Saturday, February 27, 2010

The Family Physician Cartel Objects to the Expansion of Services Offered By Retail Clinics

"The American Academy of Family Physicians (AAFP) Board of Directors has revised its official policy on retail health clinics to reflect the Academy's opposition to a growing expansion of scope of services provided by many such clinics. In addition, the Academy has discontinued its practice of entering into formal agreements with retail health clinics that support the AAFP's desired attributes.

The AAFP created its retail health clinic policy in 2005 when it became clear that the clinics were increasing in number nationwide. Subsequently, five retail health companies signed agreements with the AAFP to abide by the Academy's desired attributes for such clinics. The four retail health organizations that still hold signed agreements -- MinuteClinic, RediClinic, The Little Clinic and BellinHealth Fast Care -- have been notified that those agreements will be terminated.

In a letter sent to those companies, the Academy said its decision was not intended to reflect negatively on any retail health clinic company. Rather, it was made after observing the evolution of the retail health clinic model into expanded service lines. "The practice of having formal agreements has run its course," says the letter.

When the first few retail health clinics appeared on the health care scene in 2000, the business model featured clinics staffed primarily by nonphysician professionals, such as nurse practitioners. Clinics were designed to treat patients for a limited number of acute illnesses, such as sore throats and ear infections.

Now, nearly a decade later, clinics are operating in 32 states. According to the Convenient Care Association, the number of retail clinics has grown to nearly 1,200 nationwide (MP: And further expansion is projected, see chart above). Notably, two of the nation's largest retail health chains have disclosed to the AAFP their intent to move forward into chronic disease management.

"The AAFP revised its policy because some clinics are expanding their scope of service beyond what the Academy thinks is appropriate," said AAFP President Lori Heim, M.D. The expansion of clinic services most likely reflects the reality that retail clinics need to treat more than walk-in patients with acute health problems to survive economically, she added.

In its revised policy statement, the Academy notes that it does not endorse retail health clinics and believes that the clinics could interfere with the medical home model of care. The AAFP "opposes expansion of their scope of service" and stands against the diagnosis, treatment and management of chronic medical conditions in the retail clinic setting.

Heim commended family physicians who have expanded their office hours and changed their office procedures to allow for same-day appointments to accommodate patients with urgent health care needs. "We need to see more of those kinds of changes, because we know that above all else, patients like the convenience that retail health clinics offer," she said."

MP: Notice in the last paragraph that family physicians have responded to the competition from retail clinics by starting to operate more like retail clinics with expanded hours and same-day appointments.  Competition is a great thing for consumers -  too bad it seems like the AAFP now wants to limit it. 

7 Comments:

At 2/27/2010 11:36 PM, Blogger bobble said...

"The expansion of clinic services most likely reflects the reality that retail clinics need to treat more than walk-in patients with acute health problems to survive economically . . "

this is good news. the traditional medical delivery structure needs to change

 
At 2/28/2010 12:40 AM, Anonymous Anonymous said...

The family doctor and general internist have been underpaid for decades. Cartel implies that they have market power which they do not. Seven years of training after college is a long time to delay making a living. Because of the poor pay and high stress,
very few medical students are choosing to become family physicians or general internists. My primary care physician of 23 years closed his practice and reopened as a $1,500/yr retainer practice. That is a market solution to poor reimbursement and too much red tape. If I get ill at 2AM, I will get his expertise. When you get ill, your retail clinic will be closed.

A significant number of primary care physicians will move to a cash system, like the old days. It works fine for vets, dentists and attorneys. In fact, is this not the way 99% of financial transactions are done?

The high cost of medical care is the result of Medicare and Medicaid along with unions being pain in health benefits instead of taxable dollars. Retail clinics and urgent care clinics are fine; competition and choice are always welcome. Please do not give your readers the opinion that family doctors have or want a cartel.

 
At 2/28/2010 1:09 AM, Blogger OA said...

The worst part of doctor visits is the 20 pages of paperwork and the waiting around. If the DMV had magazines and nicer furniture, it might be a toss up. Some relief on the system was long overdue.

Retail clinics seem like a good match for people needing treatments for a chronic condition. It's already diagnosed so doctor visits could be saved for an annual review or changes in condition. For routine treatments, convenience would contribute greatly to the patient's quality of life.

 
At 2/28/2010 1:29 AM, Blogger Suzanne said...

I'm Canadian. I've never heard of a retail health clinic, and I think it sounds just dandy. I hope they can expand into Canada! Same day service instead of waiting 6 hours (or more) at the emergency room? Sign me up!

 
At 2/28/2010 9:27 AM, Anonymous Anonymous said...

Here in Mexico, it is almost all cash for service, and very little cash at that.
In 1999, I had a double cataract operation at a first rate hospital. Total cost $1300 for everything--all hospital, OR, doctors, everything.
Typical doctor's office visit costs between $1.75 to $28 dollars US. All this is FREE ENTERPRISE, not govt. Almost nobody here has insurance.
Remember, the debate is about HEALTHCARE, not insurance.

 
At 2/28/2010 10:39 AM, Anonymous Anonymous said...

I'm a family doc ... I understand that retail clinics are desired by patients ...

So why don't we do that?

Well, it's illegal for me to offer a discount. The majority of my paying patients couldn't come to me as I would be "out of network." It's against the law for me to run a "special" on pricing.

If patients made ALL decisions with regard to their care, this would work. As it is now, they control a pretty small amount of the money it takes to care for them.

 
At 2/28/2010 10:47 AM, Blogger sethstorm said...


Here in Mexico, it is almost all cash for service, and very little cash at that.
In 1999, I had a double cataract operation at a first rate hospital. Total cost $1300 for everything--all hospital, OR, doctors, everything.

Except that you're gambling with an entity that is beyond the jurisdiction of the US. Good luck trying to litigate for actual damages.


Typical doctor's office visit costs between $1.75 to $28 dollars US. All this is FREE ENTERPRISE, not govt. Almost nobody here has insurance.
Remember, the debate is about HEALTHCARE, not insurance.

And the quality is naturally lower.

 

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