Back in July, CVS bought MinuteClinic, thinking to get a jump on the coming retail health clinic boom. If you’re like me, and you oppose the fast-food medicine phenomenon, you’re probably against the whole idea.
What I can’t argue against is the convenience, and that’s what’s going to be the big thing. People aren’t going to utilize them for the management of chronic illness, they’re going to use it for the one-off things: Hey I’ve got an ear infection. Hey I’ve been hacking my lungs out for the last 3 days. Hey my sinuses are about to explode and I’m ready to go postal on anyone who f’n looks at me. That sort of thing. (“Zpak, next!” “Zpak, next!” “Amoxicillin, next!…” etc. etc. ad inifinitum) Anyways, what’s better than stopping by CVS, seeing the PA (or NP), doing some shopping, then stopping by the pharmacy to pick up your Zpak? One-stop shopping at it’s finest.
Anyway I spoke at some length with a CVS district manager two weeks ago about the MinuteClinic thing, asking for some details on how they’re run. Who are they staffed by? (An MD? Probably not.) He didn’t know, which sort of irritated me. He was thinking in terms of revenue, and I’m thinking in terms of what’s best for the patient. I guess my main question is how you’re going to have someone diagnosing and prescribing without an MD on staff. PAs and NPs, of course are able to prescribe, so long as they have a supervising physician. (In the two states I’m familiar with, anyway.) So where’s the incentive for the MD to “supervise” a clinician at a retail-based health clinic that’s taking revenue away from their own practice, regardless of whether they own their own shop, or are part of a bigger whole? From a pure business perspective, it doesn’t make sense to me, unless CVS plans to share part of the revenue from their health clinics with these practices. (Which I don’t see CVS doing.)
Maybe they’ll higher one supervising MD per district and have all their NPs or PAs report to him? That’s really the only way I could see a system like that working, but it would seem like a terribly kludgy system. Does anyone know?
In any event, retail health clinics will not be coming to New Hampshire or Massachusetts in 2007, according to aforementioned DM. There hasn’t been any money allocated to open clinics. They will be popping up in Maine, particularly in the uniquely urban-rural areas like Bangor. Apparently there’s more money to be made there than in southern NH and Massachusetts, which really isn’t terribly surprising given the relative density of clinicians to the general populace.
[tags]Medicine, pharmacy, CVS[/tags]