Comments on: Retail clinics and disruptive innovation http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html medical blog Sun, 22 Nov 2009 19:59:44 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html/comment-page-1#comment-96054 Anonymous Thu, 25 Jun 2009 22:24:08 +0000 http://clients.emmense.com/kevinmd/2008/01/retail-clinics-and-disruptive-innovation.html#comment-96054 This argument is so old and getting older by the minute. It assumes that every doctor is A) Good and unable to make a mistake and that B) Death and damage awaits the patient unfortunate enough to be 'lured' into a retail clinic. Wrong on each count. Do you people actually BELIEVE that nothing goes wrong at the 'doctor's office?'. If you do, WAKE UP. Errors occur there in amounts which can be legion. The savvy NP can make the diagnosis quickly and correctly as many medical providers already know. That the NP is working at the retail clinic and not in THEIR office is where they have lost revenue. Oh well, the market will bear this out in time and in the mean while stop cursing the darkness and light a candle. That the retail clinic is NOT the place for chronically ill patients has already been made abundantly clear and in the event anyone has any doubt, please be advices that Chronic Illness BELONGS in the patient's regular MD's office if they are lucky enough to have one. Can we move on now? These clinics are not going away because when your office is overbooked and you can't fit in one more sore throat, rash or cough the patient needs an alternative to the ER. It's so simple and necessary which is why it is born of the current dearth of appointments for the masses. Obviously, if there were no need - the market would not support the concept. I DO not believe however, that these clinics ought to employ newly minted NPs. Most NPs have years of hospital experience behind them along with diagnostic skills necessary to make the Dx of strep pharyngitis, cutaneous exanthem, upper airway infection vs. serious respiratory compromise. So the brand new NP should work with a DOCTOR who will mentor her adequately in order to acquire the necessary clinical fund needed to move on. It takes time to hone clinical skills required to work independently. As for you docs - you've usually been our mentors so thank you so much for teaching us what we need to know and how to know when to send them on. Just like YOU DO, in the office when you know the patient's illness exceeds YOUR expertise. This argument is so old and getting older by the minute. It assumes that every doctor is A) Good and unable to make a mistake and that B) Death and damage awaits the patient unfortunate enough to be ‘lured’ into a retail clinic. Wrong on each count. Do you people actually BELIEVE that nothing goes wrong at the ‘doctor’s office?’. If you do, WAKE UP. Errors occur there in amounts which can be legion. The savvy NP can make the diagnosis quickly and correctly as many medical providers already know. That the NP is working at the retail clinic and not in THEIR office is where they have lost revenue. Oh well, the market will bear this out in time and in the mean while stop cursing the darkness and light a candle. That the retail clinic is NOT the place for chronically ill patients has already been made abundantly clear and in the event anyone has any doubt, please be advices that Chronic Illness BELONGS in the patient’s regular MD’s office if they are lucky enough to have one. Can we move on now? These clinics are not going away because when your office is overbooked and you can’t fit in one more sore throat, rash or cough the patient needs an alternative to the ER. It’s so simple and necessary which is why it is born of the current dearth of appointments for the masses. Obviously, if there were no need – the market would not support the concept. I DO not believe however, that these clinics ought to employ newly minted NPs. Most NPs have years of hospital experience behind them along with diagnostic skills necessary to make the Dx of strep pharyngitis, cutaneous exanthem, upper airway infection vs. serious respiratory compromise. So the brand new NP should work with a DOCTOR who will mentor her adequately in order to acquire the necessary clinical fund needed to move on. It takes time to hone clinical skills required to work independently. As for you docs – you’ve usually been our mentors so thank you so much for teaching us what we need to know and how to know when to send them on. Just like YOU DO, in the office when you know the patient’s illness exceeds YOUR expertise.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html/comment-page-1#comment-82951 Anonymous Tue, 22 Jan 2008 03:15:00 +0000 http://clients.emmense.com/kevinmd/2008/01/retail-clinics-and-disruptive-innovation.html#comment-82951 I do not trust the pharmacy chains to manage the prescribing patterns in their clinics for their profit rather than my benefit. MBA's are involved. Simple business ethics dictate that you manage every area of the business to optimize sales in the overall operation. <br/><br/>If I went to a pharmacy clinic and got a name brand 180$ antibiotic, I would be wondering if a generic wouldn't have been as good but I was being soaked.<br/><br/>And the supervision? If the doctor isn't there to examine the patient, it is a fiction, a mere farce.<br/><br/>The funny thing is that pharmacies entering the practice of medicine have much greater conflicts of interest than doctors dispensing drugs (because the ratio of drug income to professional fee income is so many times greater)---and this comes on the heels of 100 years of pharmacies doing everything they can to supress physician dispensing. I do not trust the pharmacy chains to manage the prescribing patterns in their clinics for their profit rather than my benefit. MBA’s are involved. Simple business ethics dictate that you manage every area of the business to optimize sales in the overall operation.

If I went to a pharmacy clinic and got a name brand 180$ antibiotic, I would be wondering if a generic wouldn’t have been as good but I was being soaked.

And the supervision? If the doctor isn’t there to examine the patient, it is a fiction, a mere farce.

The funny thing is that pharmacies entering the practice of medicine have much greater conflicts of interest than doctors dispensing drugs (because the ratio of drug income to professional fee income is so many times greater)—and this comes on the heels of 100 years of pharmacies doing everything they can to supress physician dispensing.

]]> By: RJS http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html/comment-page-1#comment-82877 RJS Sat, 19 Jan 2008 18:42:00 +0000 http://clients.emmense.com/kevinmd/2008/01/retail-clinics-and-disruptive-innovation.html#comment-82877 Indeed, that is the ONLY way PCPs will have a leg to stand on against the RHCs.<br/><br/>My doctor has a clinic in his office already, and has for years. Open on the weekends, even.<br/><br/>The Ivory Tower hasn't figured out that you can't beat the RHCs with words. You need to actively compete against them on *business* terms. And frankly, I hope that more doctors DO open health clinics in their current practices. Indeed, that is the ONLY way PCPs will have a leg to stand on against the RHCs.

My doctor has a clinic in his office already, and has for years. Open on the weekends, even.

The Ivory Tower hasn’t figured out that you can’t beat the RHCs with words. You need to actively compete against them on *business* terms. And frankly, I hope that more doctors DO open health clinics in their current practices.

]]> By: TNTech http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html/comment-page-1#comment-82868 TNTech Sat, 19 Jan 2008 07:19:00 +0000 http://clients.emmense.com/kevinmd/2008/01/retail-clinics-and-disruptive-innovation.html#comment-82868 As a pharmacy technician who works at a Cvs with a Minute Clinic, my expierience is that these NP's are no worse than the ones in doctors offices. They don't diagnose anything complicated, they dont prescribe anything complicated. A doctor does monitor them, even though he respondsible for several clinics.<br/><br/>If the primary care docs would charge the same amount to walk in and see an NP, then they could be competative. However, at every doc in town that I know of you pay the same no matter who you see. So why would I want to pay 2 to 3 times as much to go wait 3 to 5 times longer when I can go see a knowledgeable NP, see her in 5 to 15 min and pay less than 100 dollars no matter what the problem (save a few expiensive travel vaccines). As a pharmacy technician who works at a Cvs with a Minute Clinic, my expierience is that these NP’s are no worse than the ones in doctors offices. They don’t diagnose anything complicated, they dont prescribe anything complicated. A doctor does monitor them, even though he respondsible for several clinics.

If the primary care docs would charge the same amount to walk in and see an NP, then they could be competative. However, at every doc in town that I know of you pay the same no matter who you see. So why would I want to pay 2 to 3 times as much to go wait 3 to 5 times longer when I can go see a knowledgeable NP, see her in 5 to 15 min and pay less than 100 dollars no matter what the problem (save a few expiensive travel vaccines).

]]> By: Anonymous http://www.kevinmd.com/blog/2008/01/retail-clinics-and-disruptive.html/comment-page-1#comment-82850 Anonymous Fri, 18 Jan 2008 17:23:00 +0000 http://clients.emmense.com/kevinmd/2008/01/retail-clinics-and-disruptive-innovation.html#comment-82850 Who better to open a retail clinic outlet than a highly qualified local primary care doc? <br/><br/>Who better to hire and supervise the NPs?<br/><br/>Ed Sodaro MD Who better to open a retail clinic outlet than a highly qualified local primary care doc?

Who better to hire and supervise the NPs?

Ed Sodaro MD

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