Nurse.com ran an article recently about Wal-Mart opening close to 400 new in-store, walk-in medical clinics in their stores nationwide.  This is an interesting trend in retailing and health care that offers new channels of employment for Nurses, especially Nurse Practitioners.  First, some background…

Retail grocery chains all across the country are trying to figure out new ways to drive shoppers into their stores and compete with Wal-Mart and other big box retailers.  These grocery chains are losing shopping trips every day as consumers are flocking to Wal-Mart and Costco to stock-up and buy in bulk at a cheaper cost.  In the retailing industry, this is called ‘taking a shopper out of the market’ – since now they have nothing left to buy – and traditional grocery retailers are feeling the pain as shoppers don’t need to come back to their store for a few weeks. 

Wal-Mart, Costco, Target and others can offer the lowest prices to consumers because they can buy high volume at a lower cost from the manufacturer, and pass along those savings to the shopper.  (There’s much more to it than that, but we’re Nurses…who cares.)  Regional grocery chains can’t compete on price, so they look to other strategies to attract shoppers.

So regional grocery chains are putting more emphasis on non-price related strategies.  They’re focusing on ideas that can connect with their shoppers in ways that a Wal-Mart could not.  For example, they:

• strive to have the freshest produce with the best presentation
• create a unique in-store ambiance that makes for a pleasant shopping experience (is Wal-Mart overly pleasant??)
• focus on customer service
• attempt to help you get in and out of the store as quickly as possible (think about how long it takes to shop a Wal-Mart – it’s a time-consuming, huge pain).

And finally, they’re starting to think of the store as an Anchor Place…somewhere a shopper would want to go for more than just grocery purchases.  Stores have been focusing on other services inside its walls to drive more traffic and give people more reasons to visit.  In-store banks, coffee shops, laundry services and mini-restaurants are all commonplace these days; soon, work stations, internet and wi-fi areas and socialization sections will be commonplace.  Retailers look at these services as ways to drive more trips to the store – trips that otherwise may not exist for the shopper just looking for the best price on Oreo® cookies.  A doctor from Harvard writing for the New England Journal of Medicine wrote a great in-depth article here.

OK…that was incredibly boring, sorry….back to the In-Store Clinics, and why they’re worth knowing about.  A walk-in medical clinic is one such concept that retailers are pursuing to drive trips into their store.  These clinics are designed to be staffed by a Nurse Practitioner; the menu of available services is much smaller than what a Physician could offer.  A typical menu includes vaccinations, screenings and treatment for simple conditions:

The care model is designed to be quick and efficient.  It offers shoppers the ability to get their prescription at the Clinic and then fill it at the in-store Pharmacy (driving more dollars for the retailer!).  In a 2005 poll, only 7% of respondents had used such a service, but 41% said they would likely do so.  So there’s definitely opportunity for growth.

For the Nurse Practitioner, a career with a company operating an In-Store Clinic might be worth looking into.  Pay is comparable to other NP jobs in the metropolitan area.  Schedules are flexible – you could work full-time, regular part-time or casual part-time (at least once every third week).  Most companies offer 401(k), paid Liability Insurance, and the standard medical/dental benefits.  The work generally offers a high degree of autonomy – you can exercise your judgment in making decisions with the patients you see.  Behind the scenes, the companies have medical directors that offer guidance, support and consultation all along the way.  Some additional perspective:

The interior of a typical Wal-Mart clinic:

I should note that In-Store Clinics are not free of controversy.  There are two sides to the argument:  The PROS - that the Clinics offer a convenient way for the general public to get a screening or simple treatment during non-traditional hours and weekends.  The CONS – that retailers should not make money off sick people, that encouraging sick people to come into a food store is a hazard, that the Clinics lack a continuum of care for a patient versus a primary care physician, and that the focus on efficiency may lead to missed diagnoses.

You can read about both sides of the argument here.

Either way, it’s worth exploring for those of you who are Nurse Practitioners.  Here's the careers site of one such company that operates in CVS stores nationwide.
Or, do a Google search for in-store Clinic companies and you’ll find more.

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Notes:
The following is a breakdown of the varying responsibilities nurse
practitioners possess on a state-by-state basis.

States in which NPs can prescribe independent of any physician
involvement (including controlled substances): AK, AZ, DC, IA, ME, MT,
NH, NM, OR, UT, WA, WI and WY.

States in which NPs can prescribe with some degree of physician
involvement (including controlled substances): AR, CA, CO, CT, DE, FL,
GA, HI, ID, IL, IN, KS, MA, MI, MN, NC, ND, NE, NJ, NY, OK, PA, RI,
SC, SD, TN, VT and WV.

States in which NPs can prescribe with some degree of physician
involvement (excluding controlled substances): AL, KY, LA, MO, MS, NV,
OH, TX and VA.

States in which NPs can receive and distribute drug samples: AK, AR,
AZ, CA, CO, CT, DE, FL, HI, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI,
MN, MO, MS, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, SD, TN, TX,
UT, VA, WA, WI, WV and WY