Retail clinics and their inevitable growth

How will this further harm our health care system?

RHCs self-consciously limit themselves to simple treatments for acute illnesses (e.g. treatment for colds, the flu, allergies, minor burns, ear infections, etc), and simple treatments are quick treatments. It’s tough to screw up taking someone’s temperature, even if you do it quickly, right?
That may be the case””for now. But like any good enterprise, retail clinics need to compete and expand their market share. That means that the current scope of simple, relatively hard-to-screw-up services will inevitably be expanded in the future, as clinics scramble to distinguish themselves in the marketplace. Wanless notes that as more RHCs open, “the competition will keep upping the ante in terms of services offered and the prices charged.”

I’ve said it before and my stance hasn’t changed. In their zeal for speed, convenience, and profit, someone will screw up.

A “bronchitis” will actually be a PE. Chest pain caused by an “anxiety attack” will be an MI. The inevitable malpractice suits against a retail clinic will no-doubt put a damper on things. Bet on it.

Comments

jayparkinsonmd
Couldn’t agree with you more. I wish no harm on anyone, but it’s bound to happen and it’s bound to cause a serious problem in that whole industry. That’s why we go to medical school and residency…to be educated so that we can pick up on those things. You take your chances when you choose convenience over quality. Just like you take your chances when you buy anything at Wal-Mart. They made all their money by selling you crap.
DermDoc
Not to mention, its not fair. If all the ST and UTI patients are seen by “Wal-Doc,” then that leaves all the tough patients for you.
None of us want to see acne all day, but interspersed, its a easy 5 min appt, sometimes much needed in a tough clinic.
whitecoatrants
The inevitable growth of retail clinics is going to be stunted significantly with the first successful malpractice lawsuit against one of them.
If plaintiff’s attorneys go after deep pockets, they won’t find many deeper pockets than those at WalMart. Hospitals suddenly become small potatoes.
RJS
Yes, let’s keep all the non-emergent cases flowing to the ER, because that’s a brilliant use of healthcare resources.
DermDoc, fairness has no place in business or medicine.
Anonymous
What is not fair is that physicians are being targeted by congress for self referrals and a lack of so called proper staffing in physician owned specialty hospitals that suppossedly skim off the easy cases from the hospital.
How is this any different other than the fact that this relates to clinic and not outpatient surgery?
You have a group of self referring, inadequately trained (for all situations that could arise) group of midlevels who are skimming off the easy cases to get good results.
So when can we expect congress to come after these clinics?
justin
Non-ER cases should go to Urgent Care or a family doctor’s office.
Dr,. Bob Advance Practice Nurse
While profit maybe a motive I doubt if any physician providers are in practice to not make $$. There is absolutely no evidenced that advanced practice nurses have any more challenges with quality care than physicians. Their malpractice insurance rates and claims are substantial less than physicians. The days of physican domination and control of the market place particularly in primary care are limited. The number of physicans seeking residencies in primary care are continuing to drop. Physicians are opting for more financially awarding practice options. This means fewer primary care providers for patients. Advance practice nurses have and will continue to provide a valuable role in such retail clincs. Are these clinics any diffent then the “doc in the box” clinics?
Dr. Bob Advance Practice Nurse
Mike
“dr” bob, the only difference I can see is that you see a DOCTOR in the “Doc in the Box”, as opposed to an “advanced care nurse”, whatever entity that might be.
Anonymous
Where whitecoatrants is wrong is similar to where all physicians go wrong on the issue of malpractice.
Wal-Mart is about saving money and customer service, and if they simply read the available literature, they’re going to see that if they want to reduce malpractice claims, customer service is key.
He’s also wrong in that he thinks a lawsuit will cause Wal-Mart any concern. They play hardball, and everyone knows it (they were once hit with a multimillion fine, subsequently withdrawn, for failing to produce documents in a case, and that only exemplifies their scorched earth tactics). Plus, they’ll be self-insured so it will be their money, which they don’t easily part with.
Nurse Practitioner
Your thinly veiled statements about quality of care are an attack on advanced practice clinicians – nurse practitioners and physician assistants – not retail health.
Tell me, do you approve of the retail clinic model that uses physicians instead? It would seem from your statements that you wouldn’t have an issue with those since the the gods — err — physicians staff these and would magically detect all of the “subtle” signs and symptoms that you purport NP’s & PA’s are incapable of detecting.
I’d be more than happy to point you in the direction of the research that compares patient outcomes for NP-directed care to physician-directed care. (To summarize, the care and outcomes are equal or better).
I just don’t understand your opposition and your physician-centric mindset. Aren’t we members on the same team where the focus should be on the patient as the center of universe??
Anonymous
Those articles that you are referencing “equal or better” are complete rubbish to anyone who knows how to read scientific articles. These articles are hack pieces that are meant as propanganda that isn’t worth the paper they are printed on.
They remind me of the “articles” that state that seaweed cures cancer. I’m not doubting there is an article that says it, but I do doubt their information gathering techniques and interpretation of data (that is probably flawed to begin with).
Anonymous
http://jama.ama-assn.org/cgi/content/abstract/283/1/59
It would behoove you to bother to do a bit of research before going off and an emotionally driven tirade in which you sputter out unfounded doubt as though it were somehow based in reality. According to The Journal of the American Medical Association (JAMA – linked above), “In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients’ outcomes were comparable.”
The authors (including four MDs) began this study insisting that previous research “did not measure nurse practitioner practices that had the same degree of independence as the comparison physician practices, nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers.” Their conclusions, however, have paralleled all previous and subsequent research which indicates that there is no difference in pt satisfaction and pt outcomes (see the slew of similar articles provided following the abstract – all from well known and professionally respected journals such as JAMA).
You are probably right about the seaweed though.

Retail clinics and their inevitable growth

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