The concern about tobacco is a pressure tactic disguised in sanctimony. Prohibiting tobacco sales at clinic-equipped stores wouldn't stop one person from smoking, but it would hurt the stores' revenue.
Wasserman points to a legitimate concern - making sure family physicians know what clinics are doing. But CVS' MinuteClinic and other chains insist that they record the primary-care doc for every patient and quickly send records.
In any event it's not like most family doctors, with their restricted hours, booked-up appointment slots and endless waiting-room stays, are providing the services people like Pam Wahbe need. When docs finally see patients in the examining room, I suspect most don't appreciate the logistical challenges, equivalent to Allied planning for D-Day, that got the patients there.
"It's the inefficiency of the business model most physicians have," said Raymond Brusca, vice president of benefits at Towson-based toolmaker Black & Decker. "If they had a better business model, maybe these [retail clinics] wouldn't have taken off."
Black & Decker studied health care received by employees in Maryland and other places where retail clinics are easily available. (There are 31 in Maryland, in CVS and Target stores, and about 1,000 nationwide, says the Convenient Care Association.)
It found that, for the typical visit, the company saved 40 percent compared with what treating the same ailment cost in a doctor's office. That doesn't count an additional discount employees got on their portion, not to mention all the time and aggravation saved.
A typical cost might be $75 for a physician visit versus $50 at a convenient-care clinic, Brusca said. (Most MinuteClinic treatments cost $59.)
The clinics treat only minor ailments, which is key to their success. They don't need to pay for a full-time doctor on duty. And because diagnosis and treatment take little time, there's not much of a backup.
To be sure, there is a primary-care crisis in American medicine. Family docs and general practitioners are woefully underpaid. Consequently there aren't enough of them, which partly explains the difficulties of getting to see one.
But the answer is not to fight the efforts of people willing and able to relieve some of their workload.
The answer is to increase reimbursement for the case management and sophisticated diagnosis skills that family docs are trained for. Let somebody else treat minor illness for lower fees, if that's what patients want.
Devoting 10-plus years of college, med school and residency to treating earwax, poison ivy and athlete's foot isn't the most efficient use of resources for the doctor or the patient.
