When it comes to minor health care issues, scheduling a doctor’s office visit can sometimes be more of a headache than many people can stomach.
At CVS Health Corp.’s MinuteClinics, however, patients can see a nurse practitioner and fill a prescription in one trip.
But as CVS plans to expand MinuteClinic’s offerings as part of its HealthHUB initiative, some primary care physicians in Rhode Island worry that the health care retailer is encroaching into vital patient-doctor relationships, especially when it comes to people seeking help for serious conditions.
“I get concerned when they’re sort of jumping into chronic care management, especially when they’re disconnected from a regular provider,” said Dr. David Bourassa, a pediatrician based in Woonsocket who also serves as chief medical officer for Thundermist Health Center. “They don’t have a lot of information, or they may be missing things. … Primary care doctors know about their [patients’] history and their hospitalizations. MinuteClinic is not going to get that stuff, they’re sort of operating in a vacuum.”
Thundermist’s Convenient Care clinics, which saw more than 21,300 visits in 2018, were created to offer quick, easy access to medical help 365 days a year. One difference between Convenient Care and MinuteClinic, though, is that Thundermist has patient records.
“In their current incarnation in Rhode Island, I think that I would prefer our patients to come to us because the care is coordinated much better,” Bourassa said of CVS. “In a future incarnation, if they’re doing more and more chronic care, I think it becomes more and more problematic, because they’re not coordinating that care with specialists.”
CVS is committed to devoting more store space to health care equipment, products and services, including nutrition counseling and expanded care to help patients cope with conditions such as diabetes and sleep apnea.
As a result of a successful pilot program in Texas, the company plans to open 1,500 HealthHUB locations nationwide by the end of 2021.
CVS declined to say how many sites are expected in Rhode Island, where eight MinuteClinics are already in operation. Company spokesman Joseph Goode added he could not provide information on how many Rhode Island patients have been treated at MinuteClinics, citing a corporate policy against releasing state-specific numbers.
Dr. Al Puerini, Rhode Island Primary Care Physicians Corp. president and CEO, spent 35 years practicing family medicine, with a patient base of about 2,000 in Cranston. He worries that CVS will eventually try to lay claim to primary care altogether.
“I firmly think that their long-term goal is to be the providers of primary care medicine in the United States, and I think they’re doing it little by little,” said Puerini, who also serves as vice chairman of the Providence-based Integra Community Care Network. “I think it’s a threat to comprehensive, patient-centered medical care. This is not patient-centered care; this is random care, which is not good.”
‘They say they communicate, my experience is they do not.’
DR. DAVID BOURASSA, Thundermist Health Center chief medical officer
Members of the Rhode Island Primary Care Physicians Corp. have been working for the past decade to shore up gaps in care by creating a patient-centered medical home network that emphasizes communication.
“We felt we were getting a little disconnected from our patients, their care was being fragmented because they would go to different specialists and treatment centers. Our concept was your primary care doctor would serve as your quarterback,” Puerini said.
Participants include South County Health and Care New England Health System, he added.
CVS, though, maintains that its MinuteClinics and HealthHUBs are set up to communicate with local doctors. The goal, Goode says, is to provide a supplemental service.
“We recognize the integral role that physicians play in people’s lives,” he said. “Our intention is to complement the patient-doctor relationship by working more closely with more types of providers, to offer more patient information and data, which we can gather at our HealthHUBs.”
Patients tend to visit pharmacies more often than doctors’ offices, he added. Plans for yoga and other health classes at HealthHUBs are expected to draw even more wellness-minded consumers, and information gathered from those interactions could add additional value to what CVS is able to pass on to primary care physicians, Goode said.
Still, Bourassa says he has not received any communication from a MinuteClinic in two years, while local urgent care clinics tend to reach out more often.
“They say they communicate, my experience is they do not,” he said of MinuteClinic.
Elizabeth Graham is a PBN staff writer. Contact her at Graham@PBN.com.
