Pam Wahbe and her family have a primary-care physician. But lately they've been skipping the traditional doctor's office for minor ailments and instead using a walk-in clinic at a Towson CVS drugstore.
"Going to the doctor takes a lot of time," says Wahbe, who has been using the store's MinuteClinic for a couple of years.
"You have to wait until they're open, and then you have to call. And then you have to wait until they call you back. By the time you get in there, you've wasted at least half a day."
For routine flu shots and sinus infections, she says, the CVS clinic and its nurse practitioner get her in and out quickly with treatment just as good as the doctor's. Her health plan covers the visit.
At a time of soaring health expense, doctor shortages and scarce personal time, this is what economists like to see. Business saw an unmet need - affordable, hassle-free treatment for minor problems such as sore throat, swimmer's ear and pinkeye - and filled it.
"Convenient care" retail clinics, which have spread across Maryland, ought to be part of the medical future.
But many doctors are resisting them.
"People should stay with their own physicians who know their patients and who know the specific problems they have," says Dr. Martin P. Wasserman, former Maryland secretary of health and former executive director of MedChi, the state's largest doctor organization.
"While the patient wants the convenience of going in and getting this symptom cared for, it could be more expensive in the long run" if clinics miss a diagnosis or don't arrange proper follow-up, he said.
The American Medical Association says drugstore-based clinics pose a conflict of interest in which practitioners might prescribe unneeded medicine to increase store sales.
The doctors' trade group also wants stores with walk-in clinics to be prohibited from selling cigarettes. Tobacco sales and healing, it argues, don't go together.
Much of this sounds like traditional turf protection by a regulated industry worried about innovative upstarts. Just as lawyers excoriate even basic legal education (a nonprofit group distributes basic contract forms for free) as quackery, organized physicians want to retain their licensed monopoly. (Many walk-in clinics are staffed by nurse practitioners, not docs.)
AMA talk of conflicts of interest would sound more convincing if the group took a tougher stand on physician-owned specialty hospitals or drug-company emoluments for docs. The conflicts of interest in those situations are far worse.
