The changing healthcare landscape

. . . . While doctor nurses are still a rare breed nationally, that's about to change dramatically. The first class of 24 doctor nurses graduated in December from the University of Minnesota's School of Nursing, one of a handful of schools at the forefront of this trend. All have returned to their jobs or new positions, some with expanded roles and pay. Now more than 90 nursing schools have introduced DNP programs and 200 more are about to start. Beginning next year, the University of Minnesota is converting its entire master's of nursing practice program into a doctoral course, meaning any nurse practitioner who passes board exams will be a doctor nurse. . . . . Experts are forecasting a shortage of physicians in the country by 2020 because the population has grown even as enrollments in medical schools have remained flat. What's more, 36 percent of active physicians are older than 55 and most will retire by 2020 . . . . The shortage is already showing up in primary care, which includes family medicine, pediatrics and internal medicine. This year, U.S. medical graduates filled just 1,156 of 2,387 residency positions nationally in family medicine; the rest were filled by foreign medical graduates. Primary care doctors are paid far less than specialists. . . . According to Delaney, there is already an 80 percent overlap between what nurse practitioners do and what primary care physicians do.

Wal-Mart Expands In-Store Health Clinics

Wal-Mart Stores Inc. will open its first in-store medical clinics under its own brand name after leasing space in dozens of stores to outside companies that operate the quick-service health stops.
Bentonville, Ark.-based Wal-Mart is among several U.S. supermarket and drug store chains that in the past couple of years have begun opening store-based health clinics, which are staffed mostly by nurse practitioners or physician assistants and offer quick service for routine conditions from colds and bladder infections to sunburn.
About 7 percent of Americans have tried a clinic at least once, according to an estimate by the Convenient Care Association, an industry trade group formed in 2006.
That number is expected to increase dramatically, as chains like Wal-Mart, CVS Corp., Target Corp. and Walgreen Co. partner with mini-clinic providers like RediClinic and MinuteClinic to expand operations. The trade group estimates there will be more than 1,500 by year-end, up from about 800 in November.

Express-Lane Medicine (Newsweek)

[By] offering patients quicker, cheaper alternatives to doctors, so-called convenience-care clinics—staffed by nurse practitioners who offer low-cost treatment for easy-to-diagnose conditions—are spreading faster than a cold in a kindergarten.