Some 17,000 physicians are currently needed to care for the 65 million Americans who live in primary care shortage areas, according to the U.S. Department of Health and Human Services ( And this shortage will increase in the decades ahead.

Under healthcare reform, 32 million formerly uninsured patients will enter the system by 2019. Due to the shortage of primary care providers, new models of care for patients with routine problems will have to be created.

Quick Care

Healthcare reform may restart the growth of retail clinics, where nurse practitioners and physician assistants offer quick care for a set fee at convenient locations. Target (, for instance, announced in June that it would add eight new clinics in stores located in Chicago and Palm Beach, Fla.

Local healthcare organizations are also showing interest in the model. In August 2009, HealthPartners ( opened a QuickClinic at its Woodbury clinic. QuickClinic is open nights and on weekends. Patients with routine problems are treated for about half the cost of a visit to urgent care.

And last September, Allina ( and MinuteClinic ( took steps to integrate their healthcare delivery systems in Minnesota - including electronic medical-records systems.

Connected Health

It's also likely that more patients will receive basic care outside the clinic through the use of technology. This model, known as "connected health," relies on electronic communication.

One of the newest examples of connected health is Zipnosis (, which allows patients to fill out a survey online and get a diagnosis. The survey is reviewed by a nurse practitioner who sends a prescription to a nearby pharmacy. Treatment is limited to minor ailments like sinus infections.

In this time of change, one thing is certain: Care is shifting to alternative sites outside the hospital and traditional clinic. This means that health professionals must be willing to work in new settings, using new approaches.