Posts
I am still nauseous after reading a recent Wall Street Journal editorial about retail-based “convenient care”. It was authored by Web Golinkin, who is the president and CEO of RediClinic, LLC. The whole article is a commercial for his garbage product. According to him, these “convenient care” clinics are the answer to the whole health care crisis.
First of all, I can’t call it “convenient care” because it legitimizes a bogus product. For the sake of this article, let’s call it “artificial care” because it imitates the real thing. Golinkin goes on to extol his product like it is the God’s gift to the universe. Here are some examples below that he brings up.
Easier access to high-quality, routine heath care at affordable prices
Research of the past 30 years has consistently shown that the primary care provided by nurse practitioners is comparable in quality to that provided by physicians
Americans receive evidence-based care only 55% of the time at conventional healthcare delivery outlets. MinuteClinic’s recent analysis conformed 99.15% of the time.
Research shows that as many as 50% of the people who seek care at overburdened ERs could be treated much less expensively in convenient care clinics.
The rest of the editorial captures the real intent of the whole piece. The first part was to convince the world that “artificial care” is the way to go. The second part was to convince the masses that any opposition to “artificial care” is hurting our country by maintaining the status quo. We physicians should embrace his product, says Golinkin. We should hold it, squeeze it, tickle its belly and change its diaper. Heck, he even brings up the point that the American Academy of Family Physicians “recognized that convenient care clinics were filling a need” and “rather than oppose the clinics, it published standards of care that it suggested convenient care operators should follow”.
His manipulation of the AAFP opinion is an example of why every physician should be against this travesty. He took their kindness for weakness. He made it seem like the membership of the AAFP is truly behind the success of “artificial care”. Other than the ones who sold out to get a piece of the action, the majority are not. The AAFP made a mistake and now it is going to bite them in the ass. They were wussies who were too afraid to take a stand like the American Academy of Pediatrics. Now they get to have their words used against them in an editorial claiming that primary care docs are no longer really needed (with these clinics around).
I highly recommend you read the editorial in its entirety. I guarantee, as usual, that I will receive hate email from some NPs or PAs right away. That usually happens if they feel that they are being criticized in any way. So be it. The bottom line is that physician extenders were meant to work hand in hand with doctors in a collaborative effort. Convenient care or artificial care has made this a competition and that will only do harm to this relationship.
First of all, I can’t call it “convenient care” because it legitimizes a bogus product. For the sake of this article, let’s call it “artificial care” because it imitates the real thing. Golinkin goes on to extol his product like it is the God’s gift to the universe. Here are some examples below that he brings up.
Easier access to high-quality, routine heath care at affordable prices
Research of the past 30 years has consistently shown that the primary care provided by nurse practitioners is comparable in quality to that provided by physicians
Americans receive evidence-based care only 55% of the time at conventional healthcare delivery outlets. MinuteClinic’s recent analysis conformed 99.15% of the time.
Research shows that as many as 50% of the people who seek care at overburdened ERs could be treated much less expensively in convenient care clinics.
The rest of the editorial captures the real intent of the whole piece. The first part was to convince the world that “artificial care” is the way to go. The second part was to convince the masses that any opposition to “artificial care” is hurting our country by maintaining the status quo. We physicians should embrace his product, says Golinkin. We should hold it, squeeze it, tickle its belly and change its diaper. Heck, he even brings up the point that the American Academy of Family Physicians “recognized that convenient care clinics were filling a need” and “rather than oppose the clinics, it published standards of care that it suggested convenient care operators should follow”.
His manipulation of the AAFP opinion is an example of why every physician should be against this travesty. He took their kindness for weakness. He made it seem like the membership of the AAFP is truly behind the success of “artificial care”. Other than the ones who sold out to get a piece of the action, the majority are not. The AAFP made a mistake and now it is going to bite them in the ass. They were wussies who were too afraid to take a stand like the American Academy of Pediatrics. Now they get to have their words used against them in an editorial claiming that primary care docs are no longer really needed (with these clinics around).
I highly recommend you read the editorial in its entirety. I guarantee, as usual, that I will receive hate email from some NPs or PAs right away. That usually happens if they feel that they are being criticized in any way. So be it. The bottom line is that physician extenders were meant to work hand in hand with doctors in a collaborative effort. Convenient care or artificial care has made this a competition and that will only do harm to this relationship.
10 comments:
I just don't know where it will all end.... But I DO know this: the entire profession/health industry is orchestrated in total by the insurance conglomerate. And their purpose is simple: extract money from all entities and then return a miniscule fraction of it back in the form of health care, thusly reaping huge windfall profits.
Does the public realize that the "middleman" is the one robbing us all??
Let's get rid of the "middleman". There would then be money for every human to have lifetimes of healthcare for generations.
(Here, have some random) Here we go with more fast food medicine. Let's add to the drive through pharmacies and society's view of "More, better, Faster". Let us provide support to the mass population and nurture the idea that it's OK to not take care of yourself in the conventional manner (Primary prevention) and then go to a fast fix for a perpetual problem. Cure the (social) symptoms! Not the (social)disease!
It's the insurance companies that are driving the cost of health care through the roof. And what a better way to make money, oops, I mean, make it look like we care about the health of the population, than create an outlet for cookbook medicine and take the thinking part out. To the government, stop GIVING socialized care to every Tom, Dick, and Mary that walks through the door. Make people accountable for their actions. Why is it that a woman who has insurance has to pay through the nose NOT to have a child, but if she does, the insurance will totally cover EVERYTHING for the baby? Wouldn't preventing pregnancy be cheaper? (20 years of birth control versus 20 years of medical bills, clothes, diapers,fees fees fees...I have a sneaking suspicion which one wins...) All religious perspectives about BC aside, if our globe has reached its carrying capacity, why are we promoting procreation? I realize it's the whole survival of the fittest, but come on, 10 illiterate children from one family only promotes the idea of fast food medicine by "providing" a service so that single mom can get in and out of that "artificial care clinic" as fast as possible so she and the rest of her herd can go back to panhandling on the street. Then, while she's sleeping in her flat, she can rest peacefully and feel warm and fuzzy inside because she's making sure that her herd is "taken care of". We need to put a sign out at the border of the country that says "USA is full. Go home."
Okay, here is your hate mail, but not from a PA or NP. (I am an RN, however, just for full disclosure). If I could get in to SEE my primary care doc, life would be wonderful. However, for routine appointments I have to wait a month or more, which is okay, but for acute care appointments I might as well go see a witch doctor, because my docs don't seem to have acute care appointments. The AMA talks about minute clinics eroding the doctor-patient relationship. I would LOVE to have a doctor-patient relationship, but I can't get in when I'm actually sick. Sorry, I would really like to see my doc when sick. ALso, my place of employment gives us about 7 days of sick leave, and they frown upon us calling in. So, I will go to a Minute Clinic if acutely ill (after attempting yet once again to see my primary care doc) so that I can get well (if possible) and go back to work.
The days of companies providing unlimited sick time is over, and so the Minute Clinics fill a desperate need. I have no problem with an MD being onsite at these clinics, that would be great, too.
I am an NP, but this is not hate mail. I think you are right. I think that NPs and PAs need to step back and realize their purpose in the healthcare system. If I wanted to practice independently, I would have gone to medical school. There is a point at which the egos of 'physician extenders' begin to interfere with the ultimate goal of our jobs, which is optimizing patient care. That is done by taking the less complicated and stable patients, and letting physicians manage complex cases. It is not done, however, by branching off away from our medical colleagues and trying to 'prove' ourselves. We are not educated and trained to the extent of physicians because we were not meant to replace or compete - we were meant to supplement. These RediClinic-type places put every member of the healthcare team, including the patient, at unnecessary risk.
There would not be a need for Convenient Care if you could receive at your physician's office. Like the RN stated it can take weeks to get an appointment. I also would like to see the rates lowered for "preventative care".
After waiting a month for an appt. with an NP, I had to wait an hour after my 8:45 am appt to see her for a 7-8 min. annual exam. The cost - $175 (of which $32 was for the lab). This was 3 years ago. If the Convenient Care places had annual exams I would go as am 3 years past due.
This is off-topic some, but as a PA in Orthopedic surgery, I know more about Orthopedics than the majority of PCPs out there. I am not a surgeon and don't hold myself out to be, but I am more competent than the PCPs out there in Orthopedics by far, and actaully train MD/DO residents. This being said, don't discount the abilities of a PA or NP who is well trained, experienced, and has had good physician mentors as being more experienced, knowledgeable, and better at their jobs than some MDs out there. You'd be better off seeing me for your Orthopedic problem than your PCP. And you can get in to see me with less than 24 hours notice.
With all due respect, there's a reason MDs go to school longer.
I am a PA who doesn't like the concept of these "convenient clinics" either. I believe that there is a real question as to their place in the great scheme of things. However, there must be a demand for this type of care because they are sure being utilized.
Also, I really wish that you would quit putting PAs in the same catagory as NPs and always pairing us together. We are not the same animal. We are similar but not the same. A donkey is similar to a zebra but not the same. PAs are educated on a medical model and NPs are educated on a nursing model. PAs have always worked on a collabrative basis with physicians being our supervisors. We don't work without having a physician on the license. NPs in many states can hang out their own shingle and practice independently and most want too. PAs are licensed under state medical boards and NPs under state nursing boards. Again, we are similar but we are certainly not the same animal.
Another point I would like to make. I work in a subspecialty and have for over 11 years. The FPs in town seem to hate it if I see their patients but the internists and other specialist seem to have no problem with it. I am well respected. Every day, I emphasiz every day, I find something that the FP has missed or mistreated. My docs all say the same thing...that they would rather be taken care of by me than an FP. I, every day, will work patients into my schedule who can't get in to see their FP. Sometimes they can't get in for weeks. I will work folks in the same day if their condition is urgent. I do that 2 or 3 times a day.
So perhaps you guys should look a little more closely at yourselves. I am not working to compete with you. I am working to take care of patients the best way I can under the supervision of the docs I work for. They trust me. My patients trust me. I wish the FPs in town would trust me too.
W.F. Comer, PA-C
LT, MSC, USN (RET)
Email: parkercircleman@yahoo.com or retnavy1996@aol.com
Doug - you are totally full of shit. There is nothing wrong either conceptually or pragmatically with the retail clinics. They are useful, safe and oh, yes, they are profitable. And the NPs/PAs which staff them operate under MD protocols. No complex care - simple stuff which we (NPs - yes, this IS hate mail), manage all day, every day, in clinics nationwide with competence, safety, satisfaction and respect of patients and colleagues alike. Guys like you are dinosaurs for certain. Best grow up, dude. The AMA and douchebags like you trot out that same, tired BS every time there is a question of NP care 'we must protect see the safety of the patients'. The jury is in on this one pal, the work we do is good, safe and we are not going away. These retail clinics will continue to proliferate and bitter, angry men like you will eventually wither on the vine. Your inherent animosity towards us speaks volumes on where you come from: a dark vortex of
fear and loathing. I think an NP dissed you in some past life. Anyway - minute clinics, GO!
An NP who used to get your formerly funny journal
i like blog ...Has anyone read or heard anything about Fatlossity? It's supposed to be a money back guaranteed weight loss system that works on nutrition, exercise, and lifestyle factors to help you lose weight fast and keep it off. Any info would be helpful – thanks!
Post a Comment