If you haven’t heard of this yet, you will soon. Health clinics are looking to slip their way into your local pharmacy, perhaps even your favorite retail department store. That’s right. Soon you might just be able to pick up deodorant, bug spray – and get tested for strep throat!
A Minnesota-based outfit, MinuteClinic, has already applied to enter a CVS in Wakefield and has its sights set on at least a half-dozen CVS locations in Rhode Island. MinuteClinic also has competition from other companies that are undoubtedly watching to see how things unfold here.
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The clinics are staffed by nurse practitioners and/or physician assistants. They can prescribe drugs and treat such common maladies as ear infections and that nagging soar throat. Their selling point – and it is an attractive one – is convenience. They are typically open on weekends and at night. There isn’t supposed to be a wait when you get there.
So this is a good thing, right?
Well, maybe not.
In our fast-paced society, where convenience is king, this foray into making your life easier might do you more harm than good. Consider the arguments against this trend put forth by the folks at the Rhode Island Medical Society.
Dr. Fredric V. Christian, the organization’s president, points out that these clinics are all about “episodic care, not primary care.” He says there is a very real difference between “consumer-driven” and “patient-centered” approaches to medicine.
Dr. Christian is concerned that the MinuteClinic centers would become a disruptive player on the health care scene, “potentially undermining doctor-patient relationships.”
“The danger is that patients will perceive MinuteClinic as an alternative to primary care,” he said.
And what’s wrong with that?
Plenty.
Somewhere lost in this equation – in this never-ending consumer quest for convenience – is the importance of the doctor-patient relationship.
Dr. Kathleen Fitzgerald, who will succeed Dr. Christian as the Medical Society’s president in September, uses the example of a patient visiting one of these clinics with what they believe are symptoms of strep throat. A quick test may come back negative and the clinic may offer to do a culture. But the patient can pass on that and be on their way, pleased to know that they don’t have strep throat after all.
But what do they have?
“Our responsibility to a patient doesn’t end,” says Dr. Fitzgerald. “When someone presents a problem, you start out with the simplest of tests and go from there … until you reach a diagnosis and then treat it accordingly.”
Another critical factor in all of this is that a primary care doctor represents a place where you can establish a “medical home” for your records – your medical history. When it comes to designing preventive care measures, detailed knowledge of your medical history is an invaluable tool for a physician.
Dr. Christian and Dr. Fitzgerald understand the push toward convenience. And Dr. Christian is quick to point out that this isn’t about the nurse practitioners or physician assistants and their ability to provide services. After all, he said, many doctors employ those professionals now.
Dr. Fitzgerald acknowledges that this idea of delivering convenience is an issue that primary care physicians cannot ignore. She’s right about that. Physicians do need to re-examine their availability and consider adjusting their schedules to better serve their patients, if at all possible.
But let’s face it – this is really about retail competition. And if MinuteClinic arrives at your local CVS, you can bet that some other outfit will soon show up at Walgreen’s or Brooks Pharmacy.
Would Wal-Mart and Target allow themselves to be left out of the mix?
And maybe there isn’t anything wrong with all of this, unless of course you start developing a false sense of security. And the next thing you know, you don’t even have a primary care physician anymore and maybe your kids don’t either, because what the heck, if there’s a problem, you can just run them into the local pharmacy.
While you’re there, you could pick up deodorant.
And if this sounds to you like a positive development in health care, you probably need to have your head examined.
