CVS partners with Dartmouth-Hitchcock for Minute Clinics in N.H.
Amanda Parry, advanced practice registered nurse, files paperwork while working at the Minute Clinic at the Hall Street CVS Pharmacy in Concord on Tuesday, December 3, 2013. The clinic opened on November 20 and, along with the other five Minute Clinics, is partnering with Dartmouth-Hitchcock to provide care. (ANDREA MORALES / Monitor staff)
CVS opened two Minute Clinics in New Hampshire yesterday and announced a partnership with Dartmouth-Hitchcock Medical Center to oversee the new facilities.
The Hall Street CVS in Concord and a store in West Lebanon are the first two of six planned clinic locations. A Salem clinic will open Dec. 11, and locations in Hampton, Manchester and Nashua will open in early January.
Two Dartmouth-Hitchcock physicians will act as medical directors for the six locations.
They won’t be on-site but will be accessible by phone or pager for guidance if the on-site provider isn’t sure what to do in a case or wants to confirm his or her diagnosis is accurate, and they will review cases afterward, said Ethan Berke, director of primary care and population health with Dartmouth-Hitchcock.
“To build a sustainable health system, we need to be able to provide the right care that’s appropriate at the right time at the right cost,” Berke said. “We do a lot of things right in the hospital and the emergency room and the primary care offices. But for low-acuity issues like colds and sinusitis, when our primary care office isn’t available, patients might use one of our other sites and be in an inappropriate setting for the care that they need.”
Berke said he doesn’t see the clinics as competition with his primary care offices.
“At the primary care offices, we don’t have the efficiency to operate the extended hours at the price point they do. For these conditions, they can provide an equal quality of service at a lower price point and in many cases more convenient times for patients,” he said.
The clinics accept private insurance and Medicare, and they have begun the process of applying for approval to be reimbursed by Medicaid, said Anne Pohnert, the eastern region manager overseeing clinics from New Hampshire to Washington, D.C.
About half of the patients that visit a Minute Clinic do not have a regular primary care physician, she said, and the provider at the clinic will provide them a list of nearby physicians accepting new patients.
The clinic is equipped with an electronic medical record to send to the primary care doctor with patient permission.
The most common complaints for people who visit one of the clinics – there are already 680 in 25 states – are sinus infections, sore throats, urinary tract infections and minor skin conditions, Pohnert said.
Retail clinics like Minute Clinic don’t have X-ray machines or laboratory equipment and can’t treat serious injuries, such as broken bones, or set sutures.
Sometimes, patients will come in with more serious conditions without knowing it, Pohnert said, like a man with abdominal injuries from a chain saw accident, she said.
Pohnert arranged for him to go to the local emergency room, she said.
Nurses at other clinics have told her stories of patients coming in with pain they think is heartburn but is actually congestive heart failure, or a woman who didn’t know she was 34 weeks pregnant.
“We really want people to get appropriate care, but sometimes it’s hard for the average person to know if they’re not feeling well, if it’s a sinus infection or if it’s pneumonia,” said Pohnert. “Nurse practitioners are trained to recognize those more serious conditions.”
Amanda Parry is the advanced practice registered nurse who will staff the Concord location.
She worked for several years at Exeter Hospital, primarily in orthopedics, but working a primary care clinic after hours.
“That’s what I wanted to do more of, because that’s what I focused on in school, treating the whole patient, not just a broken bone,” she said.
She said she’s looking forward to being the one person patients interact with during their visits, instead of having assistants who do initial intake interviews and exams.
“If they only have to tell their story once, and if it’s just you and them in this room, and not people coming and going in and out, they end up talking a little bit more. You get more of their story,” Parry said.
(Sarah Palermo can be reached at 369-3322 or firstname.lastname@example.org or on Twitter @SPalermoNews.)