Comments on: Today’s "Long ER Wait" article http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82774 Anonymous Wed, 16 Jan 2008 17:08:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82774 Retail clinics are an imperfect solution. Although they may cater to the uninsured for non-emergent issues,they will not encourage identification/treatment or prevention of chronic problems, ie dm/htn/lipids/smoking/breast cancer screening/colon cancer screening (despite claims that they do). Health care costs are driven up not so much by the 40 year old healthy carpenter with a bronchitis (probably viral but urgicares/retail clinics will almost certainly prescribe zithromax reflexively) but by complications of chronic conditions. Plus, are reatil clinics willing to accept medicaid? I doubt it, so medicaid patients will still be getting care from the ER.<br/><br/>Turf issues aside, the motivation for retail clinics is monetary, plain and simple, not quality or access. Retail clinics are an imperfect solution. Although they may cater to the uninsured for non-emergent issues,they will not encourage identification/treatment or prevention of chronic problems, ie dm/htn/lipids/smoking/breast cancer screening/colon cancer screening (despite claims that they do). Health care costs are driven up not so much by the 40 year old healthy carpenter with a bronchitis (probably viral but urgicares/retail clinics will almost certainly prescribe zithromax reflexively) but by complications of chronic conditions. Plus, are reatil clinics willing to accept medicaid? I doubt it, so medicaid patients will still be getting care from the ER.

Turf issues aside, the motivation for retail clinics is monetary, plain and simple, not quality or access.

]]> By: RJShttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82765 RJS Wed, 16 Jan 2008 00:23:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82765 <i>"Will retail pharmacy clinics help?"</i><br/><br/>Theoretically, yes. But then you get people like Zagreus Ammon having a cow because it puts patients at risk because they're not having a doctor diagnose that ear infection or strep throat.<br/><br/>In reality, of course, his quarrel amounts to nothing more than turf protection. I'm pretty sure Flea was the only MD who didn't have rectal-cranial issues when it came to retail clinics. Amusingly enough, most of Ammon's stated problems with retail health clinics could just as easily be substituted with "the ED". (Save the one where a real, live doctor sticks that otoscope in your ear, or depresses that tongue.)<br/><br/>Oh the horror. “Will retail pharmacy clinics help?”

Theoretically, yes. But then you get people like Zagreus Ammon having a cow because it puts patients at risk because they’re not having a doctor diagnose that ear infection or strep throat.

In reality, of course, his quarrel amounts to nothing more than turf protection. I’m pretty sure Flea was the only MD who didn’t have rectal-cranial issues when it came to retail clinics. Amusingly enough, most of Ammon’s stated problems with retail health clinics could just as easily be substituted with “the ED”. (Save the one where a real, live doctor sticks that otoscope in your ear, or depresses that tongue.)

Oh the horror.

]]> By: Pepsi Loohttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82762 Pepsi Loo Tue, 15 Jan 2008 21:54:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82762 Will retail pharmacy clinics help? Will retail pharmacy clinics help?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82761 Anonymous Tue, 15 Jan 2008 21:52:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82761 Interestingly our ER - in a small town about an hour North of NYC isn't that overcrowded. At least when my mother was brought there by ambulance - she had aetrial febrillation, I didn't see that many people waiting.<br/><br/>Now, that time she was brought up by ambulance, but there was one time she went there on a weekend - she had a bone stuck in her throat that was hurting, and her PCP office was closed, she didn't have to wait that long.<br/><br/>I wonder if it is because the hospital is in a small town in a relatively expensive area... In NYC, a friend of mine had to wait three hours with severe abdominal pain that turned out to appendicitis. Interestingly our ER – in a small town about an hour North of NYC isn’t that overcrowded. At least when my mother was brought there by ambulance – she had aetrial febrillation, I didn’t see that many people waiting.

Now, that time she was brought up by ambulance, but there was one time she went there on a weekend – she had a bone stuck in her throat that was hurting, and her PCP office was closed, she didn’t have to wait that long.

I wonder if it is because the hospital is in a small town in a relatively expensive area… In NYC, a friend of mine had to wait three hours with severe abdominal pain that turned out to appendicitis.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82756 Anonymous Tue, 15 Jan 2008 19:16:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82756 Massachusetts has mandated insurance and a worsening primary care access problem. Insurance without access doesn't do anything to solve this. Massachusetts has mandated insurance and a worsening primary care access problem. Insurance without access doesn’t do anything to solve this.

]]> By: DermDochttp://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html#comment-82754 DermDoc Tue, 15 Jan 2008 18:43:00 +0000 http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82754 In the article they imply that the rise is due to concomitant increase in uninsured.<br/><br/>As I mention over at the excellent PandaBearMD, wouldn't mandates (careful, don't read free healthcare here) help this problem by forcing people to purchase insurance?<br/><br/>Then they could go to their PCP instead of freeloading it at the ER. In the article they imply that the rise is due to concomitant increase in uninsured.

As I mention over at the excellent PandaBearMD, wouldn’t mandates (careful, don’t read free healthcare here) help this problem by forcing people to purchase insurance?

Then they could go to their PCP instead of freeloading it at the ER.

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