Postgrad Med. 2010 Jan;122(1):7-9. doi: 10.3810/pgm.2010.01.2093.
The landscape of primary care medicine is rapidly changing. The decline in interest, both in primary care fields and students choosing these career paths, has left a vacuum in the health care system that must be filled. One of the recent developments has been the birth of "convenient care centers," also known as "retail clinics." This form of health care delivery has mostly been entrepreneurial and based in retail organizations, such as drug stores. These walk-in clinics provide basic medical care for minor common medical conditions, such as sore throat, urinary tract infection, the common cold, and ear infections. Much of this care is provided not by physicians, but by nurse practitioners or physician assistants. After seeing the success of the earliest of these clinics, MinuteClinic by CVS, many other businesses joined the venture, and retail clinics popped up in Wal-Mart, Target, and many local grocery stores. Gradually, hospital systems, physician groups, and managed care companies have also entered the market, sometimes partnering with retail outlets, such as the local grocery store or Wal-Mart, and less often, starting a stand-alone facility. Only 12% of retail clinics are owned by hospital systems or physician groups, while 73% are owned by CVS, Walgreens, or Target. There is even a national nonprofit organization called the Convenient Care Association, started in 2006, and based in Philadelphia, PA. This new trend in delivering health care has been mostly, if not totally, ignored by the medical school practice plans, with the exception of the Mayo Clinic in Minnesota, which has developed several "express care" clinics as stand-alone facilities. As a medical school practice plan and a division of general internal medicine, we could continue to keep a blind eye toward this new trend in primary care medicine or embrace the concept. We aim to develop a new convenient care model integrating our College of Medicine practice plan in partnership with our College of Nursing graduate nursing program to form a stand-alone clinic within a bustling business district in downtown Philadelphia.
基层医疗领域正在迅速发生变化。无论是在基层医疗领域还是在选择这些职业道路的学生中，人们的兴趣都在下降，这使得医疗体系出现了一个必须填补的空缺。最近的发展之一是“便捷护理中心”（也称为“零售诊所”）的诞生。这种医疗服务形式主要是创业性质的，并且基于零售组织，例如药店。这些免下车诊所提供针对轻微常见疾病（例如喉咙痛，尿路感染，普通感冒和耳部感染）的基本医疗护理。其中大部分护理服务不是由医生提供，而是由执业护士或医师助理提供。在看到 CVS 的最早的这些诊所取得成功之后，许多其他企业纷纷加入了这一领域，而零售诊所也出现在沃尔玛，塔吉特和许多当地杂货店中。渐渐地，医院系统，医师团体和管理式医疗保健公司也进入了市场，有时与零售商店（例如当地杂货店或沃尔玛）合作，而很少单独开设诊所。只有 12％的零售诊所由医院系统或医师团体拥有，而 73％的诊所由 CVS，Walgreens 或 Target 拥有。甚至还有一个名为“便捷护理协会”的全国性非营利组织，成立于 2006 年，总部位于宾夕法尼亚州费城。除了明尼苏达州的梅奥诊所（Mayo Clinic）外，这种提供医疗保健的新趋势基本上（如果不是完全的话）被医学院的实践计划所忽略，梅奥诊所已经作为独立机构开发了几家“快速护理”诊所。作为医学院的实践计划和普通内科的一部分，我们可以继续对初级保健医学的这一新趋势视而不见，或者接受这一概念。我们的目标是与我们的护理学院研究生护理课程合作，开发一种新的便捷护理模式，将我们医学院的实践计划整合为一个独立的诊所，位于费城繁华商业区的一个繁华商业区。
