Friday, June 13, 2008

Protecting the Health and Well-Being of What?

A CD post yesterday linked to a Wichita Eagle story about Walgreens becoming the first national retailer to bring in-store, walk-in clinics to the Wichita market.

Who would possibly object to low-cost, convenient, patient-friendly, market-driven, retail health care clinics in Wichita?

The local AMA cartel of course, aka the Medical Society of Sedgwick County, which
drafted a resolution that suggests that retail health care clinics present "multiple dilemmas to Kansas physicians," such as:

1. It hasn't yet been determined whether this entrepreneurial approach to health care delivery enhances or further fragments patient health care.

2. The value of a team approach to health care is subverted in “retail health care” alternatives to the detriment of the patient.

3. A concern about the quality of health care delivered by a mid-level professional practicing in a semi-autonomous setting and the quality of the supervision delivered by the attending physician.

4. The potential for inappropriate referring of patients needing expanded health care.

THEREFORE BE IT RESOLVED THAT: The Kansas Medical Society ask the Kansas Medical Society Task Force to specifically address the issue of “retail health clinics” as a part of their on-going study and make specific policy recommendations that protect the health and well-being of patients.

MP: My inner economist suspects that the Kansas physicians might also want to "protect the health and well-being of their medical cartel and above-market wages."


At 6/13/2008 8:26 AM, Blogger Walt G. said...

As someone who has never bought into the overpaid CEO hype, I wonder what the percentage of physicians’ wages is compared to total health care costs. There could be a jealousy factor in play here. Often people don’t like people making more than themselves even if it can be justified.

Additionally, how does this percentage-to-total-cost compare to other industries such automobile manufacturing, education, government, and the like?

Anyone in the medical field have any plausible answers? This seems to be a complex problem where those who are most able to solve the cost problem have the least incentive to do so. That’s somewhat unique in the business world.

At 6/13/2008 9:05 AM, Anonymous Anonymous said...

Clinics at Wallgreens aren't much different from Walk In Clinics. There are lots of "after hours" and walk in clinics. Funnily, we don't seem to hear very many complaints about the Walk In Clinic model.

Why does locating a clinic in a store suddenly seem to make it contentious?

Is it the element of commoditization of health care or does the location in a commercial enterprise denegrate the "status" of the profession?

It reminds me of the traditional banks that closed at 3:00 pm. on weekdays and noon on Sat. They complained bitterly about trust companies that offered longer hours for customer convenience and safety. In Canada, banks tried to challenge the expansion of trust companies under the banking laws and restrict their product offerings making little headway and continuing to lose market share.

The banks have finally responded by extending hours to 4:00 M-W & to 6:00 pm on Thurs. & Friday and till noon on Sat. Canada Trust still has better hours - open till 8:00 during the week and till 2:00 on Sat.

If this model succeeds in increasing supply, it necessarily follows that the price of health care will also fall. Since salaries represent a very large percentage of any service business and there are limited ways to leverage productivity, it is not unreasonable to suggest that some of the resistence concerns the effects of increased competition on salaries.

At 6/13/2008 9:50 AM, Anonymous Anonymous said...

Opening retail health care clinics is going to result in a shortage of health care professionals? A shortage that can only be supplanted by hiring from outside this country?

That means that the wages of hard working, American health care professionals will be going down. Who wants that?

At 6/13/2008 9:55 AM, Blogger (Q) said...

Mr Walt G., why haven't you bought into the overpaid CEO hype?

BLS has a page with current estimates of doctors' incomes, and has a pie chart suggesting that "physician services" make up one-fifth of the national health spending. I hope this helps.

My question is this: how does having a semi-qualified medical person at a Walgreen or a Walmart tell you that you might be very sick and need expensive diagnostics and a possibly aggressive and very expensive treatment solve the problem that 40 million Americans wouldn't be able to afford any of it? I mean, do these walk-in clinics promise cheap operations and affordable hospital stays? Cheap hip replacements?

At 6/13/2008 9:55 AM, Blogger Walt G. said...

"Why does locating a clinic in a store suddenly seem to make it contentious?"

I don't know about stores; however, our factory clinic is staffed by RNs with oversight by a licensed doctor. The doctor is responsible for the operation of the clinic and actions of her employees at all hours, and it's her medical license on the line for any mistakes that are made. Is it that way with the store clinics?

At 6/13/2008 10:05 AM, Blogger Walt G. said...

Thanks (q),

“Mr Walt G., why haven't you bought into the overpaid CEO hype?”

I am a stockholder who wants the best performance from a CEO. I don't mind paying for it, but I don't want information that I use to make my stock buying decisions hidden from me.

What’s wrong with paying superstar CEOs like superstar athletes? Not everyone can do either job.

At 6/13/2008 1:30 PM, Anonymous Anonymous said...

I think that instead of worrying about being trying to be protectionist, they AMA should focus on keeping this type of operation safe. The way to accomplish that is tight medical direction by a physician. As long as these clinics have physician oversight of the mid-levels and chart review along with a policy of not taking complex patients (which they all have...for example you won't see "CHF exacerbation" on their "menu" of services) then these clinics will be safe and convenient.


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