The old stale medical model

Doctors are upset over the new walk in health care clinics located within Wal Mart, CVS and other drug stores. It seems to me this is the first step towards a national, consumer driven model of health care. And the first turf war has begun.

Can a retail store deliver healthcare? Wal-Mart, the largest US retailer, thinks so, together with CVS, Walgreens and Rite Aid, the leading US drug store chains. But as all four move ahead with plans to expand “walk-in clinics” in their stores, the doctors of Illinois are fighting back.

The state could be the first to impose stricter regulation on the new generation of walk-in clinics, where nurse-practitioners can examine patients, conduct basic procedures such as inoculation, and prescribe for minor illnesses, while charging less than a doctor’s practice.

Massachusetts is also considering whether and how to license the state’s first retail clinics, proposed by drugstore group CVS and its MinuteClinics unit. And the industry expects more challenges ahead.

The medical community has a right to be concerned. They want to know that the people working in these clinics are qualified to dx illnesses and prescribe treatment and medications. They want to make sure the clinics follow sound medical practices. Of course they will do so; and we can all rest assured the staff who work in the clinics are well qualified. Nurse Practitioners are well versed and educated to provide the services the clinics will be offering. I suspect many of these clinics will also have actual doctors on staff as well. Everyone needs to remember- these clinics are in it for the long haul. They want to make a profit. In order to do this, they must offer a service at a competitive rate, and the service must be equal to superior of other clinics (and doctors offices, health care groups and the like).
Why not spice up the old stale medical model of services with some good old fashioned American business model?

Walk-in clinics represent one of the most advanced and aggressive attempts by US business and entrepreneurs to drive reform of the healthcare system.

This year hundreds will be opened in some of the US’s largest drugstore and retail groups, and thousands of clinics could be running in the next decade.

Advocates say the clinics will improve access to healthcare and reduce costs; that they will reduce more expensive visits to hospital emergency rooms; and that they will catch some illnesses before they become serious and costly. As a result, physicians will have more time for complex cases.

I cannot think of anyone who would not benefit from these clinics. Really. Open 7 days a week, located at the local Wal Mart, one can bring their two year old son who is complaining of an earache to the clinic at 8pm on Saturday night...the NP will assess and DX an infection and recommend and write a prescript for an antibiotic. She will depend upon YOU to share pertinent information such as allergies and previous illness history. You can bring the prescript over to the pharmacy counter, and they will charge you a mere $4.00 for the drug. The visit will cost you around $35.00 (cash, check, debit, credit)...that is a bargain.

Dr Rodney Osborn, president of the Illinois State Medical Society, said: “This is a brand new animal. That’s why we believe legislation is important to guarantee patient safety ... They’re not putting these things in to provide healthcare; these people are businessmen.”

Oh the doctors are somewhat threatened by it all. It's really too bad a group or two of doctors don't get together and form a similar BUSINESS model and watch it bloom and grow, without all the overhead of a practice. Without all the insurance headaches.

On a national level, the American Medical Association, the doctors’ lobby group, has taken a cautious tone, issuing guidelines last year for clinics. They call for a well-defined scope of services; standardised medical protocols; and clear definitions of medical qualifications. They also call for closer doctor oversight, and emphasise the importance of referrals to doctors, which the leading clinics promise.

In any case, retail clinic companies are expanding nationally. In May, Walgreens bought Take Care, following CVS’s MinuteClinic acquisition last year. Both Wal-Mart and Target, the leading discounters, are opening clinics.

Their national footprint could eventually support the development of a much-discussed but elusive electronic records system for the US, as the clinics build patient databases, see more patients, and give patients printouts of their diagnoses and treatments.

These walk in health care clinics could have a huge impact upon how the nation delivers health care to everyone. Access is an issue for many people- especially those who work during standard MD office hours of operation. Someone almost always has to cut out of work early. Another issue many of us are familiar with is the After Hours "urgent care centers"= located in a nearby or not so nearby city that we HAVE to go to per our insurance rules...and, most of us have to pay a higher co pay when we or a loved one requires medical attention after standard MD office hours. We're punished when we get sick at 6pm on a Sunday night. These walk in clinics will help alleviate some of the hassle we face with our insurance. Heck, the rates are cheap enough I wouldn't even need to seek a reimbursement from my insurance.

With all the debate that is sure to come, this last sentence is well worth reading and thinking about:

More than anything, however, the retail clinics show that business is pushing for change on its own without waiting for government. And walk-in clinics could do for US healthcare what low-cost Southwest Airlines did for the airline industry, by making healthcare better, faster, and cheaper.