I wrote recently that I did not feel my specialty was threatened by Advanced Practice Nurses and stated why the threat (present since the mid-1990s) had not been made good. There is more evidence in a recent American Medical News that while people may like to shop at WalMart, they are not necessarily looking for health care. The article points out that the Minute Clinic concept is not consistently a break-even proposition and the number of new sites has leveled off. On top of that, many are likely loosing money if you run the math. Why is that? Turns out that the business model of putting a provider among the Kleenexes might work in the winter but isn’t a good idea in the summer. Additionally, these providers are so limited in their scope that even folks that like to consume lots of health care are left wanting. For those that still want to believe that Family Physicians can be replaced, fear not.  “Other clinics are betting that expanding their scope will have some impact. Many are expanding to include wellness services as well as chronic disease management to help spread the business year-round.” I only hope they are up to providing quality care amongst the bowel care products.

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