American Association of Nurse Practitioners<\/a> (AANP).<\/p>\n\n\n\nFPA is the authorization of NPs to evaluate patients, diagnose, order, and interpret diagnostic tests, and initiate and manage treatments under the exclusive licensure authority of the state board of nursing. This regulatory framework eliminates requirements for NPs to hold a state-mandated contract with a physician as a condition of state licensure and to provide patient care.<\/p>\n\n\n\n
SHORTAGE OF PHYSICIANS<\/h3>\n\n\n\n
The Good Clinic\u2019s NP model evolved from the shrinking volume of primary care practices in the United States, which in turn, occurred because of low reimbursement rates to primary care physicians, Diamond says.<\/p>\n\n\n\n
\u201cWhat\u2019s happened over time is because reimbursements are low, physicians graduating from medical school with these huge student loan bills can’t afford, even if they wanted to, to go into primary care, and so the number of new docs coming out of medical school who want to go into primary care has been waning,\u201d he says.<\/p>\n\n\n\n
\u201cThe AMA (American Medical Association) says there’s a shortage of about 25,000 to 35,000 primary care providers, which is one of the reasons why all of these urgent care centers have popped up, because in America today, it’s typically two to five weeks\u2019 waitlist to get in to see your primary care provider for just a normal visit, a physical, or just a follow-up,\u201d Diamond says. \u201cSo, America learned, \u2018Oh, if I have an earache, a sore throat, or a cut, let me run over to the urgent care clinic,\u2019 and the challenge there is that we stopped providing care and just started fixing problems.\u201d<\/p>\n\n\n\n
But the prevalence of chronic diseases requires that healthcare do more than simply fix problems, he says.<\/p>\n\n\n\n
\u201cDiabetes is at an all-time high, and pulmonary issues, well, they all start somewhere and it’s typically because they’re not addressed earlier in their disease process,\u201d he says. \u201cAnd the government finally has recognized that if you focus on prevention, you can avoid a lot of the costs associated with people developing chronic illnesses, and then deteriorating with them, where it always costs more to address a problem later in its cycle.\u201d<\/p>\n\n\n\n
Nursing is better aligned to primary care from a philosophy perspective than medicine, Diamond says. \u201cNursing is about working with a patient over time, to help them overcome some of the challenges that they’re experiencing, where medicine has evolved to be much more about \u2018one and done. Let me do something and solve the problem,\u2019\u201d Diamond says. \u201cAnd with chronic illness in America, it’s not typically a \u2018one and done\u2019 type of solution.\u201d<\/p>\n\n\n\n
WHOLE-PERSON FOCUSED<\/h3>\n\n\n\n
Good Clinics began when the physicians that started MinuteClinic, which has since been sold to CVS, added Diamond to their team to create a primary care model that was whole-person focused\u2014one that considered physical health, behavioral health, stressors, and how they use the healthcare system.<\/p>\n\n\n\n
\u201cThe concept is about, \u2018How do I take care of a person soup to nuts?\u2019 [by] considering complementary and alternative medicine or whatever the person is interested in\u2014yoga, meditation, supplements, vitamins, standard medicine\u2014and to have a relationship where we co-develop a wellness plan with that person.\u201d<\/p>\n\n\n\n
For example, the adolescent population has been struggling with depression and anxiety after COVID and are frequently prescribed antidepressants by behavioral health services.<\/p>\n\n\n\n
\u201cNo. 1, they\u2019re not looking at their physical health to understand \u201cHow is their nutrition?\u201d because nutrition in adolescents really is the start point of how you feel mentally, behaviorally. We were finding thyroids that are not operating at the levels they should be, and we’re finding that their vitamin D and vitamin B levels are not the adequate level,\u201d Diamond says. \u201cNutrition is the first starting place when you’re trying to address behavioral health issues, and unfortunately, so many of the behavioral health services operate in isolation of primary care.\u201d<\/p>\n\n\n\n
STARTING IN FPA-FRIENDLY STATES<\/h3>\n\n\n\n
The company\u2019s first clinic opened in February 2021, and by the end of the year it had six clinics operating around Minneapolis. This year, it expects to open an additional 12 clinics in Minnesota, Colorado, and Arizona and by next year 50 clinics are expected to be in operation in states where NPs can freely practice at the top of their license.<\/p>\n\n\n\n
And though NPs have FPA in slightly more than half of U.S. states, that doesn\u2019t preclude The Good Clinic from expanding into states where NPs don\u2019t have FPA, Diamond says.<\/p>\n\n\n\n
\u201cNurse practitioners pretty much in every state have the ability to practice; what changes as you go state to state is they often have to practice under the tutelage, from a quality control perspective, of a physician,\u201d he says. \u201cThere are different levels\u2014a physician [may have to] review chart review or they may have to sit in on a certain number of patient visits with a particular nurse practitioner. So, you can operate our model in all 50 states; it just becomes a little bit more expensive.\u201d<\/p>\n\n\n\n
Georgia and Texas, for example, have the highest level of quality assurance, and Florida requires a physician to sit in on all medical exams. But that won\u2019t prohibit The Good Clinic from expanding into those states.<\/p>\n\n\n\n
\u201cIt just lowers it on the list,\u201d Diamond says, \u201cas to where we\u2019re going to want to start.\u201d<\/p>\n\n\n\n
\u201cNURSING IS ABOUT WORKING WITH A PATIENT OVER TIME, TO HELP THEM OVERCOME SOME OF THE CHALLENGES THAT THEY’RE EXPERIENCING, WHERE MEDICINE HAS EVOLVED TO BE MUCH MORE ABOUT ‘ONE AND DONE.’\u201d<\/h3>\n\n\n\n\u2014 LARRY DIAMOND, CEO, MITESCO INC.<\/h3>\n","protected":false},"excerpt":{"rendered":"
The start-up healthcare chain is designed to emphasize wellness and continuity of care through a […]<\/p>\n","protected":false},"author":3,"featured_media":40524,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[14,72,73],"tags":[],"class_list":["post-40523","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-chronic-care-management-ccm","category-chronic-disease"],"acf":[],"yoast_head":"\n
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