The retail clinic model relies on a nurse practitioner as opposed to a physician to perform most services. Although nurse practitioners are not as highly educated as physicians, most have completed extensive medical training and are adept at addressing even complicated concerns. According to the report, many find treating minor illnesses in retail settings to be intellectually unrewarding and below their level of advanced training. Furthermore, these isolated settings fail to provide collegial relationships with other healthcare practitioners.
Compensation is also an issue, since to make a profit at the low prices they charge for services, convenience clinic chains must contain costs. This means not only keeping overhead costs low, but also ensuring that they do not overpay their staff. By 2011, the average annual salary for a nurse practitioner had risen to more than $90,000, while salaries in particularly busy areas can exceed $100,000. Some retail clinics have attempted to recruit nurse practitioners at lower salary levels in exchange for various benefits including a flexible working schedule. This has not always proven successful, as nurse practitioners increasingly consider themselves to be part of a highly compensated medical team and seek salaries closer to those offered to physicians. The report finds other fields, such as aesthetic medicine, are also competing for the approximately 100,000 nurse practitioners currently working in the U.S., and many are willing to pay higher salaries.
Lastly, contracts preventing nurse practitioners from accepting positions with competing businesses have also proven to slow recruitment. These typically restrict a nurse practitioner from working for a competitor for one year following employment with the company. In June 2007, Take Care Health became the first to eliminate this non-competing clause in its nurse practitioner employment agreements, paving the way for other retail clinics to do the same.