AMA AND OTHERS CAUTION “RETAIL CLNICS; BIG BAD WOLF!”

 

AMA AND OTHERS CAUTION “RETAIL CLNICS; BIG BAD WOLF!”

Let’s start with some of the arguments these groups put forward as reasons for concern in using a Retail Clinic!

Ø Do not have access to all chart records.

Ø Causes Fragmentation of care by adding another provider.

Ø Staffed often by Physician Assistances or Nurse Practitioner

Ø No patient follow up care.

Ø Chronically ill are more complicated than clinics usually see.  (Note it doesn’t say can’t handle)

Ø Question if have patient’s best interests at heart!

I looked in detail at five articles about these warnings.  The first covers the period around 2007.  Titled AMA Goes After Walmart Style Retail Clinics, it warns of the same concerns.  “Our primary focus is patient safety and patient care, and the retail clinics have a different mission of selling products and prescriptions,” said Dr. Rodney Osborn.  The AMA stance at that time was to lobby for increases regulations of these Retail Clinics.  Typically doctors often site regulations and dealing with insurance as an over regulated problem.

The other articles cover and aim at those clinics owned by CVS, Walgreen’s, Target and other groups. On Feb. 23, 2014 (my 52 birthday updated a statement disapproving of the Retail Clinics.  Again the list above covers their reasons for concern.

An article written in Aug. of 2012 shows these statistics.

Ø Total visits go from 1.5 million (2007) to 6 million (2009)

Ø The same study notes that there are 557 million visits to Doctors and 177 to ER’s

Ø One significant change in demographics was that those over 65 were at 7.5% (2000 to 2006) and at 14.7 (2007 to 2009).

Ø About 40% of the visits from 2007 to 2009 were for immunizations.

I now have a few questions and statements I think need to be considered.

Ø How often can the people that visited a Retail Clinic did so because of lack of access to an appointment needed now?

Ø How many ER’s have access to a patient’s health record or chart?

Ø How many Pediatricians really know a patient and remember that child’s chart when called after hours?

Ø How many Nurse Practitioners or PA’s are employed by Pediatricians or Doctors?

Ø Is it really fair to say no access to follow up care?  I say this because many say to follow up with your family practitioner or come back to them if they do not have one!

Ø If it is still true that most(almost half, 40%) go for immunizations, is this really a big issue?

Ø What study said this are that?  Compare it to what is actually going on. 

Ø Should Pharmacists really be giving vaccinations when they are bogged down just filling prescriptions?

Ø How many groups are going to have a formal relationship with your Pediatrician?

Ø Is some of the disjoint and lack of communication the fault of the AMA for going after the Retail Clinics instead of really working with these groups to shore up the holes? Or, is this just about the bottom line?

Ø How many people complain about not enough time with their doctor?

Ø  

I would think again about what the AMA and AAP says about these clinics.  I would think also about getting prescriptions where pharmacists are doing a lot of vaccinations.  I am a pharmacist and will get plenty of feedback for this I am sure.

The bottom line is go to places that you feel comfortable.  I can personally vouch for a Nurse Practitioner owned clinic.   Excellent care is what my husband (also a pharmacist), my son and I get when we go there.  This does not stop me from having a family practice physician.  I have gone to this man since 1987 and will not go elsewhere  besides that NP owned clinic in Yukon, OK.  They do not compete but compliment each other. 

Below are the 5 articles used to write this essay; along with my personal knowledge and opinion.  

Ollamok AKA Sandra

http://www.amednews.com/article/20120827/business/308279963/7/                                    http://healthland.time.com/2014/02/23/pediatrics-group-advises-against-retail-based-clinics/           http://www.kevinmd.com/blog/2013/08/drug-store-retail-clinics-primary-care-fast.html http://consumerist.com/2007/06/27/american-medical-association-goes-after-walmart-style-retail-clinic /http://virtualmentor.ama-assn.org/2013/11/pdf/vm-1311.pdf