I was sitting in the resident workroom at Massachusetts General Hospital (MGH) when my co-resident showed me the text from her sister: two explosions had shaken the finish line of the Boston marathon. Though news sites had not yet published the headline, it was immediately corroborated by the cacophonic wails of ambulances heading towards us and our shock was quickly replaced by the urge to learn more and to do something. We scrolled through the emergency department’s internal log and saw with horror as patient after patient entered with the chief complaint of "amputation." We made our way to the residency office to report our availability to pitch in, passing orthopedic residents called in to help and sharing the elevator with a case manager frantically wheeling one of several patients to another part of the hospital to make space in the Emergency Department (ED) for the expected deluge of injured runners and onlookers.
A few of us were recruited to help clear out the ED by expediting hospital admissions for patients with medical problems like pneumonia or heart failure. Other internal medicine residents continued their usual - now busier - work on the floors. Those, like me, on elective stayed close by in the off chance we were needed. We huddled in the resident lounge, checking in with our families and friends, scanning the ED log, and reading out loud Twitter updates filtered by source credibility. We bemoaned our internal medicine training - we could treat a heart attack but were useless when it came to mangled limbs - and shared our magnified respect for our colleagues in surgery and emergency medicine.FULL ENTRY
Walgreens, the country’s largest drugstore chain, announced on Thursday that its 330+ Take Care Clinics will be the first retail store clinics to both diagnose and manage chronic conditions like asthma, diabetes, high blood pressure, and high cholesterol. The Nurse Practitioners (NPs) and Physician Assistants (PAs) who staff these clinics will provide an entry point into treatment for some of these conditions, setting Walgreens apart from competitors like Target and CVS whose staff help manage already-established chronic illnesses or are limited to testing for and treating minor, short-lived ailments like strep throat.
A one-stop shop for toothpaste, prescription drugs, and a diabetes diagnosis? The retail clinic phenomenon has its appeal: it allows patients convenience and better access to care through longer hours and more locations than our health care system now provides. Walgreens leaders bill their latest offering as a complementary service to traditional medical care. They envision close collaboration with physicians and even inclusion in Accountable Care Organizations, according to reporting by Forbes' Bruce Japsen (though it's not clear how the retailer would share the financial risk or savings in such a model).FULL ENTRY