10.20.2006

Minute Clinics

I saw a story on the ABC Nightly News this week that really was rather one sided (I haven't been able to find the link yet). The story dealt with so called rapid health care available in mass merchandisers like chain pharmacies, and big block retailers. Now with 40 million Americans with no insurance, anything that gets more affordable health care to folks should be a good thing, but the story was still kind of slanted. Here are my thoughts:

-The piece did not mention once that the care is often delivered by ancillary providers like nurse practitioners. This is not necessarily inferior, but they should realize there is no doctor at the clinic.

-While the costs are less, these places often don't accept insurance. For those that have health insurance, then this will end up being an out of pocket expense.

-If the clinic is in a pharmacy, there may be financial pressure exerted to prescribe more expensive drugs for treatment of a particular condition. Think about it, would a pharmacy clinic really encourage its practioner to utilize less expensive generic drugs?

-The story made no mention that this is probably adequate care for younger, healthier adults with simpler, acute health care needs. For a 20 year old women with a simple bladder infection, this can be a cost effective and convenient way to get an antibiotic. However, older Americans, with chronic health conditions deserve continuity of care, and better followup than these clinics can provide. Our diabetics, cardiac patients and COPDers need careful long term care to ensure their long term disease free survival. With our aging demographic, we have far more of these that need health care.

With the above points in mind, this makes the idea of a "minute clinic" just not right for the majority of adults that need health care.




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