CAMLAW: Complementary and Alternative Medicine Law Blog

Retail medicine making inroads at walk-in health clinics

Retail medicine are making inroads at walk-in health clinics, undercutting conventional care and bypassing hospital fees.

The Wall Street Journal reported that walk-in health clinics are proliferating in pharmacies and discount stores, but questioned whether these are financially and medically beneficial to consumers.

The Journal cautioned: "Patients with serious ailments should steer clear of the clinics, which are set up to handle minor problems such as sinus infections, pink eye and bee stings. Beyond that, the answer partly depends on whether a person has health insurance, and if so, what kind."

Caveat emptor. Scope of practice restrictions would also apply to non-MD professionals, helping regulate possible excesses.

"For people who aren't insured or have high-deductible policies, the retail health clinics -- run by companies such as MinuteClinic, Take Care Health Systems and RediClinic -- can offer significant savings. Many minor ailments are treated for $49 to $59, significantly less than at many doctors' offices....People with traditional insurance, by contrast, usually have to pay the same co-pay as they would at their doctor's office. But a few employers have lowered co-pays for clinic visits in an effort to encourage workers to use them for simple ailments, says Michael Howe, chief executive of MinuteClinic, a subsidiary of CVS."

Retail medicine would probably be considered a "disruptive technology" in undercutting conventional medical care, but it would only cover the lower end of the health care spectrum. In that sense, it may also compete with complementary (CAM) care -- or incorporate it, by eventually including acupuncturists, chiropractors, naturopaths, and possibly others such as midwives and nutritionists.

Notes the Journal: "One appeal of the clinics is that they post prices for services, such as treating bronchitis or giving a flu shot. Such information is rarely seen in physicians' offices or hospital emergency rooms, and consumer advocates have been pressing for more price transparency.

"For many consumers, though, convenience is the main appeal of the clinics, which are usually staffed by nurse practitioners and have one or two examination rooms."

There is opposition: "Some doctors and physicians' groups, however, disapprove of the retail clinics. Last September, the American Academy of Pediatrics said it "opposes" the clinics because they lead to "fragmentation of care" and raise questions about the quality of care. In particular, the group said children should have a "medical home" -- a doctor who sees them on a consistent basis."

"Anne Pohnert, director of operations for MinuteClinic in the Washington, D.C., area, says MinuteClinic tries to establish and maintain a relationship with primary-care physicians by sending them reports of patients' visits. (Some other chains do that as well.) She says the clinics follow strict guidelines on what they will and won't treat.

"For example, she says, MinuteClinic won't treat a patient more than four times in one year for sinus infections because that person should see an ear, nose and throat specialist to rule out a more serious condition. Similarly, she says, the clinics won't treat anyone who is 65 and seems to have bronchitis, because the person could have a serious respiratory problem, or congestive heart failure."

Law Offices of Michael H. Cohen offers general corporate legal services, litigation consultation, and expertise in health law with a unique focus on alternative, complementary, and integrative medical therapies.

Michael H. Cohen is Principal in Law Offices of Michael H. Cohen and also President of the Institute for Integrative and Energy Medicine (also known as the Institute for Health, Ethics, Law, Policy & Society), a forum for exploration of legal, regulatory, ethical, and health policy issues involved in the judicious integration of complementary and alternative medical therapies (such as acupuncture and traditional oriental medicine, chiropractic, massage therapy, herbal medicine) and conventional clinical care. The most recent published book by Michael H. Cohen on health care law, regulation, ethics and policy pertaining to complementary, alternative and integrative medicine and related fields is Healing at the Borderland of Medicine and Religion. This is the fourth book in a series, following Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives (1998), Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Human Evolution (2000), and Future Medicine: Ethical Dilemmas, Regulatory Challenges, and Therapeutic Pathways to Health Care and Healing in Human Transformation (2003).

Health care and corporate lawyer Michael H. Cohen has also been admitted to the Bar of England and Wales as a Solicitor (non-practicing), adding to Bar membership in four U.S. states.

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