Posted on 09/12/2009 5:25:50 AM PDT by reaganaut1
Retail health clinics are adding treatments for chronic diseases such as asthma to their repertoire, hoping to find steadier revenue, but putting the clinics into greater competition with doctors' groups and hospitals.
Walgreen Co.'s Take Care retail clinic recently started a pilot program in Tampa and Orlando offering injected and infused drugs for asthma and osteoporosis to Medicare patients. At some MinuteClinics run by CVS Caremark Corp., nurse practitioners now counsel teenagers about acne, recommend over-the-counter products and sometimes prescribe antibiotics.
...
Walgreen, the second-largest pharmacy chain by stores, plans to start a pilot program for managing diabetes in coming months. The program will coordinate its pharmacies, retail clinics, call centers and mail-order operations. Diabetes patients may browse the rest of the store for testing supplies such as blood glucose meters and strips, and sugar-free candy. The company has nearly 350 clinics in its drugstores and at big employers including Toyota Motor Corp. and Walt Disney Co.
CVS's MinuteClinic is piloting a rapid test for conjunctivitis, or pinkeye, at its Atlanta clinics and working with the Cleveland Clinic to provide care to asthma patients.
But such moves are raising the ire of physicians' groups that see the in-store clinics as inappropriate venues for treating complex illnesses. In May, the Massachusetts Medical Society urged its members to press insurance companies on co-payments to eliminate any financial incentive to use retail clinics.
"The whole notion of diagnosis and treatment is not just about passing out pills based on a cookbook recipe," said Dr. James Milam, president of the Illinois State Medical Society and an obstetrician and gynecologist in Vernon Hills, Ill. "We look for coordinated, continuous, comprehensive care, not episodic, fragmented, drive-through care."
(Excerpt) Read more at online.wsj.com ...
I condemn the AMA for supporting the Democrats' health plans but note that many doctors, including several Freepers, are opposed.
Sometimes doctors are their own worst enemy.
Running a doctor’s office in a drugstore isn’t any brilliantly new concept. If they spot something that can’t be treated there they would send the patient to a hospital, same as a conventional urgent care center would.
The article rises the issue however of the demand for different levels of care.
There are emergency care and instant care facilities for paying customers outside the normal doctor’s offices and hospitals.
We know that hospitals are forced to treat all comers and the numbers of these people are burdening emergency rooms. Why don’t hospitals establish formal outpatient clinics along side the ER to handle the non emergency patient needs?
Not everyone can afford a Cadillac. And many of those who can, just don’t care to spend that kind of money for transportation and drive a used Ford or ride the bus.
Quick and discounted medical treatments should be available-the AMA is all wet here in their opposition to private clinics.
I think that private clinics can offer real value to consumers.
Sure in the ideal world, its better to have a fully informed physician treating you and to have all of the options carefully weighed and considered. But that is a very expensive way to go, and not all private doctors are as up-to-date as they ought to be.
Depends on what the goal is. The first goal of any physician should be to provide the very best care that you are capable of. If people want to work for a ‘doc in a box’, that's OK with me, as long as you provide a high level of care. The problem is that the general public thinks that a doc is a doc is a doc. That's just not true. I know plenty of physicians that I don't think make good decisions, and they are ‘well-trained’. Medicine is not a field like mathematics in which there is a definitive answer to a problem, an answer that doesn't vary depending upon who is trying to solve the problem. The complexity and variability in presentation is such that you could go to six different physicians for the same problem and get six different answers. That's not because there is a lack of standardization in training. It's because all physicians are not equal in their abilities or their approach.
My wife could shop.
When I'm done we could hit Orange Julius or Famous Amos and she can drive me home.
Regards
CVS’s MinuteClinic is piloting a rapid test for conjunctivitis, or pinkeye, at its Atlanta clinics and working with the Cleveland Clinic to provide care to asthma patients.
Rapid test for pink-eye? As a mom of four I can tell you without paying for a test whether you have the creeping eye crud or not.
Your typical group practice bought a building in a "commercial district" with minimal garage parking for the tenants, and unsatisfactory on-street parking for the patients.
Worse are the "medical care" complexes just choc full of doctors ~ mostly specialists ~ that don't have sufficient "handicapped parking" for the type of business they're running.
Just spent a couple of months dealing with Scripps which is one of the worst places for parking outside of Manhattan Island.
You laugh but that is the sort of outside the box thinking that will show results.
There are vacant spaces in malls as retail moves to newer strip centers. A decent sized shop could easily be used for just such a singular use facility. It would be no different than similar GI facilities in multistoried buildings.
Treating chronic diseases is where the money is in medicine (not amputating legs, as Obama suggested.)
As one doctor told me: “The most profitable practice is dermatology. The patients never die, and they never get better. The just keep returning for treatment over and over again.”
I think we need more of this.
For one thing, CVS is a block away from my house. When I get sick, I self-diagnose and self-medicate because the nearest doctor must be driven to.
When it’s cold season, do I really need a doctor to tell me I have a bad cold?
So much of medicine is regulated “for our own good” to the point we can barely do anything for ourselves, and then we’re lectured about not taking responsiblity for our health.
If we had better access to information, and could bounce our own reasoned decisions off a qualified individual, and then get some level of prescription drugs (if needed), most of us wouldn’t need a doctor.
This would free them up for the real needs - chronic disease treatment, emergency treatment, cancer, etc.
The argument could be made that we might hurt ourselves without a fully qualified doctor for every little thing. However, the fact is, that visiting the doctor is such a PITA for a plethora of reasons, even with good insurance, that most of us just don’t go unless we’re near death or are afraid of losing a body part.
Many have, and most are in the "consideration" or "planning" stages of doing so.
As a nurse myself, I have NO problem with a PA or NP handling "routine" DR's-office-type visits. They should be quicker, easier to get into on short notice, and far cheaper than "traditional" MD visits and FAR better than the hospital ER for the basic medical complaints. Things like routine colds and flu, physical exams, immunizations, etc. can be far more effectively, and more inexpensively, dealt with in this type of setting.
The biggest plus to this is that it will FORCE MD's to cut their prices and increase their Customer Service aspects of their practice(s). How many times have you still been sitting in the waiting room 30-45 minutes AFTER your appointment time?
However, a "Doc-in-a-box" (by whatever name) is NOT a replacement for a Primary Care Physician, ESPECIALLY when it comes to the management of chronic conditions such as COPD, diabetes, and hypertension. These conditions really do need the long-term management provided by a qualified physician.
I have long advocated that there should be NO such a thing as PRESCRIPTION drugs. Any adult should be able walk into any pharmacy, sign a wavier stating that they are a) an adult, and b) are aware of the risks/benefits of a medication - then leave after paying for the purchase.
If a medication is certified by the FDA as beneficial for a specific condition, it should be readily available to any adult.
One of the things that frosts me the most is my wife HAVING to go to the MD once par year (at an OUTRAGEOUS price), be examined and tested, then get a script for birth control pills. Or, you get a script for 10 days worth of an antibiotic for an infection. 10 days later, you are feeling better but still not quite well yet. You HAVE to go BACK to the Doctor, pay another copay or office visit charge, just to get a refill!
Bump
Doctors are not required for most ailments. We had three babies without a OBGYN (2 Midwives + hospital, 1 Midwife home birth). The more services offered without MDs the better. And these massive corporations can easily handle any liability claims.
I used one of these awhile back. My own doctor was booked solid, and I thought this might be a better option than an emergency room. It wasn’t an emergency, but I DID need to see a doctor. This actually worked out very well, and it’s nice to have this other option. Sometimes it’s hard to get in to see your regular doctor—illness and accidents don’t always give you a two week margin for making appointments!
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