You’ve got that telltale tickle in your throat again, and you’re pretty sure it’s not just another cold. But your doctor’s office says the next open appointment is in two weeks. You’re traveling for business in another city. You don’t have a primary care physician to call. You’re self-employed and don’t have health insurance.

For all these reasons and more, potential patients are turning increasingly to retail clinics to cure their minor ailments.

According to a 2008 report by Mary Kate Scott of Scott & Co., the number of retail clinics in the United States grew from 150 to nearly 700 clinics last year. Renting space in drugstore chains such as CVS and Walgreens, major retailers such as Wal-Mart, and even hospitals, the clinics are filling a need for convenience, cost and a more consumer-like approach to health care.

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John White was running a low fever, his sinuses and ears felt full and he was tired, so he walked into a Bradenton medical clinic.

Valerie Fortunato asked a series of questions about his medical history, then performed an examination including checking his ears, eyes and throat, and listening to his lungs and heart.

In about 30 minutes, White left with a diagnosis of a sinus infection and prescriptions for antibiotics, antihistamine and a nasal steroid.

Fortunato is an advanced registered nurse practitioner, and her clinic is a gray-walled box inside a Publix supermarket.

Welcome to another facet of the future of medicine.

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Most Americans can share horror stories of trying to schedule a doctor’s appointment — if you want to get in quickly, well, good luck.

You have about as much chance as getting a private audience with the pope.

Routine checkups often must be scheduled weeks or even months in advance. Once there, better find a magazine and expect to wait some more.

I’ve never understood why doctors’ offices make people wait so long. Don’t they know we have jobs, lives?

If an appointment is for 1:30, patients should expect to be seen at that time — and if the doctor is running behind, the customer deserves an update or apology.

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Driven by consumer demand, the convenient care clinic (CCC) tsunami seems unstoppable. Despite initial resistance to the nurse practitioner-staffed CCC concept from many physicians, NPs and the CCC industry have pushed forward. They now stand in a national spotlight that is highlighting an innovative and successful approach to delivering affordable, accessible, quality care for minor conditions.

“NPs are the best kept secret in health care, but the healthcare system cannot afford these types of secrets. The CCC industry puts NPs front and center,” says Susan Apold, RN, PhD, ANP, immediate past president of the American College of Nurse Practitioners. The secret is officially out, and Convenient Care Association member clinics are employing NPs to staff 80% to 85% of clinics.

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The drug stores and big-box retailers opening in-store clinics should make a choice: Stop selling cigarettes, or shut down the clinics. At least, that’s the position the AMA adopted this week at its big annual policy meeting.

The AMA doesn’t oppose retail clinics, but doctors’ groups in some states have called for tighter regulation of the clinics, which are typically staffed by nurse practitioners. We wondered whether the new AMA policy was a back-door way to slow the growth of the clinics

“In no way is this resolution to get back at them,” William A. Dolan, an orthopedic surgeon on the AMA’s board of trustees, told the Health Blog. “It’s ridiculous that a health deliverer should be dispensing cigarettes.

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According to the American Public Health Association, there were approximately 700 retail-based healthcare clinics operating in the U.S as of December 2007. These clinics, also known as convenience care clinics, are typically found in stores such as Walgreens, Target and Wal-Mart, and are usually staffed by Nurse Practitioners and Physician Assistants.

According to the latest WSJ.com/Harris Interactive health care study, U.S. adults who have used these health clinics in a pharmacy or retail chain are generally pleased, as almost all are very/somewhat satisfied with the quality of the care (90%), cost (86%) and staff qualifications (88%). As in prior surveys on this topic, the biggest driver of satisfaction appears to be convenience, with 73 percent very satisfied and another 20 percent somewhat satisfied with the convenience of these clinics. These clinics continue to be a destination for comparatively routine services like vaccinations and care of respiratory infections, and while public acceptance is increasing, they not particularly appealing for attention to more serious conditions.

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