Yep, let's target more regulation at Wal*Mart, this time to protect doctors

[wiegie]

Wal-Mart health clinics divide US medics

By Christopher Bowe in New York

 

Published: May 23 2007 16:18 | Last updated: May 23 2007 16:18

 

Can a retail store deliver healthcare? Wal-Mart, the largest US retailer, thinks so, together with CVS, Walgreens and Rite Aid, the leading US drug store chains. But as all four move ahead with plans to expand “walk-in clinics” in their stores, the doctors of Illinois are fighting back.

 

The state could be the first to impose stricter regulation on the new generation of walk-in clinics, where nurse-practitioners can examine patients, conduct basic procedures such as inoculation, and prescribe for minor illnesses, while charging less than a doctor’s practice.

 

Massachusetts is also considering whether and how to license the state’s first retail clinics, proposed by drugstore group CVS and its MinuteClinics unit. And the industry expects more challenges ahead.

 

Walk-in clinics represent one of the most advanced and aggressive attempts by US business and entrepreneurs to drive reform of the healthcare system.

 

This year hundreds will be opened in some of the US’s largest drugstore and retail groups, and thousands of clinics could be running in the next decade.

 

Advocates say the clinics will improve access to healthcare and reduce costs; that they will reduce more expensive visits to hospital emergency rooms; and that they will catch some illnesses before they become serious and costly. As a result, physicians will have more time for complex cases.

 

But the clinics also have a direct impact on doctors, who see themselves as the gatekeepers of common, everyday healthcare.

 

Dr Rodney Osborn, president of the Illinois State Medical Society, said: “This is a brand new animal. That’s why we believe legislation is important to guarantee patient safety ... They’re not putting these things in to provide healthcare; these people are businessmen.”

 

Dr Arnold Milstein, chief physician at Mercer health consultancy, says doctors are playing on patient fears to thwart change.

 

“[Doctors] wrap themselves in the holy garb of quality ... completely ignoring the facts that all the research shows current care stinks,” Dr Milstein says. “The weaknesses that are endemic in the current healthcare system are being trotted out to block innovation and change.”

 

The clinics see themselves as advancing medical care, not diminishing its quality, with a retailer’s focus on service: the slogan of CVS’s MinuteClinic, for instance, is “You’re sick, we’re quick”.

 

Hal Rosenbluth, chairman of clinic company Take Care and head of the industry group Convenient Care Association, says any pushback against the clinics actually validates their existence, and adds that the concept is here to stay.

 

“That’s what people are clamouring for - they want healthcare on their terms not the system’s,” says Rosenbluth. Doctors’ quality concerns, he says, are merely anti-change “turf protection.”

 

On a national level, the American Medical Association, the doctors’ lobby group, has taken a cautious tone, issuing guidelines last year for clinics. They call for a well-defined scope of services; standardised medical protocols; and clear definitions of medical qualifications. They also call for closer doctor oversight, and emphasise the importance of referrals to doctors, which the leading clinics promise.

 

In any case, retail clinic companies are expanding nationally. In May, Walgreens bought Take Care, following CVS’s MinuteClinic acquisition last year. Both Wal-Mart and Target, the leading discounters, are opening clinics.

 

Their national footprint could eventually support the development of a much-discussed but elusive electronic records system for the US, as the clinics build patient databases, see more patients, and give patients printouts of their diagnoses and treatments.

 

Nevertheless, there are still some tough questions, raised by doctors and others, on the clinics and whether they can deliver what they promise.

 

First, despite US business’s push to inject and increase consumer principles into healthcare, it is still unproven whether people understand how to shop for medical care like other products, or even whether they want to do so. Clinics also could be a controversial way for employers to push more health costs on to employees.

 

Second, retail clinics claim they will increase doctors’ business by referring new patients or allowing them to spend more time on higher-value tasks.

 

But experts agree that they could be sapping high-margin, easy tasks like vaccinations from doctors’ businesses, and that clinics do not yet generate significant referral business to doctors.

 

Third, the clinics are for-profit businesses. Dr Osborn, of Illinois, says: “They’re not at this to increase doctors’ business; they’re in it to make money. That’s a smokescreen.”

 

More than anything, however, the retail clinics show that business is pushing for change on its own without waiting for government. And walk-in clinics could do for US healthcare what low-cost Southwest Airlines did for the airline industry, by making healthcare better, faster, and cheaper.

 

“This is a conceivably disruptive innovation of our happy little empire,” Dr Milstein says.

http://www.ft.com/cms/s/5b301a64-093c-11dc...0b5df10621.html

[Chargerz]

I don't feel threatened by this concept at all. It's not new. Kaiser started his own non-profit clinic more than 50 years ago to take care of his workers. Other businesses have followed suit over the years. If the motivation is providing quality health care at a lower cost to the employees (and others, for that matter), it's a good idea. If the motivation is profit, I'm against the idea because of the bias profit introduces into patient care decisions.

[untateve]

I don't feel threatened by this concept at all. It's not new. Kaiser started his own non-profit clinic more than 50 years ago to take care of his workers. Other businesses have followed suit over the years. If the motivation is providing quality health care at a lower cost to the employees (and others, for that matter), it's a good idea. If the motivation is profit, I'm against the idea because of the bias profit introduces into patient care decisions.

 

 

I think a primary motivation for any business venture is profit...and it should be or else you don't stay in business. I like the work I do but if it weren't profitable, I'd be doing something else.

 

So long as they provide quality health care (and hopefully at a lower price), I don't care if they make a nice profit.

[H8tank]

If the motivation is profit, I'm against the idea because of the bias profit introduces into patient care decisions.

 

 

I don't think I have ever read a more stupider, naive statement in all my years in the internets.

 

Now I know this is coming from some beer truck pro-socialists kommie... but really, do you really beleive what you just typed?

[bushwacked]

Now I know this is coming from some beer truck pro-socialists kommie... but really, do you really beleive what you just typed?

 

 

Chargerz is a doctor moran.

[Azazello1313]

Now I know this is coming from some beer truck pro-socialists kommie...

 

 

 

i have to say, i've done the chargerz/chavez double-take a few times myself.

[CaP'N GRuNGe]

Jeebus wiegie, you own stock in Walmart or what?

[H8tank]

doh...

 

yeah, I didn't get that one right. Oops. So dumb, I just assumed it was Chavez...

[wiegie]

Jeebus wiegie, you own stock in Walmart or what?

 

Nope--I just hate seeing special interest groups (like the ABA, AMA or NAR) screw us over.

Edited May 24, 2007 by wiegie

[CaP'N GRuNGe]

Nope--I just hate seeing special interest groups (like the ABA, AMA or NAR) screw us over.

 

 

And Walmart isn't a special interest group? You are just picking one side of the same coin here. You really want Walmart to become "the company store" and provide anything and everything to every small community in the country. You think that in the long run that driving out all competition and having hundreds of mini-monopoly economies is a good thing?

 

Yes H8, I realize this is not the case in large cities where the population supports Walmart and Target and dozens of alternatives. But this is not the case in small town America.

[wiegie]

And Walmart isn't a special interest group? You are just picking one side of the same coin here. You really want Walmart to become "the company store" and provide anything and everything to every small community in the country. You think that in the long run that driving out all competition and having hundreds of mini-monopoly economies is a good thing?

 

I am picking on the special interest groups who want regulations to protect their own little monopolies from the threat of competition.

 

In situations where Wal*Mart starts lobbying for regulations to prevent people from opening up businesses that will compete with Wal*Mart, then I will be against Wal*Mart.

Edited May 24, 2007 by wiegie

[cre8tiff]

I don't think I have ever read a more stupider, naive statement in all my years in the internets.

 

Now I know this is coming from some beer truck pro-socialists kommie... but really, do you really beleive what you just typed?

 

 

Irony attacks.

Edited May 24, 2007 by cre8tiff

[Caveman_Nick]

If the motivation is profit, I'm against the idea because of the bias profit introduces into patient care decisions.

 

 

I think that the motivation can be profit, if the strategy to receive that profit is appropriate.

 

If the clinic is set up as a separate, non-profit entity and proper checks and balances are created to make certian that the practitioners in the clinic do not interact with the 'business' side of the stores, then this can be a good model to increase foot traffic in the store. If a patient gets a prescription, then the greatest probability is that they will fill it before leaving.

 

The danger is in the clinic getting pressure to write prescriptions. That needs to be protected against, but otherwise I think it's a fine idea.

 

EDIT: And I would like to add that the current system doesn't keep profit out of the equation either. The treatment decision-making doctors get from pharmaceutical companies isn't exactly one that creates a bias free situation.

Edited May 24, 2007 by Caveman_Nick

[Bill Swerski]

If the motivation is profit, I'm against the idea because of the bias profit introduces into patient care decisions.

 

 

Pharmaceutical and biotech companies are motivated by profit and bias, yet they deliver the vast majority of treatments.

Edited May 24, 2007 by Bill Swerski

[H8tank]

Yes H8, I realize this is not the case in large cities where the population supports Walmart and Target and dozens of alternatives. But this is not the case in small town America.

 

Let's assume for a minute all the lies you spew about walmart were true, wouldn't it still be good to have walmart for the prices and jobs it provides for poor peolpe?

 

Who do you care about, the capitalistic rich pigs who own their own small businesses, or the poor who cannot afford to shop anywhere but walmart?

[dmarc117]

I am picking on the special interest groups who want regulations to protect their own little monopolies from the threat of competition.

 

In situations where Wal*Mart starts lobbying for regulations to prevent people from opening up businesses that will compete with Wal*Mart, then I will be against Wal*Mart.

 

 

 

could one consider a union such as uaw as a special interest group trying to protect themselves from competition.......ex. globilization or non-union areas.

 

and i dont see walmart lobbying against competition anytime soon. they are the big boys on the block and can drive out most others.

[CaP'N GRuNGe]

Let's assume for a minute all the lies you spew about walmart were true, wouldn't it still be good to have walmart for the prices and jobs it provides for poor peolpe?

 

Who do you care about, the capitalistic rich pigs who own their own small businesses, or the poor who cannot afford to shop anywhere but walmart?

 

 

No doubt that Walmart does alot of good as well. It's a double edged sword. I'm just saying that there is some irony to portray Walmart as some totally altruistic company that is the little guy going up against evil special interests when the company itself is its own multi-billion dollar special interest. Profit motivates them as well as anyone else.

[Chargerz]

No doubt that Walmart does alot of good as well. It's a double edged sword. I'm just saying that there is some irony to portray Walmart as some totally altruistic company that is the little guy going up against evil special interests when the company itself is its own multi-billion dollar special interest. Profit motivates them as well as anyone else.

 

Well said.

[wiegie]

No doubt that Walmart does alot of good as well. It's a double edged sword. I'm just saying that there is some irony to portray Walmart as some totally altruistic company that is the little guy going up against evil special interests when the company itself is its own multi-billion dollar special interest. Profit motivates them as well as anyone else.

 

Who in the world is portraying Wal*Mart as altruistic?

 

They are solely trying to get more profits--which, if markets work well (and are not distorted by BS regulations) ends up making society better off.

[CaP'N GRuNGe]

Who in the world is portraying Wal*Mart as altruistic?

 

They are solely trying to get more profits--which, if markets work well (and are not distorted by BS regulations) ends up making society better off.

 

 

I take it that your economics studies have convinced you that any and all regulations are bad for society. I disagree and I doubt I will be able to convince you otherwise.

[wiegie]

I take it that your economics studies have convinced you that any and all regulations are bad for society. I disagree and I doubt I will be able to convince you otherwise.

 

no--but it has convinced me that BS regulations are bad.

[H8tank]

I take it that your economics studies have convinced you that any and all regulations are bad for society.

 

Should I have to take a class and get a license if I want to braid your Supercut®?

[Bill Swerski]

I take it that your economics studies have convinced you that any and all regulations are bad for society. I disagree and I doubt I will be able to convince you otherwise.

 

LOL, nice strawman argument.