As you know my wife and I travel in our RV full time. As a result we see and experience many things that others do not. Not only do we see the normal tourist sites but we also observe people, communities and trends. One of the trends that I intend to invest in at its future IPO is what I call "drive through health care."

We recently visited Jeff and Wanda our long time friends who reside in North Carolina. Jeff was a Nurse in the U.S. Navy and went back to school to become a Nurse Practitioner (a PhD. no less). He is now the manager of a whole group of Nurse Practitioners who have offices in pharmacies and even some Wal-Marts. For $60.00 you can see a Nurse Practitioner without an appointment and get your medical needs taken care of with the convenience of a co-located pharmacy. How cool is that!

Nurse Practitioners are very good diagnosticians and (under the supervision of an M.D.) can prescribe medicine just like a regular Medical Doctor. NP's can refer you to medical "Specialists" just like any Family Practice M.D. would. In fact, we have a crisis in the M.D. field in that most of our current medical students don't want to be Family Practice docs. Instead, they want to be "Specialists" (more $$$). Bottom line, if we don't do something like encourage and promote "drive through health care," and soon, we will all be looking for a Family Practice doc and waiting in long lines at crowded germ-infested offices.

These NP walk-in clinics were designed by the same person who designed the Starbucks interiors, so they are very pleasant and inviting spaces. Wal-Mart and the other large pharmacy chains must be thinking that this is a reasonably inexpensive way to provide on-site health care for all their employees. This is a new concept that seems to fit the American lifestyle well. If we can keep this type of care inexpensive from the start it will be a boon to those who currently have little or no access to health care.

What we need the government to do is to limit NP malpractice litigation, promote the profession by officially recognizing them as a professional body by cutting their statutory reliance on supervising M.D.s. and allow them more freedom to do what they do best - family medicine. Do these things and the marketplace will keep access to medical care at optimum levels and the price of health care to a minimum.

I even like this concept better than socialized medicine because it resides in the heart of the American retail marketplace and fits our "drive through" lifestyle. Socialized medicine costs too much and is ineffective precisely because it is not driven by market forces. Customers suffer because they have little or no say in how socialized health care is managed. Just look to Canada to get a snapshot of the slow, overcrowded ineffective deployment of socialized medicine. Socialized medicine is "camp out in the lobby bring your sleeping bag and extra food" medicine while this new model is "drive through" or "just in time" medicine. This is a huge part of the answer to our health care crisis, but we need to help the NP community get this off the ground and the sooner the better!

Jim Twamley