Wednesday, June 27, 2007

Chicago Tribune endorses Retail Clinics 

Categories:  Retail Clinics

Competition is the best Rx says the Chicago Tribune:

"Medical care isn't all about heart attacks and brain surgery. Sometimes it's about pink-eye. Sometimes it's about flu shots. Sometimes it's about that same beastly sinus infection that shows up every December, like clockwork, just when your doctor's office is swarmed with senior citizens getting flu shots, kids with pink-eye and people like you nursing their annual sinus infections. Good luck getting an appointment on short notice.

Other options: You can suffer. You can take your sinus infection to the emergency room, where you'll have to wait in line behind all the real emergencies. Or you can stop by your local Wal-Mart and come away with a prescription, a gallon of milk and 48 rolls of toilet paper.

That last option doesn't sit well with the American Medical Association. Meeting in Chicago this week, the AMA's House of Delegates voted to lobby for greater state and federal regulation of the retail medical clinics that are becoming fixtures at places such as Target, Walgreens and CVS.

The AMA members want to make sure the nurse practitioners and physician assistants who staff those clinics get enough supervision from actual doctors. They worry about conflicts of interest between the nurses writing prescriptions and the in-store pharmacies that fill them. They worry that drop-in medical care discourages patients from building a long-term relationship with a family doctor. We appreciate their concern; we really do. We just wish they'd demonstrate it by trying to offer what Wal-Mart is offering -- accessible, affordable care -- instead of throwing up bureaucratic hurdles to stifle the clinics' explosive growth.

The doctors are obviously concerned about their turf and are engaging in some rent seeking for protection. Regrettably, it's an all too familiar phenomenon. But in the case of the doctors it is counterproductive in the long term.

There are two competing models for reigning in health costs: a free market dominated by consumers and a model dominated by the government. In a government-run system its going to be doctors and patients who get squeezed. In a consumer driven market at least doctors get a chance to compete. Thwarting the market to protect their bottom line makes doctors a big scapegoat for keeping costs high. That's the road to government control.

I know the lobbyists at the AMA must have something to do to earn their pay, but I think there are probably bigger threats to doctors than Target.



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