The Sacramento Business Journal (subscribers only) has surveyed the "drop-in" clinics that have sprouted up around the state's capital city in the last three years or so.

It's amazing what a diverse group they are! Sutter Express Care, owned by a large non-profit, hospital chain, has been hoping to use its convenient clinics as a "feeder" for more value-added, hospital-based services. It's not an approach favored by the founder of QuickHealth, a stand-alone chain of clinics located in Wal-Mart, Long's Drugs, and Farmacia Remedios, who believes that people are more loyal to retailers than health-care providers. The entrepreneur in question, Dave Mandelkern, is a businessman who engages physicians, not nurse practitioners, in QuickHealth clinics. Another clinic, Medi-Stop, is owned by two physicians but care is given by nurse practitioners. And it's not in a drugstore, but an office park, to attract workers who want to take a short break (not half a day) from their jobs to get health care.

And guess what? Some are succeeding, some are not doing so well, and all are facing conditions a little different than they had expected. Despite California's over-regulated scope of professional practice codes (as discussed in the U.S. Index of Health Ownership) a number of different business models are competing to gain a foothold.

How distressing this must be for the central planners of American health care! No Center for Medicare & Medicaid Services regulations & guidance for providers (cash payment only, please); no co-ordinating with the U.S. Secretary of Health & Human Services' 500 (or 5,000) day plan to "transform the health care system"; no compliance with the Office of Statewide Health Planning & Development (OSHPD) Facilities Development Division (FDD) such as burdens hospitals; et cetera.

Just entrepreneurs and health care professionals trying to figure out how to deliver care in their communities. How dare they!