Re: Drugstore Clinics Spread, and Scrutiny Grows


"Jim Higgins" <gordian238@xxxxxxxxxxx> wrote in message
news:13ctmiudicqkd60@xxxxxxxxxxxxxxxxxxxxx
Nixon.D wrote:
"Jim Higgins" <gordian238@xxxxxxxxxxx> wrote in message
news:13cruhoc0av6263@xxxxxxxxxxxxxxxxxxxxx
Drugstore Clinics Spread, and Scrutiny Grows
http://tinyurl.com/2ghwtm

The concept has been called urgent care ?lite?: Patients who are tired
of waiting days to see a doctor for bronchitis, pinkeye or a sprained
ankle can instead walk into a nearby drugstore and, at lower cost, with
brief waits, see a doctor or a nurse and then fill a prescription on the
spot.

With demand for primary care doctors surpassing the supply in many parts
of the country, the number of these retail clinics in drugstores has
exploded over the past two years, and several companies operating them
are now aggressively seeking to open clinics in New York City.

But with their increasing popularity, the clinics are drawing mounting
scrutiny. Several states including New York, New Jersey, Rhode Island,
Massachusetts and California are examining ways to more closely monitor
the clinics, which are overseen by a hodgepodge of state agencies
applying a wide and inconsistent range of regulations.

More than 700 clinics are operating across the country at chain stores
including Wal-Mart, CVS, Walgreens and Duane Reade.

New York State regulators are investigating the business relationships
between drugstore companies and medical providers to determine whether
the clinics are being used improperly to increase business or steer
patients to the pharmacies in which the clinics are located.

And doctors? groups, whose members stand to lose business from the
clinics, are citing concerns about standards of care, safety and
hygiene, and they have urged the federal and state governments to step
in to more rigorously regulate the new businesses.

?We?ve got big problems in health care, and this is not the answer,?
said Dr. Rick Kellerman, president of the American Academy of Family
Physicians. ?They are a response, they are a niche market and an
economic opportunity, but we still have an underlying primary care
crisis in this country.?

Patients, however, have flocked to the clinics, according to a new
industry group, the Convenient Care Association.

?I think it?s great you don?t have to make an appointment. That could
take weeks,? said Ezequiel Strachan, 33, who lives in Manhattan and
walked into the clinic at the Duane Reade store at 50th Street and
Broadway on a recent morning for treatment of a sore throat. ?People
here value their time a lot.?

The average waiting time for an exam at such clinics nationwide is 15 to
25 minutes, according to the Convenient Care Association.

The association estimated that 70 percent of clinic patients have health
insurance and are using the clinics because of convenience. For them,
costs may not be much different from those at doctors? offices, because
the same insurance co-payments apply. But uninsured patients could reap
substantial savings.

In New York City, one in five residents lacks a regular doctor and one
in six is uninsured, according to a recent survey by the city?s
Department of Health and Mental Hygiene, and overcrowded emergency rooms
are often their first resort for routine care.

State officials acknowledged the clinics? appeal. But they said they
were looking into possible violations of state law prohibiting
unauthorized corporations like pharmacies, which are licensed only to
provide pharmaceutical services, from delivering medical care.

?If we determine the business corporations are practicing medicine, then
they are illegally practicing the profession and we have the authority
to investigate,? said Frank Munoz, associate commissioner of the State
Education Department?s Office of the Professions.

MinuteClinic, a wholly owned subsidiary of CVS Caremark, the drug chain?s
formal name, and the largest of more than a dozen clinic operators
nationwide, manages seven clinics at drugstores in New York state,
including one on Staten Island, and 20 others in New Jersey and
Connecticut. The company said it hoped to open as many as 150 more
clinics in the New York area, which would be staffed by nurse
practitioners and physician assistants.

New York law requires that nurse practitioners work closely with a
physician, who oversees the practice but is not required to be at the
clinic, and that the clinics operate as independent practices or
professional corporations. In other states, the medical providers can
work directly for a drugstore company, a practice that has touched off
concern that the providers might place the interests of their employers
above those of patients.

MinuteClinic officials insisted that there was nothing improper in the
relationships between providers and the drugstores and that medical care
is not being compromised.

?We are transparent with regulators,? said Michael C. Howe, the chief
executive of MinuteClinic, which is based in Minneapolis and operates
more than 200 clinics nationwide. using the motto ?You?re Sick, We?re
Quick.?

Mr. Howe said the concerns of doctors? groups and other critics ?are
being raised by voices of people who have not really studied the model.?

Preliminary data from a two-year study of claims from MinuteClinic by a
Minnesota health maintenance organization, HealthPartners, which was
released to The Minneapolis Star Tribune in July, showed that each visit
to the retail clinic cost an average of $18 less than a visit to other
primary-care clinics, but that pharmacy costs were $4 higher per
patient.

Duane Reade, New York City?s largest drugstore chain, which opened four
clinics in Manhattan in May, plans to open as many as 60 more across the
city in the next 18 months. A key difference at the Duane Reade clinics
is that they use doctors, while nurse practitioners and physician
assistants typically provide the care at most retail clinics.

The American Medical Association, contending that patients might be
sacrificing quality for convenience or seeking help at drugstore clinics
for problems that should be addressed by their doctors or a hospital,
has proposed a series of guidelines, including a requirement that the
clinics have a ?well-defined and limited scope.? The association has
also urged federal and state governments to investigate how the clinics
operate.

Pediatrician groups have strongly opposed reliance on the clinics
because of the importance of having doctors who are familiar with a
child?s medical history.

After doctors? groups in Massachusetts protested MinuteClinic?s plans to
open the state?s first retail clinic, the Health Department issued
guidelines for what the state is calling ?limited service clinics,? and
has scheduled two public hearings next month.

New Jersey health officials said they were looking at what Massachusetts
and other states were doing to regulate the clinics and were considering
whether they should propose new regulations to oversee them.

In New York, the company operating the Duane Reade clinics, Consumer
Health Services, announced last week that it had entered into a
partnership with several New York City hospitals that will work closely
with the Duane Reade doctors.

?We are in the embryonic stage of a new era in New York City health
care,? said Adam Henick, senior vice president for ambulatory care and
medical enterprise at Continuum Health Partners, the parent company of
St. Luke?s-Roosevelt Hospital Center and Beth Israel Medical Center,
which are working with the Duane Reade doctors. ?The traditional place
that we deliver care is no longer in the traditional location.?

Under the partnership agreement, the doctors at Duane Reade will have
admitting privileges at the Continuum hospitals and the drugstore
clinics can streamline a patient?s journey to a specialist or through
the emergency room, when that is necessary, because of the relationship,
company officials said.

The Duane Reade retail clinics, advertised at the stores as ?Duane Reade
Walk-In Medical Care,? function as private medical practices that lease
space from Duane Reade. Despite the name, doctors own the clinics, which
have low overhead costs in a city where setting up a practice can be
wildly prohibitive.

Doctors? groups said they had fewer objections to doctor-run retail
clinics, because the doctors are accountable to a state licensing board.

But New York State officials are still looking at these ?physician based
models,? Mr. Munoz said, to determine whether there were any
inappropriate connections between the prescribing doctors at the clinics
and the pharmacy?s bottom line.

The pharmacy companies and the operators of the clinics insisted that
customers are not told where to fill their prescriptions. But the
proximity of the pharmacy is part of the appeal for consumers, and Duane
Reade officials said they would undoubtedly see increased sales at
pharmacies with clinics.

The clinics accept most health insurance plans, although the Duane Reade
ones do not yet accept Medicare and Medicaid. At Duane Reade, prices for
services are posted on a large board near the check-in counter ? from a
basic exam at $95 to more complicated procedures for wart removal,
abscess drainage or treatment of a sprained ankle for $199.
========================

Seems to me as if it just might be an idea whose time is NOW.
Interesting. But, I'd still prefer to have a single doctor (an
internist) to oversee my health care.
(With me overseeing his decisions of course; after all I celebrate life
within this body 24/7)

McDave of Merryland
========================================================================



I too would prefer a single Doc overseeing my healthcare but considering
the "on the go" society we live in its right for current times.

Just imagine the "Blue Light Specials" ads :-)

===========================================================

Yes. Well, this "on the go" society is one of the principle reasons we
Americans have to take so many pills and require so much medical care.
This "on the go" way of life allows little time to meditate, leads to many
mistakes, and is certainly an undignified way in which to go through life.
It leads to divorce and other anti-social activities. I much prefer a
more methodical and caring lifestyle. We only go this way once; we have
to get it right the first time. One chance.

................

McDave
======================================================================


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Relevant Pages

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  • In-store health clinics take off
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    ... The concept has been called urgent care ?lite?: ... With demand for primary care doctors surpassing the supply in many ... them are now aggressively seeking to open clinics in New York City. ... including Wal-Mart, CVS, Walgreens and Duane Reade. ...
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  • Re: Drugstore Clinics Spread, and Scrutiny Grows
    ... With demand for primary care doctors surpassing the supply in many parts of the country, the number of these retail clinics in drugstores has exploded over the past two years, and several companies operating them are now aggressively seeking to open clinics in New York City. ... More than 700 clinics are operating across the country at chain stores including Wal-Mart, CVS, Walgreens and Duane Reade. ...
    (soc.senior.issues)
  • Re: Drugstore Clinics Spread, and Scrutiny Grows
    ... The concept has been called urgent care ?lite?: ... With demand for primary care doctors surpassing the supply in many ... them are now aggressively seeking to open clinics in New York City. ... health insurance and are using the clinics because of convenience. ...
    (soc.senior.issues)