No doctor can match the perfection that retail health clinics offer:
With the 99.15% proper treatment rate that you reported, never before seen in the annals of health care, perhaps the next step should be in-store cardiac and neurosurgery because there is no way any physician or hospital can match that “perfection.” Didn’t our parents tell us that when something sounds too good to be true it usually is? It’s about time state officials try to insure appropriate patient protection, even for that one minute.
Update:
The Independent Urologist with his thoughts on the matter.
Related posts:
- Regulating the retail clinics
- The Ashley Treatment
- The AMA takes on retail clinics
- Physician-staffed retail clinics
- Are retail clinics living up to expectations?
- Retail clinics are not for patients with chronic disease
- Retail health clinics a "throwback"?
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{ 19 comments }
Or maybe their rate is so high simply because no one goes there for anything past strep throat or an ear ache and most middle schoolers could be trained to treat those properly? a
Wow…what a highly defensive comment in the original post.
Frankly, most docs are overtrained for the day to day, simple issues that are the bread and butter of retail clinics. These are the people that would receive 5 or fewer minutes in the doctors office, as they have lives to save–so the proper treatment rate is much likely to be worse in physician offices.
The fact that nurse practitioners see these conditions as their core focus, will spend 15 minutes with a patient to deal with them, have organized extensive IT systems to ensure quality and adherence to standardized protocols, and do it without appointment for half the price is fantastic.
There is no need to spend expensive physician time on bread and butter, and I’m excited that patients are gaining better, cheaper alternatives focused on solving these simple needs.
I talk a little more about the need for simple, cheaper solutions in my post: Using a bazooka to swat a fly: the overinvestment in America’s medical infrastructure
It is of course true that most docs are overtrained for simple things. So are nurses. Receptionists could follow the flow chart to its conclusion and dispense appropriate treatment.
The issue is the degree of medical training required to assess when the patient isn’t following the flow chart anymore. I think it’s fairly safe to say medical school + residency improves your ability to recognize this. Enough to be worth the extra expense? Perhaps, perhaps not. I don’t see why people shouldn’t have the right to pick which path they prefer, as long as it’s made abundantly clear that the minute clinics are not doctors. But I think the PR suggesting ridiculous success rates should be challenged for the absurdity it is.
That’s gotta be almost as good as the patient satisfaction with Cuba’s health care!
patients want quick and easy access,affordability and competence. For the simple conditions these clinics are set up to treat, they provide what the patient wants. There is nothing stopping any physician from offering the same service in their office.
Also, why is it that the same people who don’t want any government interference or oversight in their practice, want restrictions on everyone else?
Almost a 1% error rate, and that is acceptable to most people?! At that rate, with the volume that these clinics plan to operate, 1% is very high. Think of it like this, for every 1000 people they see, 10 will be treated incorrectly. Imagine if 1% of planes crashed. Most doctors have a much lower mistake rate.
Independent Neurologist- Not in my experience. It was a doctor that refused to give me so much as a u/a when I had every symptom of diabetes, it was a doctor that misdiagnosed my dad’s CHF as asthma, and it was a doctor that missed my GI condition. Hopefully most people have better experiences than I have.
Well,
Let’s face it. There are good doctors, average doctors, and bad doctors. The same holds true for NPs and PAs. Perhaps Viajy is right. We are overtrained to see sore throats and earaches. But what happens when they turn into mastoiditis? What about the patient who hates doctors and vaccines, presenting to the QuickU with sore throat as diptheria? What about the knee ache that actually turns out to be homochromatosis. We would be fools to think that minor complaints ALWAYS EQUAL minor conditions. That is why these clinics will lead to even more delay in proper diagnosis of some serious conditions!!!!
-Steve A.R. Murphy MD
http://www.thegenesherpa.blogspot.com
http://www.helixhealth.org
As long as we are going to have millions of uninsured Americans, a reversal of the trend that you need to wait 2 weeks to get into your PCP when you get sick (by which point it is too late any way), and when you have so many reports of doctors who rush you out of the office with poor bedside manner, retail clinics are going to thrive and won’t go away any time soon.
Dominic A. Carone, Ph.D.
Founder and Webmaster of MedFriendly.com and The MedFriendly blog.
Aside from the STRETCH that NPs & PAs can properly diagnose a URI or ear infection 99% correctly, I don’t see how the minuteclinics are going to solve the problem of the uninsured, as these “minor problems” are not a big expense.
What IS expensive (for everyone) is when the uninsured have a major trauma (eg. MVA), or a heart attack & get admitted for a prolonged hospitalization. then the bill goes unpaid & everyone’s premiums go up.
The miraculous $30 gimme-a-zpak-for-my-cold visit is like pissing in the wind, not to mention the occasional serious problem that is missed.
Since the ‘proper’ treatment is defined by algorithm, it is no surprize that success rate can be high. If however one defines success as being correct on subjective matters then certainly it would plummet. Was that an acute otitis you saw on otoscopy? There is certainly no post hoc analysis of judgement calls or retrospective comparison with the gold standard of 20/20 hindsight.
The success rate of following an algorithm is not the same as a success rate of real patient outcomes.
Why continue with this red herring of “patient advocate” when only the most unthinking will fall for such an intellectually dishonest claim? If the allopathic organization was truly about patient protection, then there is much that it would first do within its own ranks to even make a prima fascie case for such a contention. The reality of the situation is that retail clinics are viewed as both an economic threat and a territorial threat. One understands the fear from the existing junta in opening up the system even slightly to actually let patients make their own choices. As more and more come to realize that NPs and PAs are more than capable of the art of diagnosis, the more difficult it will be to continue the existing charade that exists in the healthcare system.
“much that it would first do within its own ranks to even make a prima fascie case for such a contention…”
so don’t go to an allopath, go see an NP or PA – believe me, it’s not making the primary care MD worse off to lose your business – on the contrary you seem like the typical patient i’d fire.
good luck with your cold – if you get really sick, i’d be really curious if you stick to avoiding the criminal allopaths you so easily denigrate.
As long as I have the volitional choice to see whatever practitioner I wish to see for whatever reason I wish to see him/her then some segment of choice has been returned to me – the health care consumer. Fire me, the paying customer, if you wish. Just don’t impede my ability to obtain healthcare from whatever provider I choose to enter into such a business relationship with (including trying to limit their scope of practice to protect your fiefdom).
If retail clinics present no real threat to the primary care MD, then why the animosity and directed oligopolistic targeting of them by the AMA? Methinks that there is much more to this story in regards to the actions of organized medicine when it comes to protecting its turf and the basis of such action(s) having nothing to do with patient safety.
anybody who uses terms like “oligopolist” and “plebeian” in the 21st century is just a f-ing nutjob.
anyway, as far as hurting the allopath position, i think the minute clinics will HELP the allopath position while hurting the healthcare system & insurers in general: everyone with anything serious e.g. CHF exacerbation, COPD exacerbation, uncontrolled diabetes, pneumonia, asthma, stroke, MI, etc. will wind up in an ER after a course of augmentin or zithromax, & be told to follow-up with a DOCTOR instead of a minute-clinic.
as a doctor who works with NPs every day, I can say that some are great as an assistant, some suck, but ALL are a far cry from a physician, & i’d never use one as a primary care “provider” for myself or my family without real supervision from someone with the training & experience (& intelligence) of a physician.
“anybody who uses terms like “oligopolist” and “plebeian” in the 21st century is just a f-ing nutjob.”
So says the “f-ing nutjob” that is an oligpolist and proponent for the current medical feudal system. After all, we have to ensure that the medical lords continue to take their cut of the share of the work done competently by others.
The choice that you make for yourself and your family grants you zero authority to make the same choices for others and their families. It also grants you zero authority to pick my pockets to enrich yourself secondary to promoting a system that forces the equivalent of a mandated Yugo at Lexus prices that is paid through the extortion of the work product of the productive. I understand that the Dons want their cut of the pie by retaining supremacy over the system, but the openly anti-competitive nature of such a move is one that would have made Standard Oil proud.
I would love it if the Economics professors here could explain to me how one is supposed to know if they should go to an NP or an MD??? And without the current system of training, which angers you so much, how you expect a core of higher competency than NP’s, which should then just “wait aorund” until you decide you are sick enough to come in.
You make no sense.
And again, the retail clinic (in small rural areas) probably just hurts the business of those MD’s, which you will only need a small percentage of the time, but which you expect to just sit around making no money until YOU decide to waltz over there. Do you see that such an idea is ludicrous.
Mike:
The issue here is economics and economics only. It has squat to do with patient care. So, why not drop that front when it comes to this issue and instead objectively discuss how the sole issue here is providers continuing to want the easy cases?
anon 12:20, the issue is multifactorial. There is no “front” to drop. It’s just a bad idea all around. But if it makes you more comfortable to just pigeonhole physicians as greedy and uninterested in good care, than you have my permission to address the ONLY issue you understand.
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