Thursday, August 9, 2007
"Minute Clinics" be afraid, be very afraid
We have lots of problems with access to care in the good ole' USA. Forty five million (and growing) have no insurance. Eight in 10 are from working families and 28% of young adults have no insurance. Even with health insurance, we are paying more out of pocket for health care.
So with all of these issues, isn't it amazing that the delegates to the American Medical Association have singled out retail clinics (also known as "quick care" or "minute clinics") as an area of burning concern.
These retail "drop in" clinics are showing up in Walmarts, drug stores and strip malls across the country. Staffed by advanced practice nurses or physician assistants, they limit their care to acute simple problems. Sore throats, urinary tract infections, rashes, and ear aches, managed using clinical guidelines, are the fare of these clinics and prescriptions can be quickly filled by the pharmacy close by. The clinics charge a flat fee (average $40-65) and no appointments are needed.
Some of the opposition comes from doctors that say these easy "in and out" patients are what keeps their practice viable and the clinics are unwelcome competition. Other opposition is concerned with patient safety (read: competition) and conflict of interest between the clinics and retailers that own them.
In Northern California a patient without insurance may call dozens of doctors before they can get an appointment. I challenge you to call a doctor in your community and try to schedule an urgent new patient appointment. The first question will be "What kind of insurance do you have?" There is a serious problem with access to care for patients who wish to pay!
For a single mom with kids, a busy college student or a blue collar worker who can't afford to take a whole day off trying to find a doctor, the retail clinics serve a purpose. The same organization that prides itself on autonomy and free market should focus on other more pressing issues facing health care.
Posted by Toni Brayer, MD at 9:20 PM