The Evolution of Primary Care: Part 2

Delivery of primary care services in the U.S. used to involve a physician and a patient. The physician would see the patient in a clinic, conduct an examination, enter notes in a paper record, prescribe a follow up appointment, and say goodbye until the next scheduled visit. Usually this process occurred within a 15-minute window arranged by the physician's front office staff. Although this type of health care visit still occurs, it is fast becoming an exception to the new rules of primary care. This column, the second in a series on the players changing primary care, focuses on non-physician health care providers.

Part of the reason that primary care is changing is because other providers are offering the same services. These non-physician health care providers include nurses, physician assistants (PAs), and nurse practitioners (NPs). They have less training than physicians but can competently give services such as check-ups, medication monitoring, and vaccinations. The lack of training also means they command smaller salaries than physicians, and this savings is passed on to the patient in the form of smaller visit fees and co-pays. Along with lower price points, non-physician health care providers offer more convenient services. Rather than a clinic or ER these providers deliver services in more accessible locations such as drugstores. Others offer convenience through more flexible scheduling and shorter wait times.

An example of this shift toward non-physician primary care providers can be found at CVS stores. The drugstore chain now offers MinuteClinics for patients with or without insurance interested in receiving on-demand diagnoses and care for common ailments. The PAs and NPs that staff MinuteClinics also offer preventive and wellness services and vaccinations. After seeing the provider patients can walk across the store to fill any prescriptions or purchase over the counter treatments recommended by their provider. This allows patients to fulfill many primary care needs without visiting the doctors office - or leaving the drugstore.

(For more on non-physician health care providers changing primary care, continue to Part 3 here.)

Photo credit: minuteclinic(dot)com