Wednesday, May 23, 2007
Dr Arnold Milstein, chief physician at Mercer health consultancy, says doctors are playing on patient fears to thwart change.
"[Doctors] wrap themselves in the holy garb of quality ... completely ignoring the facts that all the research shows current care stinks," Dr Milstein says. "The weaknesses that are endemic in the current healthcare system are being trotted out to block innovation and change."
The clinics see themselves as advancing medical care, not diminishing its quality, with a retailer’s focus on service: the slogan of CVS's MinuteClinic, for instance, is "You’re sick, we're quick".
Hal Rosenbluth, chairman of clinic company Take Care and head of the industry group Convenient Care Association, says any pushback against the clinics actually validates their existence, andadds that the concept is here to stay.
"That’s what people are clamouring for - they want healthcare on their terms not the system’s," says Rosenbluth. Doctors’ quality concerns, he says, are merely anti-change "turf protection."
Is it true that "all the research...shows current care stinks?" No. There is a perception, though, that quality means fast. It doesn't. You know what they say about fast, good, and cheap.
posted by Sydney on 5/23/2007 08:58:00 PM 6 comments
In the past month my family has made two visits to the ED at our local hospital. These were our first emergency visits in decades and we have primary care relationships with physicians. On the first visit, my own, I was seen and treated by a nurse practitioner, not an MD was in sight. I received excellent care, but it cost my insurance company a ton of money. On the second visit, my wife's, she was seen and treated by a physician's assistant, again with not an MD in sight. My wife also received excellent care at considerable cost to our insurance company. If we had the high-deductible coverage now on offer and there was a clinic nearby at a local Wal-Mart or CVS or RiteAid, would we have gone there? You betcha!
Cokaygne brings out a excellent point. If your going to see a midlevel anyway (and there is nothing wrong with that for minor complaints), why not do it for a fraction of the cost in a retail clinic rather than an ER. You might be seening the same midlevel since many moonlight between ER's and Urgent Care settings. Many of the ER's in my area have placed midlevels at Triage. This is done for two reasons, 1 - to claim a rapid door to provider time (used to be called door to doc time) and 2, rapidly dispo the minor stuff, much of which does not need to be there. Sicker patients are Triaged to the main ED. The problem I have seen with that (other than statistic buffing) is the midlevel will take longer in Triage than an experienced Nurse and sometimes gets in over their head by trying to see higher acuity stuff since they are with the patient anyway. The Nurses path is much shorter and not biased by the desire to see more patients.
I'm not interested in picking on cokaygne, but there are two points he/she is missing- one is that ED costs are extremely high for a reason. They have to be staffed to handle anything from a splint to multiple trauma cases. No care rendered in the ED is cheap, which is why it is every hospital's goal to keep people OUT of it.
By 1:44 PM, at
Danie, I'm guilty as charged. That is my point. Someone else is paying. At the point of sale, I don't care what the charge is. The provider will charge as much as the third party will let them get away with. This system is inherently inflationary.
Rich people should be able to obtain the best health care from experienced MD's. Poor people should go to the local Wal-Mart clinic.
By 9:31 PM, at