What Medical Practices Can Learn from Retail Clinics

I am not necessarily a fan of "minute clinics," for the obvious reasons. You are visiting a minimally staffed and supplied clinic that is really only set up to manage a few simple problems; such as sinusitis, small cuts, seasonal allergies, etc. You are also seeing a provider who has never seen you before and doesn't know your medical history. And, the thought often crosses my mind "Why is this provider working in a store-front clinic?" Surely, the best physicians work in more robust settings.

Nevertheless, I found myself visiting such a clinic for a blocked ear. I didn't want to drive all the way to my primary-care physician and I really didn't want to have to take time off from work for such a minor issue.

I've been to an assortment of "minute clinics" and urgent-care centers in the past. I know what to expect. So I was more than pleasantly surprised when the receptionist called my name after only three minutes. (To be fair, it appeared to be a slow night.) I was shown directly to an intake desk, where the clerk not only went through my health insurance information, but also inquired who my primary physician was and what medications I was taking. She typed everything into the computer as we spoke. My insurance cards were scanned into the computer as well, eliminating fuzzy "front-back" photocopies of cards that are impossible to read. She finished off with payment: politely informing me of my copay and asking how I'd like to pay. Check or charge!

I was impressed. They also had an onsite pharmacy, and I was asked if I wanted to fill any prescriptions there. Wow, eliminate a trip to the pharmacy and 20 minutes waiting for the prescription to be filled. This was getting even better. I gave her my prescription card to scan into the computer.

After intake was finished, I was shown directly to the treatment area. Granted, this facility was fairly new, but again I thought, "Wow!" Everything gleamed; clean, organized, and new. Each cubicle had a floor-length curtain to provide privacy, there was a central workstation much like a modern emergency department with flat-screen monitors showing cubicle numbers and assigned providers. Having worked as a healthcare provider, I am a bug about cleanliness. There is nothing worse than medical supplies left out in the open; vulnerable to cross-contamination. Here everything was put away in large, easily reached cupboards.

I sat only for a few minutes before a medical assistant popped in to review my chief complaint, look in my ear with the otoscope to confirm the blockage, and assemble supplies to perform the lavage. She was kind and efficient, and after she was finished a physician's assistant checked her work and gave me instructions and a prescription for home - which was filled at the front desk on my way out. Another plus? Staff wore clean, white lab coats with clearly visible name tags that indicated their role. I like to know who I am speaking to: the physician or the nurse.

Perhaps my experience would have been much different on a crowded day; but I still give them high marks. One person handled intake, a prescription list, insurance information, and payment. And when she was done, all that information was in the EHR. My payment was in the cash drawer before I saw the physician's assistant, so no extra billing steps or chasing payment. And I had the option of having the chart note sent to my primary-care physician - eliminating the need for my physician to call and ask for a visit summary. My treatment was efficient, coordinated, and completed with a minimum of extraneous steps or work.

Clearly, I think there are lessons here for private practices. Even though an urgent-care center like this is limited in focus and therefore better able to standardize procedures, processes, and staff roles, there is power in simplicity and forethought. To me, it just makes sense.

Erica Sprey is assistant managing editor at Physicians Practice. She has worked in healthcare for over 20 years in a variety of settings: as a dental assistant in military and civilian graduate residency programs and at the front desk in a midsized rheumatology practice. She can be reached at erica.sprey@ubm.com.