Our Changing Health Care System

Rather than waiting a week to see your doctor when you’ve got a sore throat, your past choice could have been the emergency room at your local hospital.  Once there, you could be privileged to wait for hours in a crowded noisy room.  Then, adding to the insult, you could be hit up for hefty co-insurance fees.

That’s changing.  Walk-in cinics, also called Retail Health Clinics are showing up in strip malls, megastores, major shopping malls, and drugstores. cvs health survey, Walgreens, Target, and Wall-Mart are in the business.  At the end of 2007, there were 921 walk-in health clinics nationwide as compared to just 129 the year before.  So the growth has been nothing short of phenominal; sort of like Starbucks.  Within the next five years, the number is expected to exceed 3,000.

The search for cheaper, faster, and more accessible health care is fueling this trend.  Timely and affordable health care is becoming increasingly difficult to obtain as doctors continue to migrate into the specialties.  The reason for this is simple.  They pay better.

Some doctors are fighting back.  Dr Jim King, president of the American Academy of Family Physicians has developed a program that allows patients with minor problems, the kind that could be treated at a walk-in clinic, to see a doctor within 45 minutes of coming in.  There are a number of practices attempting to become more patient centered than has been their customary routine, but to date, they are still very few and far between.

So meanwhile, if you have a cold, sinus problem or a bug of some kind that isn’t likely to get serious, a walk-in clinic may provide a solution.  But before you go running off to the nearest Target, be aware of the possible drawbacks.

Walk-ins — What Are They?

The Mayo Clinic defines a walk-in clinic as a clinic that treats certain common conditions. They are often staffed by licensed nurse practitioners who are specially trained to work in these clinics and can write a prescription for you if necessary.  Most walk-in clinics treat conditions such as:

– Sinus infections or upper respiratory infections
– Bladder infections
– Strep throat
– Pink eye or styes
– Minor injuries
– Skin conditions such as warts or eczema

Some clinics also provide flu or tetanus shots, pregnancy tests, and routine physicals.  They are not a substitute for regular visits to your doctor and you should keep your doctor informed of any treatment you have received at a walk-in clinic.

Mixed Reviews by Consumers

The Deloitte Center for Health Solutions recently conducted a survey that found 34% of consumers inclined to use a walk-in clinic, with 16% saying they already have.  Walk-in clinics are cheaper, more convenient, with many of them keeping late hours.  And many insurance companies are now covering visits to these clinics, with much lower co-pays than for a doctor’s visit.  According to Dr Ezekiel Emanuel, head of the Bioethics Department at the National Institutes of Health, walk-in clinics are good for “short, simple stuff.”  They are not about complicated health problems.

Even so, patients are not uniformly happy with walk-in clinics.  Canada, just like the U.S., is suffering from a shortage of primary care physicians. And Canada also has its share of walk-in clinics.  A study in the Annals of Family Medicine surveyed patients on the kind of care they liked best.

Seeing or speaking on the telephone with one’s family physician scored the highest, the emergency room followed and then came a health information service staffed by nurses.  Walk-in clinics made a very poor showing of last.

And then of course, the question of safety and appropriate treatment is always out there.  When you walk into a clinic, chances are you won’t be seen by a doctor.  Most clinics are managed by nurse practitioners or physician’s assistants and don’t have a doctor on the premises,  This leaves the decision of prescribing medication up to someone with considerably less comprehensive training and can result in overdosing, especially where antibiotics are concerned.  Doctor Bruce Auerbach, president elect of the Massachusetts Medical Society believes that this can be downright dangerous.  If the patient fails to communicate with the practitioner concerning the medications he is already taking, a medication could be prescribed that seriously conflicts with them, is Dr Auerbach’s contention.

b>Alternatives for Chronic Conditions