In-store clinics approved

Direct profit from the Drugs they prescribe? Sounds like a conflict of interest to me.

When your own physician is not immediately available anything that might decrease the hours someone has to wait in an emergency room for treatment of a nagging or painful but minor illness is worth a try. Hopefully, HMOs will allow a visit at a low copay instead of the $50 to $100 I estimate CVS will charge.

Yay! I've seen these in New York, Atlanta, and the Midwest, and I've always wondered why there were none in this state. I work in an ER, and you would not believe how many people come in for Rx refills, strep tests, and suture removal.

I could have used one of these last year, when I needed a strep test. I had no doctor (my old one dumped me, and i was trying to find a new one). Health Services at my school referred me to a clnic in Charlestown that saw walk-ins for 2 hours a day (10-11 and 2-3). Otherwise, I could go to the ER, pay $75, and wait 4 hours. It was an insane amount of drama for a (literally) 10-minute test.

This is a good decision. Won't solve all the problems of access to care, but it will make minor medical care more convenient. And, insurance will cover the visits because it's cheaper than them paying for visits to the ER.

And will CVS accept all insurances, including MassHealth?

There are significant concerns about these clinics breaking the continuity of care, communication w/ Primary Care Physicians, and how "larger than planned" problems will be handled. Are they prepared to handle the occasional misdirected patient who shows up with chest pain?

I completely agree with this, as should anyone who has ever had to travel clear across town to an approved medical facilty and wait for 2 hours just to have a doctor signing a note that you should stay home and rest because you have a high fever, and congestion. Complete no-brainer.

Also, for those without health insurance it shields them from ridiculous costs for diagnosis and treatment of a basic medical condition. I had a friend without insurance who had to go to the hospital and pay $800 for a nurse with a flashlight and a popsicle stick to diagnose strep throat.

And when my father recently had near heart failure he had to wait EIGHT hours in the emergency room for a bed, because the hospital was packed solid with individuals with far less serious ailments.

Jim (NO. 4) Writes "And, insurance will cover the visits because it's cheaper than them paying for visits to the ER."

I hope they do, but my doubts are based on the cost of getting treated for minor problems that normaly would be taken care of by the patient himself. The increased volume caused by these treatments would cut into profits of health plans. I do not think health plans will allow treatment at CVS without higher than normal copays.

Personally I prefer competition. Can I send my complex geriatric assessments to Minute Clinic? No? Hmm. Maybe I can sell medications directly to my patients. No? Do you think, maybe it's not a level playing field?

More at http://executivephysician.blogspot.com/2008/01/retail-clinics-versus-public-hospitals.html

Good move, albeit surprised it took them so long, by the Public Health Council. Now if we could only get our illustrious Mayor Menino to stop with all the political posturing and along with this as well. After all, a research report published in today's Health Affairs points to an ever growing problem in emergency rooms, wait times, that will only get worse. Worse yet, th longest waits were in urban areas. Could not retail clinics provide some relief? More info on the Health Affairs article can be found at www.chilmarkresearch.com

I'm a nurse who recently moved from MA to Connecticut, where there are Minute Clinics already. They are great! I went to one for my flu shot and was very favorably impressed by the standard of care. The clinics are staffed by Advanced Practice Nurses (I saw an Adult NP) -- the same professionals who would do similar exams and procedures in a private practice or a health clinic. The clinic was spotless, the technique flawless.

I've recommended the Minute Clinic to many family members, and all have been delighted with the efficient care. Recently, my sister took a sick friend there on a Saturday morning, and they were immediately sent to the emergency room for an X-ray to r/o a broken arm. After languishing in the ER for over 10 hours, they went home. Later the friend was dx'd with cellulitis -- days later, when she could get in to see her primary MD. It's clear where the gap of care occurred in this case.

As for conflict of interest, what's to stop Walgreen's, Rite-Aid, or even an independent pharmacy from instituting a similar program in their own stores? Furthermore, patients receiving an rx aren't required to fill them at the CVS. I really can't see a down side to Minute Clinics -- unless it's to an MD's bottom line, and any responsible MD will want his/her patients to receive timely, convenient care for relatively minor complaints.

These types of clinics are what people want for restoration of thier health, with limitations. Considering the state of our health care system presenly, which has been a catalyst for overworked and demoralized primary care docs that typically require long waits by thier patients for brief visits, our desire for these types of clinics are justified. NPs or PAs typically provide quality care as much as or in some cases more than doctors. If a patient seen in this type of clinic presents with concerning symptoms, protocols exist that will refer these patients to another facility that is better equipped to address such symptoms.