Drugstore Clinics Widespread, Despite Criticisms: Texas May See More Walk-In Options

Basic healthcare may have just gotten easier, albeitstandards of care, including hygiene and safety.
controversially. The number of walk-in clinics at"We've got big problems in healthcare, and this is not
drugstores like Walgreens, CVS, Wal-Mart, and Duanethe answer," said Rick Kellerman, president of the
Reade has been increasing over the last two years,American Academy of Family Physicians.
and very little is slowing down plans to add hundredsMany state officials agree, at least to a certain
more across the country. Recent studies cite shorterextent. The walk-in clinics are currently being
waiting periods, lower costs, and instant prescriptionmonitored by a confusing mix of agencies applying a
fills for the clinics, in contrast to more expensive andwide and inconsistent range of regulations and
time-consuming trips to doctors' offices. The majorityenforcement principles. After Massachusetts doctors'
of these clinics also accept most health insurancegroups issued loud protests to the proposed opening
plans, leaving little incentive for on-the-go Americansof a MinuteClinic, the Health Department issued
to wait days or weeks for non-specializedguidelines for the state, calling for the facilities to
appointments in conventional offices.clearly specify that they are "limited service clinics."
The rise in healthcare costs, the decrease in theThe American Medical Association is pushing for
number able to afford private health insurance, andsimilar national requirements on the drugstore
the inadequate number of primary care physiciansfacilities, urging local and federal governments to
across the country have all been building up to this --require them to be "well-defined and limited [in]
perhaps inevitable -- solution. One can now walk in toscope." Two public hearings on the issue are
any number of seven hundred clinics located inscheduled in Massachusetts in September.
several nationwide drug and discount store chains andConflicts of interest between the clinics and the
be seen, on average, in under twenty-five minutes.drugstores cannot be ignored, either. New York state
While the clinics are not recommended for anythingregulators are investigating possible inappropriate
but basic care -- such as treating a cold, flu, or mildrelationships between drug companies and medical
infection -- that's just fine for many, especially thoseproviders. The risk, they say, is of healthcare facilities
going back to school, who are often bombarded bybeing used improperly to increase business or to
common, acute illnesses in those first, returningfunnel patients into their adjacent pharmacies. In
months.certain states, like New York, it is also necessary for
Texas, a state in which twenty-five percent of theclinics to operate as independent practices or
populace is without health insurance, may particularlyprofessional corporations; i.e., they must not be a
stand to benefit from increased healthcare options. Apart of the drugstore chains themselves.
visit to a MinuteClinic, a wholly owned subsidiary of"If we determine the business corporations [like CVS]
CVS Caremark, costs an average of eighteen dollarsare practicing medicine, then they are illegally
less than other primary-care clinics, according topracticing the profession and we have the authority
HealthPartners, a Minnesota health maintenanceto investigate," said Frank Munoz, associate
organization. Emergency rooms across Dallas,commissioner of the New York State Education
Houston, Austin, and the rest of the state areDepartment's Office of Professions.
overloaded with the uninsured seeking basic,Duane Reade, a pharmacy chain located primarily on
non-emergency care simply because they havethe East coast, is attempting to limit possible
nowhere else to go. Offering easier, cheaper accesscomplications by partnering up with well-known
to basic diagnostic care and treatments may alleviatehospitals, such as New York City's Beth Israel Medical
some of the burden on both individuals and localCenter and St. Luke's-Roosevelt Hospital Center.
facilities overwhelmed by too many people and notDuane Reade clinics will be staffed by medical
enough funding.doctors, versus nurse practitioners or physician
Twenty percent of people in the United States haveassistants, and have admitting privileges to partnering
no or inadequate access to a primary care physician,facilities. Such agreements will give the doctors the
with few indications that statistic will improve in theability to send those in need of emergency care
near future. In 2004, seventy-five percent of thestraight to the hospital, and streamline patients'
counties in Texas lacked sufficient numbers ofprocedures to see specialists. Additionally, the clinics
primary care physicians to meet local needs, andwill function as private medical practices, run by the
twenty-four counties had none at all. Drugstore clinicsphysicians themselves, who will lease the space from
often employ more cost-effective nurse practitionersthe corporation.
and physician assistants -- healthcare workers withMichael C. Howe, chief executive of MinuteClinic,
the ability to diagnose and treat everyday conditions,which runs over two hundred clinics nationwide,
but who are under the supervision of a licenseddefends CVS's practices as they are, however. "We
medical doctor. These workers are growing more andare transparent with regulators," he said, and
more popular within the industry, partially as a resultconcerns "are being raised by people who have not
of the shortage of family practitioners.really studied the model."
But doctors' groups are protesting, and some withBeing aware of current events and issues affecting
good cause. Many of these groups stand to loseyour health is an important part of taking care of
substantial business, and are arguing that suchyourself. Minding your health will certainly affect you
facilities may be unable to provide the properas you age, and eventually your wallet.