There’s a good (short) article via Reuters discussing the use of these walk-in clinics, which are usually found at grocery stores or pharmacies. To some people they’re controversial, and perhaps it’s no surprise that one of the groups concerned with the use of the clinics is the American Medical Association. Ah, yes…the AMA.
The article mentions the AMA passing resolution a few months ago “asking state and federal authorities to investigate whether there was a conflict of interest in drug-store chains that both write and fill prescriptions.” Now, I have no problem with investigating conflicts of interest, but it’s a bit ironic that a group such as the AMA is pointing their fingers at walk-in clinics and not themselves. What better example of a potential conflict of interest than a physician who receives undisclosed perks from drug companies and then prescribes those drugs? To be honest, I don’t have strong feelings regarding whether physicians should be allowed to receive food/(small)freebies/etc from drug companies so long as they are honest and disclose these things. I should also take this moment to point out that the AMA doesn’t represent all, or even most physicians – only about 25-30% of physicians are members of the group.
Still, I checked out what their website had to say about these walk-in clinics, and there’s some entertaining stuff (well, actually it’s kind of sad…but I prefer to laugh at the absurdity rather than cry). For example, the AMA says that:
“Store-based health clinics must use standardized medical protocols derived from evidence-based practice guidelines to insure patient safety and quality of care.”
Now, you might not think this is laughable, but it is when one considers that many doctors do not adhere to so called “standardized medical protocols derived from evidence-based practice.” There will always be patients who do not benefit from such standards, because every patient is unique. However most patients do benefit from such standards which is why they are “standards”, but again – why point the finger only at the quick clinics and not also at the physicians they represent? From the AMA website:
“Store-based health clinics must establish protocols for ensuring continuity of care with practicing physicians within the local community.”
Have regular health clinics and hospitals ensured continuity of care yet? Didn’t think so. Again, says the AMA:
“Store-based health clinics must establish appropriate sanitation and hygienic guidelines and facilities to insure the safety of patients.”
This one seems so obvious that it’s a bit silly they feel the need to point it out. Or is it? Maybe not when one considers the research that estimated about 2 million patients a year acquire an infection from their hospital stay, and up to 90,000 will die as a result. Bottom line – I don’t have a problem with the AMA recommendations per se, but it’s a bit like the pot calling the kettle black. To me it comes across as the AMA only looking out for their own interests (and by that I mean the salaries of their members) instead of what is in the best interest of the patient. They’ve also lobbied hard to get these clinics under the supervision of a physician, which defeats the affordable part of the experience. I have no problem with leaving Registered Nurses in charge – I’ve had clinical visits with RN’s on a few occasions, and they are certainly competent to deliver the level of care required by many people visiting these clinics. If they can’t provide the care needed, they refer out to a physician. My guess is that if for some reason a person visiting this clinic didn’t feel like they were receiving appropriate care, they would stop going and instead find another clinical setting where their needs are met. But considering the success these clinics have achieved thus far, they seem to be operating appropriately.
Reuters article on walk-in clinics “Clinics in US retail stores bring controversy”