Is 'Quick' Enough? (Store Clinics Tap a Public Need, but Many Doctors Call the Care Inferior)

Washington Post ^ | 16 January 2007 | Ranit Mishori

[shrinkermd]

Some of the newest players in health care are rubbing doctors the wrong way.

You may know them: those small clinics at your neighborhood Wal-Mart, Target or CVS that promise quick attention for routine visits -- sore throats, minor aches and pains, flu shots -- with no appointments needed. The clinics, which go by such names as MinuteClinic, RediClinic, QuickClinic, Medpoint Express, Curaquick and MediMin, offer convenience and low price -- scarce commodities in today's medical marketplace. But while consumers are taking to the concept, physician resistance is building.

...Not that many are convinced this trend is good for patients. Within the past six months, the American Medical Association and the American Academy of Pediatrics have both decried it.

[shrinkermd]

The AMA is making a big mistake. These clinics are helpful in both providing immediate, necessary services and in keeping health costs down.

Almost everyone I know received their "flu shot" from a store clinic. This is a service whose time has come and professional groups will be unsuccessful in stopping it.

[Libertarianchick]

My mom was just sick and I took her to one of these. They did a strep test, a flu test, and diagnosed it as viral, which you can't do anything about.
Unless these quick clinics hand out antibiotics for viral illnesses or miss warning signs, they're much better than bothering another doctor with minor problems.

[Publius Valerius]

Yeah, interesting. I visit urgent care facilities from time to time, but I also have a PCP that I'll go to for more serious things. I've generally had good experiences, and it just doesn't make too much sense to me to go to my PCP when all I need is a guy to write me a prescription.

I think a line from the article is telling: "Van Vleck agrees: 'When I see a kid for a sore throat, I get to go through their chart. If they have a little bit of scoliosis I might check their spine. I will check their immunization record. We go over the record, and we try to go over what's going on besides the sore throat, or besides the ear infection.'"

Translation: I add on a bunch of services that the patient hasn't requested, and then I charge them for those services.

[Gabz]

Translation: I add on a bunch of services that the patient hasn't requested, and then I charge them for those services.

You got that right. The AMA and APA are picking up where the unionnn goons leave off in attacking free enterprise.

[TASMANIANRED]

These clinics will continue to prosper as long as it takes up to a week to make a sick visit....and 3 months to make an appt for a well visit to a physician.

[Virginia Ridgerunner]

As traditional medicine sees it, when a young patient gets hurry-up treatment for a single symptom at a retail-based clinic (RBC), also known as a convenient care clinic (CCC), the process leads to "fragmentation of care."

Heck this is what we're getting anyway with our primary care physicians. Every time I visit, I'm in and out in under five minutes with a prescription, and this is presuming that an appointment is available when I need it. My wife had some kind of bug last week, and she couldn't even get in to see her doc period, and she ended up just treating herself with Thera-flu.

As this article strongly implies, I just think that the regular docs feel threatened and that they don't want to adjust their hours or fees to compete. Go clinics!

[Harmless Teddy Bear]

These clinics will continue to prosper as long as it takes up to a week to make a sick visit....and 3 months to make an appt for a well visit to a physician.

Bingo. And half the time you don't even see the doctor, just the PA

[Jeff Chandler]

half the time you don't even see the doctor, just the PA

We have some very good PAs. It takes a long time to get an appointment with our Primary Care Physician, but we can get to see our PA in the same office right away. If all I need is antibiotic and cough syrup scripts to ward of a bout of bronchitis, why not? If I need to go over CT scan results, I see the Doc.

[usmom]

These clinics will continue to prosper as long as it takes up to a week to make a sick visit....and 3 months to make an appt for a well visit to a physician.

Exactly. These clinics are filling a need that consumers want- quick, convenient and reasonably priced care. MD's will not be successful in fighting these unless they are willing to provide some of those same services themselves- and that is highly unlikely.

[Harmless Teddy Bear]

There is nothing wrong with seeing a PA. My mom is one. But far too many offices you make a doctors appointment and you don't see the doctor. They need to say up front that you will be seeing a PA.

[rbookward]

Some folks sure do hate capitalism, don't they?

If a little clinic messes up, they'll get sued, just like a big clinic.

Meanwhile, a lot of people get at least some kind of care right away that they would otherwise have to wait for.

[Tax-chick]

In the military, we saw a nurse or a physician's assistant for just about everything. Heck, a paramedic can do much of what civilians have to see a doctor for.

[USMCWife6869]

Heck, I barely get past the Corpsmen when I go to our clinic. We don't have a full-srevice clinic here at our base. I understand the stresses on military medicine, really I do, but if I call and say I know my daughter must have strep, being the mother of three and experiencing it before, and I get told that I can't get in to see ANYONE at all for 3 or 4 days...forget it.

On this particular occasion, I just waited until 4 PM, called the clinic duty medic and then got a referral for the out in town urgent care clinic. We were in and out of that clinic in 20 minutes, whereas on base I have to schedule an entire day for appointments.

I'd go to these clinics if they were near me.

[Gorzaloon]

Meanwhile, a lot of people get at least some kind of care right away that they would otherwise have to wait for.

OR for which they will tie up the local Emergency Room, as they do now.

[Gabz]

I see absolutely nothing wrong with these clinics.

[rbookward]

OR for which they will tie up the local Emergency Room, as they do now.

Sounds like a win-win.

Folks get quick care for little problems, emergency rooms get a lighter load, and somebody makes money.

Now, if we can just keep the lawyers out of the loop!

[Doghouse Riley]

Yep. The MD trade groups have been whining for years about how there isn't enough reimbursement in primary medicine.

So here's an outfit that puts the lie to that by making it work profitably. More power to them say I.

[shrinkermd]

If you are over 65 on Medicare and live in a big city you will seldom see a physician unless necessary. You will receive excellent followup and other care from a physician's assistant or other non-MD professional provider.

Medicare has reduced benefits to such a degree this is the only way a cognitive specialist or outpatient physician can survive. In doing so they have proved the value of the physician's assistants and registered nurses.

I look forward to my registered nurse far more than to my physician. She is more contactful, patient and interested than my highly trained specialty physician. She also, like any professional, knows what she doesn'g know. Many have similar experiences and that is why I am optimistic about the trend in medical care.

[Kirkwood]

A viral infection can quickly become a bacterial infection which should be treated with antibiotics, particularly in the elderly. So for many people it is better to go to the same doc who has your medical record and knows if you are prone to certain complications from an illness (e.g., bacterial sinus infections accompanying a viral cold) or even complications to the treatment to an illness (e.g., allergies to certain meds). The Walmart-style clinic serves a purpose, but it doesn't replace having your own personal doctor who knows your history.

[Recovering Ex-hippie]

Excellant.