Sunday, August 26, 2007

No Docs in This Box

Several years ago the so-called doc-in-a-box concept cropped up with urgent care facilities springing up everywhere.

Well, maybe not everywhere, but in a lot of places.

Some liked them. Some didn't. Regardless, they are here to stay and serve a much needed function. That being, providing on the spot medical treatment for minor conditions with little or not wait time. Quicker, more efficient and less costly than a trip to the ER, these clinics are now considered respectable.

Now comes the retail based clinics in the form of MinuteClinic, RediClinic and others. These quick treatment centers are located in retail establishments such as WalMart, CVS & Eckerd Drugs.

One difference in these clinics and the urgent care centers is, most are staffed by nurses, PA's & NP's.

This has some crying foul.

But concerns are rising in the medical industry that these operations remain largely unregulated and are prone to conflicts of interest. Some physicians are also concerned that the clinics could disrupt the continuity of care and result in serious underlying health conditions going undetected.

My take?


Is there a conflict of interest when your PCP refers you to a lab or MRI facility where they have ownership? How about a geriatric physician who suggests you check into a skilled nursing facility he just happens to own? Or a doc writing a script on a pad given to him by the pharmacy in the building where he practices and get's a kickback based on the number of scripts filled there?

Is there a conflict of interest when a doc is paid a bonus to keep you out of the hospital or suggest an alternative form of treatment that is less expensive but maybe not as effective? What about docs who are provided with continuing education on an exotic isle, courtesy of a pharmaceutical company?

Sounds like the pot calling the kettle black.

Support among health insurance companies is also growing; about 40 percent to 50 percent of clinics accept insurance from providers like Humana Inc., UnitedHealth Group Inc. and Aetna Inc., according to CCA

Carriers view this as an effective cost cutting tool, but would not reimburse for care in these facilities if they felt the care was substandard.

A visit to a store-based clinic averages about $60, but a doctor's visit costs twice as much, particularly in urban markets, according to Barry Barnett, a health care consultant for PricewaterhouseCoopers. That compares to about $300 for an emergency room visit, according to Barnett. About 40 percent to 50 percent of clinics take insurance. Hansen-Turten estimated 50 percent of clinic customers pay cash, but she noted that the majority have insurance.

In addition to the cost savings, this relieves some of the strain of overcrowding in doctors waiting rooms & ER's.

Sounds like a good idea to me.
blog comments powered by Disqus