Eight years ago, when MinuteClinic first tried to open retail health clinics in Rhode Island, the Minneapolis-based company withdrew its application for a certificate of need after facing significant opposition from Rhode Island’s doctors, among others.
Arguing on behalf of the state’s physicians, the Rhode Island Medical Society worried that the quick care provided by MinuteClinics would diminish the doctor-patient relationship and discourage patients from having a medical home.
“RBCs (retail-based clinics) are structurally unsuited to provide primary care, preventive care, chronic disease management or emergency care,” the society stated in a 2008 white paper on retail clinics.
Now, MinuteClinic has filed a new application with the state seeking to open seven clinics in CVS Caremark Corp. stores from Woonsocket to Westerly. The public comment period on its Nov. 1 application hasn’t yet begun, but when it does, the society will once again voice its opinion about the retail-based model, said Steven R. DeToy, director of legislative and government affairs.
“Many of the same questions remain,” he said.
Among them: Will the clinics interrupt continuity of care to the detriment of patients? Is so-called convenience care really the model of health care delivery that the state should embrace? Is it right for the state to license clinics in stores that sell tobacco? Back in 2005, and now, the latter idea is objectionable to the Rhode Island Medical Society, DeToy said.
“Whether you agree with the model or disagree with the model, everybody is in agreement that they [clinics] should not be located in retail establishments that sell tobacco,” DeToy said.The seven CVS stores, where the clinics are proposed, sell tobacco.
At the same time, as DeToy noted, much has changed in the last eight years that could signal a different outcome for MinuteClinic’s new application. Not only has the health care climate in Rhode Island – and nationally – changed dramatically with the adoption of the Affordable Care Act, among other developments, but also MinuteClinic’s business model has changed.