Should Chronic Illnesses Be Managed in Convenient Care Centers?

Abstract

The first convenient care clinics opened in the United States in 2000. Twenty years later, with more than 2,700 locations in 44 states, convenient care has logged more than 40 million patient visits, most of them by family nurse practitioners (FNPs). 1 Few would argue that health care in the United States is in need of innovation, and innovation always brings controversy, opposition, and doubt before it achieves broad acceptance. The numbers alone argue that convenient care is meeting a need that had been unmet previously. The question of drawing a line between urgent/acute care and chronic disease management and suggesting that the latter should take place elsewhere, to my mind, is the wrong question. These are NPs we are talking about. How many NPs would ignore a chronic condition in a patient they happened to be seeing for another problem? When an innovation that is working is criticized, it begs a few questions: How many of those 40 million visits could have been absorbed by already overburdened "traditional" health care resources? How many of those patients would instead have gone without care? How many went to a convenient clinic because they prefer seeing an NP? But are convenient care centers set up to dealing with chronic problems?