What is the main concern of doctors questioning the new Walgreens approach?
Critics wonder whether the expansion of services in retail clinics means that patients with a chronic condition who seek affordable, convenient care will end up forgoing quality, coordinated care. If nurse-practitioners at Walgreens are managing chronic diseases, "having a piece of your blood pressure checked here or your diabetes checked over there means that nobody's taking care of the whole person," says Jeff Cain, M.D., president of the American Academy of Family Physicians.
"You miss the opportunity to do prevention, to do diet counseling, to make sure that the diabetes and the blood pressure and heart failure that are complex issues [are] managed together," he says.
How do nurse-practitioners respond to doctors' concerns?
Anne Norman, associate vice president of education of the American Association of Nurse Practitioners, counters that nurse-practitioners are indeed treating the "whole person" in retail settings. She says they work to "involve the patient in developing an appropriate plan of care" and concentrate on evidence-based care for the "best patient outcome." Just like doctors.
Alan London, M.D., chief medical officer at Take Care, says he stands by the training of his board-certified nurse-practitioners. For the 40 percent of patients who have no primary care doctor, the staff tries to refer them to one, London says. Having trained side by side with nurse-practitioners, he concludes, "They're wonderful at providing this kind of care."
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