As Walgreen Plays Doctor, Family Physicians Bristle

http://www.forbes.com/sites/bruceja...r-family-physicians-bristle/?partner=yahootix



As Walgreen Plays Doctor, Family Physicians Bristle


Walgreen’s latest push into primary care has one major doctor group taking issue with the retailer’s expansion into “management for chronic conditions” such as high cholesterol, diabetes and hypertension.

The nation’s largest drugstore chain earlier this week announced that its more than 330 Take Care clinics staffed by advanced degree nurses known as nurse practitioners were expanding the scope of the health care services beyond routine maladies like treating strep throat or pink eye.

Walgreen is now providing new services that include “assessment, treatment and management for chronic conditions such as hypertension, diabetes, high cholesterol, asthma and others, as well as additional preventive health services.” Walgreen said it was moving further along than clinics run by rivals like CVS/Caremark (CVS) or Wal-Mart Stores (WMT).

But some physicians are upset by the expansion, saying it will further splinter an already fragmented health care system and therefore harm quality and patient safety.

“It is more difficult to comprehensively manage a patient’s care if they are treated in multiple settings,” said Dr. Jeffrey Cain, president of the American Academy of Family Physicians in a statement to Forbes. Here’s a link to the academy’s policy statement in regard to retail clinics.

“Our health care system is already fragmented, and our concern is that the expansion of retail clinics into chronic care will lower quality, increase costs, and pose a risk to patients’ long-term health outcomes,” Cain added. “Retail clinics may not have some specialty services needed to treat those with complex diseases. In addition, family physicians establish relationships and get to know their patients, which better enables them to help someone with diabetes learn how to eat better, start exercising and stick with their treatment plan.”

But Walgreen says the services offered at its Take Care clinics meet the company’s “objective to help address the need for greater access to care by working collaboratively with physicians to support and complement their care plans for chronic patients.”

Walgreen, for example, has formed various affiliations with large hospital systems and doctor-led clinics across the country to create patient-care protocols and other programs. Walgreen has also formed and is joining with larger providers to create accountable care organizations, which organize a collection of medical-care providers to care for a group of patients.

ACOs work to keep patients healthy and out of the more expensive hospital setting. If ACOs are successful and reduce costs, the providers in the organization divvy up the savings with the health plans that are paying them.

“With this service expansion, Take Care Clinics now provide the most comprehensive service offering within the retail clinic industry, and can play an even more valuable role in helping patients get, stay and live well,” said Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions, Walgreens.



Yet Walgreen may still have some physician groups to win over as it forges ahead in its effort to be a larger provider of health care services.

The American Medical Association, for example, and the retailer have discussed the new service expansions but the nation’s largest group said it had no comment on the retailer’s latest move. A source close to the AMA said the doctor group was evaluating the expansion into chronic care services.

Still, the AMA and Walgreen have had various meetings over the years in regard to retail clinic expansion, which led to the AMA’s House of Delegates adopting policy in 2006 that was updated in 2007 on retail clinics. And Walgreen said it has been abiding by AMA policies.

The following are key aspects of the AMA policy:

“Store-based health clinics must have a well-defined and limited scope of clinical services, consistent with state scope of practice laws.
Store-based health clinics must use standardized medical protocols derived from evidence-based practice guidelines to ensure patient safety and quality of care.
Store-based health clinics must establish arrangements by which their health care practitioners have direct access to and supervision by MD/DOs, as consistent with state laws.
Store-based health clinics must establish protocols for ensuring continuity of care with practicing physicians within the local community.
Store-based health clinics must establish a referral system with physician practices or other facilities for appropriate treatment if the patient’s conditions or symptoms are beyond the scope of services provided by the clinic.
Store-based health clinics must clearly inform patients in advance of the qualifications of the health care practitioners who are providing care, as well as the limitation in the types of illnesses that can be diagnosed and treated.
Store-based health clinics must establish appropriate sanitation and hygienic guidelines and facilities to ensure the safety of patients.
Store-based health clinics should be encouraged to use electronic health records as a means of communicating patient information and facilitating continuity of care.
Store-based health clinics should encourage patients to establish care with a primary care physician to ensure continuity of care.”

 

Doctors claim they are retiring or leaving medicine because of Obamacare yet they are constantly fighting to prevent nurse practitioners / nurse anesthetist /pharmacy clinics etc from moving in on their turf

 

and you find this confusing or paradoxical:WHY?

 

The medical profession is somewhat of an illness. A doctor is just a Technician that speaks Latin. They have this tiny little playbook provided by Big Pharma. There is much more in this world than that shitty little playbook they have. They have to defend their inferior product by getting legal protection so they use the system to fight off competition. They have become extremely adept at using the system to keep themselves on top of the heap and they play dirty.

Personally, I have a lot of knowledge about natural stuff.. if I got diagnosed with something serious I'd do some medical tourism starting with the shamans in the Amazon. They will treat you to some ayahuasca and if nothing else, you could die really happy..

When I go to a doctor he's just a subcontractor. If he won't share the data from tests but just wants to give me his version of the data, I find another subcontractor.

Who knows which is a better technician really, some doctors with 7 minutes to spend with a patient or some skilled nurses at a drug store? I'd try them both before deciding.

We need to fight for our medical freedoms all the time. It should have been written into the Constitution, the same things were going on in those days.

 

good luck with that.

 

+ eight .

 

Even I agree with most of eights post

 

and when they fail , they refer you to a specialist or the hospital..

 

Thats the part of eights post I disagree with,I wouldn't trust my health to the natural healers.

 

A couple of years ago my FAA medical examiner mentioned that over 3,000 doctors nationwide had stopped giving FAA medical exams to pilots just the year before. They were sick and tired of dealing with the feds.

Surely though Obama care will be...uh...better in that regard.