinical Nurse Specialist (across the continuum from wellness through acute care)[expected launch 2014]

ANCC’s existing APRN certifications will be updated according to their regular 3-year update cycle to incorporate the requirements of the Consensus Model. These include:

  • Family Nurse Practitioner
  • Pediatric Nurse Practitioner
  • Family Psychiatric & Mental Health Nurse Practitioner (across the life span)
  • Pediatric Clinical Nurse Specialist (across the continuum from wellness through acute care)”

The goal here is to simplify the many existing specialties of nurse practitioner practice by making it population-based. National certification is only part of this as the State’s themselves must also make the transition to the APRN consensus model. Then there is the whole issue of the DNP being made the terminal degree for all incoming nurse practitioners starting in 2015.

There is much work to do on many levels for all of these initiatives to take place. It is so very important for existing NPs and future NPs to be aware of the changes that will be taking place very soon.

Posted in Career, Education, Health, Health Care, Nurse Practitioner | Tagged , , , , , , | Comments Off

New Funding Opportunities for Nurse Practitioner Students

Posted on March 23, 2012 by

The Centers for Medicare and Medicaid recently announced a new initiative for advanced practice registered nurses including nurse practitioners that is aimed to bolster the primary care workforce.  The program is called the Graduate Nurse Education Demonstration and will award 5 hospitals up to $200 million over four years to train APRNs. An interesting caveat is that half of the training must occur in non-hospital community settings. This project was made possible through the Affordable Care Act and from the CMS Innovation Center.

I believe this is a huge step forward for APRN education in our country. While this doesn’t appear to be a formal residency program, it is recognition that nurse practitioners are largely community-based providers and should therefore have significant training specifically in the community setting. Will we ever see a formal “Match Day” where medical and pharmacy students are matched to their preferred residency? We are still a long way from seeing such a formal program but I believe programs like the Graduate Nurse Education Demonstration may be the early beginnings of recognizing a community-based residency program of sorts for nurse practitioners.

There are a few limitations to this project: only current Master’s degree students are eligible to participate in this demonstration and if one is already licensed as a nurse practitioner in another specialty (i.e. adult) they are not eligible for this demonstration if returning for schooling in another specialty (i.e. pediatrics).

In other nurse-related funding opportunities, the Health Resources and Services Association (HRSA), recently increased the annual limits on the Nurse Faculty Loan Program from $30,000 to $35,000 (also thanks to the Affordable Care Act). The shortage of both undergraduate and graduate nursing faculty has been well documented in recent years. In addition, the average age of doctorally prepared nursing faculty is 60.5. So we not only have a current shortage of nursing faculty, but is expected that the current faculty will retire in the coming years. Therefore, an influx of nursing faculty must happen. The Nursing Faculty Loan Program will award schools of nursing up to a total of $24 million dollars starting in July 2012. Be sure to check with the nursing schools to inquire if they will be applying for and offering these grants. (Having one’s education paid for is also a good step in the right direction, but we also must see faculty salaries increase in order to keep up with nurses in clinical practice. I have heard estimates that there can be more than a $10,000 dollar difference in salaries among clinical staff and faculty.)

Both of these initiatives are congruent with the IOMs Future of Nursing document. It is great to see innovative programs and funding for the largest sector of our healthcare workforce. You might perhaps be in a position to take advantage of these wonderful opportunities!

Posted in Uncategorized | Tagged , , , , , | Comments Off

Budgeting Your Nurse Practitioner Annual Fees

Posted on March 20, 2012 by

One of the questions that I am often asked by nurse practitioner students is: “How much money will I need to spend on professional fees once I graduate?” This will vary somewhat based on your state but generally they are all in the same ballpark.

For example, in my state of New York, I must maintain both my registered nurse (RN) license as well as my nurse practitioner license. The initial application for the nurse practitioner profession is $85. Both licenses are renewable every 3 years at an approximate cost of $130 for each.

The Drug Enforcement Agency recently announced that they are increasing fees for registrants. The new three year fee for NPs will be $731 (up from $551).

One may want to take a review course to prepare for the national certification exam. Figure about $500 dollars for a in-person review.

Then there are national certification exam fees. The initial fee for the AANP exam (via the American Academy of Nurse Practitioners Certification Board [AANPCP]) is $240 for members and $315 for nonmembers. While certification for American Nurses Credentialing Center (ANCC)  is $270 for ANA members, $340 if you are a member of the American College of Nurse Practitioners (ACNP) and $395 for nonmembers.

Renewals for both exams range from $120 – $350 dollars every 5 years.

Malpractice insurance is another requirement and also depends on where your practice is located but is about $900/year.

Here is a visual representation of those fees broken down by year:

1. RN License – $43

2. NP Initial License – $85

3. DEA Fees – $146

4. Review Course – $500

5. ANCC Certification Exam – $395

6. Malpractice Insurance – $900

Total: $2069.00

Be sure to take advantage of some of the benefits that professional associations including discounts on the national certification exams. For example, a student membership with the AANP costs $55. That is an overall $20 savings alone from the membership and doesn’t include all of the other benefits that goes along with membership.

As you can see, fees can add up very quickly and careful planning is required to budget appropriately for these items that never decrease. This doesn’t even include if there are any outstanding student loans that must be paid back (once the grace period ends). Other fees may include paid subscriptions to continuing education programs and additional medical tools (new stethoscope, etc).  However, if budgeted properly, there will be no shock when it comes to paying those bills!

Posted in Career, Health, Health Care, Nurse Practitioner, Resources | Tagged , , , , , , | Comments Off

Electronically Exchanging Health Information

Posted on March 17, 2012 by

According to the Health & Human Services, “the Nationwide Health Information Network (NHIN) is being developed to provide secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare.” The operational health exchange that I’d like to highlight is the Indiana Health Information Exchange (IHIE).

I. Involved Healthcare Providers

“The Indiana Health Information Exchange operates the nation’s largest health information exchange…and connects hospitals, rehabilitation centers, long term care facilities, laboratories, imaging centers, clinics, community health centers and other health care organizations…”. The two networks operated are the hospital network, comprised of 90 facilities, and the physician network, comprised of over 14,000 physicians throughout Indiana. In addition, the IHIE has approximately 40 partners.

II. Why?

IHIE was launched in 2004 to help combat exorbitant health care costs in Indiana and the overwhelmingly high rates of smoking and chronic illness such as diabetes, hypertension, and obesity. To facilitate the rollout, IHIE partnered with the Regenstrief Institute, an international health and informatics research organization. “…The Regenstrief Institute is recognized for its role in improving quality of care, increasing efficiency of healthcare delivery, preventing medical errors and enhancing patient safety.

As a result of the exemplary work by the IHIE, in 2010, one of their coalitions was selected as a United States Health and Human Services Health IT Beacon Community. This is prestigious recognition that “…showcases how IHIE’s robust health IT network can enhance patient care and improve outcomes while promoting a better, safer and more efficient healthcare system” (IHIE).

Today, work continues on the IHIE. In fact, IHIE recently partnered with AT&T to eventually support 10 million patients and more than 19,000 physicians. IHIE will begin by implementing AT&T Healthcare Community Online Clinical Message Exchange in three hospitals. The features will include: any-to-any messaging to automate point-to-point automation; a messaging hub that enables all message translation and routing; message tracking for audit logging for HIPAA and HITECH purposes; and secure communication and collaboration capabilities across network domains and organizations (Lewis, 2012).

III. Types of Information Exchanged 

Interoperability and continuity of care are based on the tenets of information sharing and exchange. The current healthcare system is fraught with waste and duplication of services. A critical piece for clinicians is having near real-time data that will assist with making complex health care decisions. Fortunately for the stakeholders in Indiana, the IHIE enables the sharing and exchange of patient information to result in enhanced quality of care and outcomes.

IHIE’s DOCS4DOCs electronic results delivery service exchanges the following types of information to all Indiana participating hospitals, physician practices, labs and radiology centers:

  • Laboratory results
  • Radiology reports
  • Transcriptions
  • Pathology and hospital admission reports
  • Discharge and transfer reports

Users have 24 hours a day and 7 day per week access to the system and the information can be viewed through a web portal or can be delivered directly into an electronic health records system.

IV. Conclusion

IHIE is a true exemplar of a functioning health information exchange. Indiana recognized the spiraling health care costs and poor overall health of its residents. They chose to address these issues by creating a robots health information exchange with full stakeholder involvement. As a result, Indiana has been able to improve health care outcomes using national benchmarked measures while curbing costs and potentially saving scarce financial resources. Other states can follow Indiana’s lead so that we will someday have an inter-connected, inter-operable repository of clinical information to improve patient outcomes and reduce costs.

 

Posted in Health, Health Care, Nurse Practitioner, Technology | Tagged , , , | Comments Off

Are you utilizing culturally competent web health resources for your patients?

Posted on March 15, 2012 by

One of the three pillars in my Doctor of Nursing Practice program was cultural competence (the other two were evidence based practice and primary health care). A great definition of cultural competence in health care is from The Commonwealth Fund:

Cultural competence in health care describes the ability of systems to provide care to patients with diverse values, beliefs, and behaviors, including tailoring delivery to meet patients’ social, cultural, and linguistic needs. The ultimate goal is a health care system and workforce that can deliver the highest quality of care to every patient, regardless of race, ethnicity, cultural background, or English proficiency.

Nearly every industry has taken to the World Wide Web for purposed of e-Commerce, information dissemination, and automation. The health care sector is not immune from such transactions. As the health care industry modernizes with the introduction of integrated electronic health records, patients have the increasing opportunity to further participate in the provision of their care by accessing web-based patient portals thus raising their level of engagement. However, it is important to consider web and website accessibility for people and patients with disabilities – this is essentially a form cultural competence. Accessibility is applicable across the spectrum of websites and should not be limited only to health care related sites. For example, patients with vision, hearing, or even cognitive disabilities will need additional resources to accomplish tasks on websites compared to those without disabilities. Fortunately, Web Accessibility Content Guidelines were created for website design and Section 508 of the law was enacted for Federal agencies to address electronic and information technology for people with disabilities.

Specifically, consumers with visual impairments may experience blurriness and the inability to read small text on websites if they experience partial sightedness. Visual impairments can also include color blindness, which may make some text and/or hyperlinks imperceptible to the user. Complete blindness would also fall under visual problems making navigating the Web with a traditional mouse and keyboard impossible. According to the American Foundation for the Blind, “…21.5 million American Adults age 18 and older reported experiencing vision loss” and at least 1.5 million Americans with vision loss use computers. According to the U.S. National Library of Medicine, approximately one in ten men experience some form of color blindness while very few women suffer from this condition. Clearly, visual problems affect a large portion of the U.S. population.

The Web Content Accessibility Guidelines (WCAG) were created to help those with disabilities navigate the Internet with some form of standardization. According to the WCAG, “… [the] guidelines will make content accessible to a wider range of people with disabilities, including blindness and low vision, deafness and hearing loss, learning disabilities, cognitive limitations, limited movement, speech disabilities, photosensitivity and combinations of these.”

Blindness is just one culture and an individual can be a member of multiple cultures. It is important for clinicians to recognize this and utilize patient resources that are congruent with their patient’s culture(s). It is also something to mindful of when designing or updating your practices’ website.

Posted in Health, Health Care, Nurse Practitioner, Nursing, Resources, Technology | Tagged , , , , | Comments Off

Nurse Practitioners and Policy Making

Posted on March 9, 2012 by

I wrote the following piece for the March issue of the American College of Nurse Practitioner’s, Journal for Nurse Practitioner’s Point/Counterpoint column. I took the “point” or pro side on the question, “Can Clinical Nurse Practitioners Be Involved in Policy Making?”

There are 2 clichéd statements about policy making that I would like to share: “Policy is like sausage: you don’t want to watch it being made” and “If you are not at the table, you are on the menu.”

Policy making is a complex process. Special interest groups, compromise, and passionate debate present challenges to the policy-making process. By design, incremental change in policy is most easily implemented. Sweeping change is rare. We recently witnessed just such a monumental change with the Affordable Care Act, which is rapidly changing our health care system.

The table in the second cliché is, of course, the negotiating table. Frontline nurse practitioners (NPs) hold unique insights into patient care and can share our patients’ stories with stakeholders. These stories in turn initiate needed changes. Therefore, we must be involved in the very negotiations that will shape our health care system and our future as a profession. In order for NPs to be politically effective, we must have a strong network of partners and be able to communicate effectively. Since these principles are fundamental to many of our philosophies, we are well positioned to help shape our nation’s health policy.

Every day, NPs partner with patients and guide them through disease management, health promotion, and wellness integration in a health care system fraught with waste, duplication, and, for many, limited access. NPs hold unique skills in collaboration, communication, health education, and forging partnerships. These are the very skills needed to work with stakeholders to ensure that our patients have access to care by all members of the health care team, including NPs.

Why would busy, practicing NPs want to be involved in this process? The answer is simple: our patients cannot afford us not to be.

Posted in Health, Health Care, Nurse Practitioner | Tagged | Comments Off

NP Career Option: Retail/Convenient Care

Posted on March 8, 2012 by

The rise and fall and rise again of the retail clinic has garnered much attention in the health care community. Retail clinics were popping up in many locations and were all the rage 5 – 7 years ago. Then with the dismal economy, expansion and even contraction happened.  The second wave of retail clinics is now upon us with slight modifications in their offerings. So is the retail clinic a good career option for the nurse practitioner now that clinics are starting to expand again?

I have experience in retail clinic ownership and operations and have witnessed the highs and lows. I will say this: the retail clinic setting is not for everyone nor is every clinician right for this setting. That is not necessarily a negative just like every NP may not do well in another specialty such as orthopedics.

The retail clinic model primarily utilizes nurse practitioners, physician assistants while some employ physicians. The biggest advantage that I see in retail clinics is patient access. Where else can  you walk in without an appointment on a Friday afternoon with a sore throat and expect to be seen expeditiously and know exactly how much you will pay for it? It truly is the retail clinic setting.

The retail clinic, often referred to as a disruptive innovator,  has also forced traditional practices to be more patient-centric as a result. Private practices are now offering open access scheduling and more upfront pricing for example.

Clinicians in these settings can expect to care for many episodic illnesses including otitis media, rhinosinusitis, and pharyngitis. Also, there are a good amount of children seen (because that sore throat always starts at the most inconvenient time!) and vaccinations administered. Clinic operators are also adding screenings for chronic conditions such as diabetes/hypertension and camp physicals to the menu of offerings.

The clinicians utilize an electronic health record and are typically the sole provider in the location. This is not an urgent care so there is a good chance that some potential patients will be turned away for services not offered at the clinic. Therefore, one must comfortable  with these provisions.

The retail setting probably is not the best place for a newer nurse practitioner since there is usually not enough support for mentoring. Of course, clinical resources are available to these clinicians including other clinicians to collaborate with. However, lesser experiences NPs may require additional hands-on support.

Some clinicians that I’ve spoken with dislike the narrow scope of the clinic offerings which is certainly a valid concern. The clinics are usually not primary care practices and encourage patients to have a regular established provider. While many other clinicians enjoyed practicing in their local communities and treating those individuals in it.

As some clinics expand again, there will be plenty of opportunities for clinicians to work in these locations. Having realistic expectations about what the clinics are and how they operate can help to ensure a good fit for both the clinic and for the nurse practitioner.

 

Posted in Career, Health, Health Care, Nurse Practitioner | Tagged , | Comments Off