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

Basic healthcare may have just gotten easier,hygiene and safety. "We've got big problems
albeit controversially. The number of walk-inin healthcare, and this is not the answer,"
clinics at drugstores like Walgreens, CVS,said Rick Kellerman, president of the
Wal-Mart, and Duane Reade has been increasingAmerican  Academy  of  Family  Physicians.
over the last two years, and very little is
slowing down plans to add hundreds moreMany state officials agree, at least to a
across the country. Recent studies citecertain extent. The walk-in clinics are
shorter waiting periods, lower costs, andcurrently being monitored by a confusing mix
instant prescription fills for the clinics,of agencies applying a wide and inconsistent
in contrast to more expensive andrange of regulations and enforcement
time-consuming trips to doctors' offices. Theprinciples. After Massachusetts doctors'
majority of these clinics also accept mostgroups issued loud protests to the proposed
health insurance plans, leaving littleopening of a MinuteClinic, the Health
incentive for on-the-go Americans to waitDepartment issued guidelines for the state,
days or weeks for non-specializedcalling for the facilities to clearly specify
appointments  in  conventional  offices.that they are "limited service clinics." The
American Medical Association is pushing for
The rise in healthcare costs, the decrease insimilar national requirements on the
the number able to afford private healthdrugstore facilities, urging local and
insurance, and the inadequate number offederal governments to require them to be
primary care physicians across the country"well-defined and limited [in] scope." Two
have all been building up to this -- perhapspublic hearings on the issue are scheduled in
inevitable -- solution. One can now walk inMassachusetts  in  September.
to any number of seven hundred clinics
located in several nationwide drug andConflicts of interest between the clinics and
discount store chains and be seen, onthe drugstores cannot be ignored, either. New
average, in under twenty-five minutes. WhileYork state regulators are investigating
the clinics are not recommended for anythingpossible inappropriate relationships between
but basic care -- such as treating a cold,drug companies and medical providers. The
flu, or mild infection -- that's just finerisk, they say, is of healthcare facilities
for many, especially those going back tobeing used improperly to increase business or
school, who are often bombarded by common,to funnel patients into their adjacent
acute illnesses in those first, returningpharmacies. In certain states, like New York,
months.it is also necessary for clinics to operate
as independent practices or professional
Texas, a state in which twenty-five percentcorporations; i.e., they must not be a part
of the populace is without health insurance,of  the  drugstore  chains  themselves.
may particularly stand to benefit from
increased healthcare options. A visit to a"If we determine the business corporations
MinuteClinic, a wholly owned subsidiary of[like CVS] are practicing medicine, then they
CVS Caremark, costs an average of eighteenare illegally practicing the profession and
dollars less than other primary-care clinics,we have the authority to investigate," said
according to HealthPartners, a MinnesotaFrank Munoz, associate commissioner of the
health maintenance organization. EmergencyNew York State Education Department's Office
rooms across Dallas, Houston, Austin, and theof  Professions.
rest of the state are overloaded with the
uninsured seeking basic, non-emergency careDuane Reade, a pharmacy chain located
simply because they have nowhere else to go.primarily on the East coast, is attempting to
Offering easier, cheaper access to basiclimit possible complications by partnering up
diagnostic care and treatments may alleviatewith well-known hospitals, such as New York
some of the burden on both individuals andCity's Beth Israel Medical Center and St.
local facilities overwhelmed by too manyLuke's-Roosevelt Hospital Center. Duane Reade
people  and  not  enough  funding.clinics will be staffed by medical doctors,
versus nurse practitioners or physician
Twenty percent of people in the United Statesassistants, and have admitting privileges to
have no or inadequate access to a primarypartnering facilities. Such agreements will
care physician, with few indications thatgive the doctors the ability to send those in
statistic will improve in the near future. Inneed of emergency care straight to the
2004, seventy-five percent of the counties inhospital, and streamline patients' procedures
Texas lacked sufficient numbers of primaryto see specialists. Additionally, the clinics
care physicians to meet local needs, andwill function as private medical practices,
twenty-four counties had none at all.run by the physicians themselves, who will
Drugstore clinics often employ morelease  the  space  from  the  corporation.
cost-effective nurse practitioners and
physician assistants -- healthcare workersMichael C. Howe, chief executive of
with the ability to diagnose and treatMinuteClinic, which runs over two hundred
everyday conditions, but who are under theclinics nationwide, defends CVS's practices
supervision of a licensed medical doctor.as they are, however. "We are transparent
These workers are growing more and morewith regulators," he said, and concerns "are
popular within the industry, partially as abeing raised by people who have not really
result of the shortage of familystudied  the  model."
practitioners.
Being aware of current events and issues
But doctors' groups are protesting, and someaffecting your health is an important part of
with good cause. Many of these groups standtaking care of yourself. Minding your health
to lose substantial business, and are arguingwill certainly affect you as you age, and
that such facilities may be unable to provideeventually your wallet.
the proper standards of care, including



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