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	<title>Comments on: Today&#8217;s &quot;Long ER Wait&quot; article</title>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82774</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Wed, 16 Jan 2008 17:08:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82774</guid>
		<description>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.&lt;br/&gt;&lt;br/&gt;Turf issues aside, the motivation for retail clinics is monetary, plain and simple, not quality or access.</description>
		<content:encoded><![CDATA[<p>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.</p>
<p>Turf issues aside, the motivation for retail clinics is monetary, plain and simple, not quality or access.</p>
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		<title>By: RJS</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82765</link>
		<dc:creator>RJS</dc:creator>
		<pubDate>Wed, 16 Jan 2008 00:23:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82765</guid>
		<description>&lt;i&gt;&quot;Will retail pharmacy clinics help?&quot;&lt;/i&gt;&lt;br/&gt;&lt;br/&gt;Theoretically, yes. But then you get people like Zagreus Ammon having a cow because it puts patients at risk  because they&#039;re not having a doctor diagnose that ear infection or strep throat.&lt;br/&gt;&lt;br/&gt;In reality, of course, his quarrel amounts to nothing more than turf protection. I&#039;m pretty sure Flea was the only MD who didn&#039;t have rectal-cranial issues when it came to retail clinics. Amusingly enough, most of Ammon&#039;s stated problems with retail health clinics could just as easily be substituted with &quot;the ED&quot;. (Save the one where a real, live doctor sticks that otoscope in your ear, or depresses that tongue.)&lt;br/&gt;&lt;br/&gt;Oh the horror.</description>
		<content:encoded><![CDATA[<p><i>&#8220;Will retail pharmacy clinics help?&#8221;</i></p>
<p>Theoretically, yes. But then you get people like Zagreus Ammon having a cow because it puts patients at risk  because they&#8217;re not having a doctor diagnose that ear infection or strep throat.</p>
<p>In reality, of course, his quarrel amounts to nothing more than turf protection. I&#8217;m pretty sure Flea was the only MD who didn&#8217;t have rectal-cranial issues when it came to retail clinics. Amusingly enough, most of Ammon&#8217;s stated problems with retail health clinics could just as easily be substituted with &#8220;the ED&#8221;. (Save the one where a real, live doctor sticks that otoscope in your ear, or depresses that tongue.)</p>
<p>Oh the horror.</p>
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		<title>By: Pepsi Loo</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82762</link>
		<dc:creator>Pepsi Loo</dc:creator>
		<pubDate>Tue, 15 Jan 2008 21:54:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82762</guid>
		<description>Will retail pharmacy clinics help?</description>
		<content:encoded><![CDATA[<p>Will retail pharmacy clinics help?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82761</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Tue, 15 Jan 2008 21:52:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82761</guid>
		<description>Interestingly our ER - in a small town about an hour North of NYC isn&#039;t that overcrowded. At least when my mother was brought there by ambulance - she had aetrial febrillation, I didn&#039;t see that many people waiting.&lt;br/&gt;&lt;br/&gt;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&#039;t have to wait that long.&lt;br/&gt;&lt;br/&gt;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.</description>
		<content:encoded><![CDATA[<p>Interestingly our ER &#8211; in a small town about an hour North of NYC isn&#8217;t that overcrowded. At least when my mother was brought there by ambulance &#8211; she had aetrial febrillation, I didn&#8217;t see that many people waiting.</p>
<p>Now, that time she was brought up by ambulance, but there was one time she went there on a weekend &#8211; she had a bone stuck in her throat that was hurting, and her PCP office was closed, she didn&#8217;t have to wait that long.</p>
<p>I wonder if it is because the hospital is in a small town in a relatively expensive area&#8230; In NYC, a friend of mine had to wait three hours with severe abdominal pain that turned out to appendicitis.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82756</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Tue, 15 Jan 2008 19:16:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82756</guid>
		<description>Massachusetts has mandated insurance and a worsening primary care access problem.  Insurance without access doesn&#039;t do anything to solve this.</description>
		<content:encoded><![CDATA[<p>Massachusetts has mandated insurance and a worsening primary care access problem.  Insurance without access doesn&#8217;t do anything to solve this.</p>
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		<title>By: DermDoc</title>
		<link>http://www.kevinmd.com/blog/2008/01/todays-long-er-wait-article.html/comment-page-1#comment-82754</link>
		<dc:creator>DermDoc</dc:creator>
		<pubDate>Tue, 15 Jan 2008 18:43:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2008/01/todays-long-er-wait-article.html#comment-82754</guid>
		<description>In the article they imply that the rise is due to concomitant increase in uninsured.&lt;br/&gt;&lt;br/&gt;As I mention over at the excellent PandaBearMD, wouldn&#039;t mandates (careful, don&#039;t read free healthcare here) help this problem by forcing people to purchase insurance?&lt;br/&gt;&lt;br/&gt;Then they could go to their PCP instead of freeloading it at the ER.</description>
		<content:encoded><![CDATA[<p>In the article they imply that the rise is due to concomitant increase in uninsured.</p>
<p>As I mention over at the excellent PandaBearMD, wouldn&#8217;t mandates (careful, don&#8217;t read free healthcare here) help this problem by forcing people to purchase insurance?</p>
<p>Then they could go to their PCP instead of freeloading it at the ER.</p>
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