The cheaper option

AMA should stop looking down nose at in-store health clinics

Thursday, July 5, 2007

Experts who study health-care finance agree that a significant way to contain costs would be to encourage more patients who aren't suffering acute or life-threatening ailments to visit facilities that provide routine care and not occupy scarce and expensive emergency-room beds.

An ER visit to treat strep throat on average costs $329, the Rocky's Joyzelle Davis found, more than three times the cost of a trip to an urgent-care center; doctors' offices routinely charge at least $100 for such a visit.

Enter in-store health clinics, now opening at retail pharmacies and department stores. Over the past couple of years, hundreds of these clinics have sprung up across the country and thousands more are in the works. They're staffed by nurse practitioners or physician's assistants, accept patients without appointments and can write prescriptions, treat infections and perform a host of other routine procedures. Many are open seven days a week.

Physicians are available on-call if a patient requires more-extensive care and needs to be sent to a doctor's office or emergency room.

You'd hope the American Medical Association would support the concept, but you'd be wrong. The medical association claims the clinics are not safe alternatives for many patients, because they provide only limited services. It also worries that a clinic located, say, in a Walgreens might push patients to buy their prescriptions at that store rather than at another pharmacy.

The doctors' group also argues that patients might decide to avoid primary-care physicians, since the clinics offer treatment at a lower cost than traditional medical practices. For instance, Davis reported that SmartCare, which has locations in several local Wal-Marts, charges a patient without insurance $65 to treat strep throat; an insured patient can get treatment and a prescription for the $25 co-pay.

Last month the association's House of Delegates voted to urge tighter federal and state regulation of the clinics. The medical society in California has already leaned on the legislature, getting a law enacted that allows only in-store clinics that are owned by physicians. This means that these clinics charge about the same for treatment as a traditional doctor's office.

What's really going on here is protectionism, pure and simple. The association would deny patients this convenient, cost-saving alternative rather than surrender turf to innovative rivals.

The professionals who staff in-store clinics are doing nothing illegal, and they're providing patients with a service they value - affordable health care with hours that fit their desires.

We'd urge regulators and lawmakers who claim they want to make medical services more affordable to steer clear of new rules that would inhibit the development of this healthy alternative.

It shows that some segments of the health-care marketplace would benefit from good old-fashioned competition . . . even if that gives the medical establishment heartburn.