Retail Health Clinics Pick up Momentum in Tx.

Published June 1, 2007

Retail health clinics are becoming increasingly popular nationwide, and the movement got a boost in Texas on February 15 when Baylor Health Care System and MedBasics announced a formal collaboration.

Under the agreement, Baylor physicians will provide medical oversight for certified nurse practitioners (NPs) working at MedBasics clinics, enabling the company to expand its operations in the Dallas/Fort Worth area.

Grace-Marie Turner, president of the Galen Institute, a free-market think tank in Virginia, praised the deal. “These walk-in clinics are answering a growing demand for health care that is accessible, convenient, and consumer-friendly,” she said.

Deregulating Practitioners

To facilitate the growth of the retail health clinic industry in Texas, state Rep. Bob Orr (R-Burleson) introduced H.B. 1096 on February 5 to provide flexibility in the marketplace for staffing NPs.

In effect, the bill would increase the number of NPs a physician can supervise from three to six and would eliminate the mandate that a physician be on the premises 20 percent of a clinic’s operating hours. At press time the bill was pending in the House Public Health committee.

The Texas Medical Association strongly opposes the legislation, saying NPs should provide only those medical services that are safely within their education, training, and skill levels.

Solving Crisis

Texas is not the only state to attempt to deregulate its practice barriers to NPs and advanced practice nurses (APNs). According to the American College of Nurse Practitioners, 22 states and the District of Columbia allow NPs to treat patients without supervision, and 28 allow them to do so with documented physician involvement.

While the number of general-practice doctors declines nationwide, the need for access to qualified health care providers is growing.

Regulatory reform such as that proposed in Texas goes “a long way to solving the crisis in hospital emergency rooms,” noted John R. Graham, director of health care studies at the Pacific Research Institute, a free-market think tank in San Francisco, “because they offer a more sensible alternative when your physician’s office is closed.”

Meeting Needs

In addition, the Medicare Modernization Act of 2003 has generated the push towards consumer-driven health care–a niche the clinics fill nicely.

“Retail health clinics, whether in shopping malls or workplaces, offer consumers significant convenience and price advantages for a wide range of relatively minor conditions,” explained John McClaughry, president of the Ethan Allen Institute, a free-market think tank in Vermont. “They are especially compatible with consumer-based health plans, built around health savings accounts, where informed customers are consciously seeking price and value.”

With 300 stores in 25 states run by 13 different operators, the seed for these convenient clinics has been planted. The growth of the industry will be limited only by the scope of practice regulations for NPs and APNs, who make up a growing share of the health care professionals in the country. They will carve out a niche market to help consumers have convenient basic medical care at a fair and transparent price, Graham said.

James Rottet ([email protected]) is a legislative analyst specializing in insurance at The Heartland Institute.