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Illinois Doctors Warn Against In-Store Clinics

Wal-Mart’s recent announcement that it plans to introduce 400 new in-store health clinics over the next several years has raised concerns throughout the medical community. In a release issued today, the Illinois State Medical Society insists that poorly-regulated health clinics operating without permits or government oversight - as Wal-Mart’s health clinics currently do - pose a sizeable risk to public health. This in addition to the fact that the clinics are often operated by companies of questionable medical expertise. From the Chicago Tribune:

Doctors push law on clinics in stores

The Illinois State Medical Society, which represents more than 13,000 doctors, is pushing a proposed law to more closely monitor hundreds of in-store clinics being opened by retail giants Wal-Mart Stores Inc., Walgreen Co. and CVS/Caremark Corp.

The doctors claim the clinics, staffed by advanced-degree nurses and physicians’ assistants, are largely unregulated and therefore put patients’ health at risk.

The Illinois group said it also will lobby for federal laws aimed at increasing regulation of the clinics at the annual American Medical Association meeting next month in Chicago.

“[Doctors] see this as a very big competitive threat to the traditional office-based physician,” said Todd Swim, a Chicago-based principal with Mercer Human Resource Consulting. “Employers have had on-site services like these staffed by nurse practitioners or physicians, and this, too, is preventative, routine medical care but hardly the scale and scope of a Wal-Mart. Whenever Wal-Mart sneezes the whole world shakes.”

The potential loss of business for doctors is great because most health insurance companies are beginning to cover retail clinic procedures. The clinics are also designed as an option for low-cost care for the huge number of Americans who have no health insurance and would pay out of pocket.

Wal-Mart, the world’s largest retailer, said late last month that it plans to open as many as 400 clinics in U.S. stores in the next three years and more than 2,000 within five to seven years.

Walgreens, based in Deerfield, expects to have about 250 locations nationwide by the summer. It already operates about 60 clinics, including 17 in its Chicago-area stores.

CVS/Caremark operates more than 150 retail health clinics, including a half-dozen recently opened or scheduled to open in the Chicago area.

Facing off against the doctors’ powerful lobbying organization are the powerful pharmacy and retail industry lobbyists, who are trying to block the proposed legislation. Retailers say the clinics are staffed by licensed health professionals who track their patients’ health in medical records and make referrals.

The American Academy of Nurse Practitioners expects more legislative initiatives like Illinois’ as retail clinics expand throughout the country, but an official said efforts by doctors and their lobbies have been pushed back in states that include Georgia and Missouri.

“[Doctors] are concerned about losing patients, and I think this is going to get them more patients and get people in to see them,” said Jan Towers, a nurse practitioner and director of health policy for the American Academy of Nurse Practitioners. “It will help because nurse practitioners will be referring them to health providers in the community.”

Wal-Mart officials declined to comment for this story.

Walgreens is advocating that the Illinois bill be “held this year” so that “everyone involved has a chance to discuss their concerns.”

“Increased regulation has the potential to restrict access to these health-care services and create more costs to patients,” Walgreens spokesman Michael Polzin said. “That would work against the growing concern over affordable, quality health care that our Health Corner Clinics are directly addressing.”

Most clinics are open seven days a week, and no appointment is necessary. They treat patients with routine maladies in 15 minutes or less and work under physicians’ supervision, although doctors usually are not on site. Most treatments are for ailments such as ear and sinus infections, strep throat and athlete’s foot.

Some clinics are establishing ties with traditional medical-care providers such as physician practices and hospitals.

In Will County, for example, CVS subsidiary MinuteClinic has formed an alliance with Silver Cross Hospital in Joliet. The hospital accepts referrals for patients needing emergency room and urgent and primary care. In addition, a member of the Silver Cross medical staff serves as MinuteClinic’s medical director in Will County, the pharmacy chain said.

“Silver Cross’ alliance with MinuteClinic helps us achieve our mission of caring for the health-care needs of our community residents and to educate people about living healthier,” said Ruth Colby, chief strategic officer of Silver Cross.

Doctors say they are concerned about the quality of care if the clinics uphold their promise to treat patients in less than 15 minutes. The doctors said that is not enough time for consultation, and that follow-up may not be adequate.

“We want the Illinois Department of Public Health regulating these like all other providers of care,” said Dr. Rodney Osborn, a Peoria anesthesiologist who is president of the Illinois State Medical Society. “These retail storefront clinics, if you will, should face standards just as there are for hospitals, surgery centers and doctors offices. This is a brand-new animal, and that is why legislation has been written.”

The bill moving through the Illinois legislature and headed for a committee hearing this month, doctors say, would slow the retailers’ expansion by requiring permits for each in-store clinic. In addition, the doctors say marketing should be regulated and physician supervision of clinic nurse practitioners should be increased.

The doctors group is hoping to get a bill passed before the spring legislative session ends.

The Illinois State Medical Society is one of the state’s biggest spenders on elections. Last year it contributed $925,000, putting it behind only the Service Employees International Union ($1.2 million) and the Illinois Hospital Association ($938,000) on a list of the top 20 contributors compiled by the Illinois Campaign for Political Reform for the 2005-06 election cycle.

The Medical Society’s efforts to deal with the retail clinics has support of other doctors groups, particularly those who provide primary care, such as the American Academy of Pediatrics’ Illinois chapter, which said it worries about medical care in retail clinics for children, saying most nurse practitioners do not have a specialty for children.

About a mile and a half from a Walgreens clinic in Mount Prospect staffed by a nurse practitioner, family physician Dr. John Sage said he and his six colleagues worry about competition, particularly from suburban retail clinics. He said he believes retailers are cherry-picking patients with insurance.

“The people that are putting these clinics together are smart people, and they are picking and choosing the neighborhoods that they put these in,” said Sage, 60, a family physician for three decades.

“What is going to happen to the future of family medicine going forward in the future? Do people want corporate-style medicine?”

Posted by Alex Goldschmidt on Monday, May 07, 2007

Click Here for a Printer-Friendly Version

COMMENTS

Why would doctors and the medical society be opposed to competition from low cost medical clinics at Wal-Mart? Well, why are labor unions opposed to competition from non-union workers? Why are US companies demanding tariffs and special protection from foreign competition? Why does the AMA demand “licensing” and why does it control who will be permitted to work in the medical field?

All these questions have simple answers: to protect their incomes. The AMA complained decades ago that there would be too many doctors (why is that a problem?) and so they convinced the government to let them control med schools and licensing. This is no different than giving Target the only license to operate a retail store and then giving Target the power to decide what companies will be permitted to open stores, what they can sell and how much they can make. As we found out from experience, not only was the AMA’s fear of competition overblown, but now we have a doctor shortage. Doctors finishing their residencies have at least 50 job offers each and average doctor earnings have topped $250,000 due to lack of competition.

Do we want “corporate style” medicine? Well, yes! We WANT competition! We want service for fee care and we want the lower prices and better service that come with a free market!

Cry a river for highly paid and competition protected doctors. BOO HOO.

Nick in
Monday, May 07 at 06:22 PM

How come you guys are against me getting health care at an affordable cost? Why can’t I pay cheaper fees and accept the risk? At least WM can keep the lines short and the costs low. Can you imagine if the govt ran health care? OMG.

We want corporate style medicine because they have a philosophy..the customer is right… not the govt.

Go ahead, let this happen and let WM compete with Govt run health care. Try it… on a pilot basis and see who: 1) gets the most customers and 2) can hire the best doctors.

Again, politicians are in politics because they are too stupid to make it in the real world and couldn’t even get hired in liberal universities.

Evil Conservative in Evil Conservative Industries
Monday, May 07 at 07:43 PM

I thought that Walmart supporters in the United States were happy with their medical system???
I guess they really are not.

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Alex in Ontario, Canada
Monday, May 07 at 08:08 PM

Alex,

“Can you imagine if the govt ran health care? OMG. ~ Evil Conservative”

Does that sound like something a person who is unhappy with our present system?  There is nothing wrong with trying to make it better though!!

Bob in
Monday, May 07 at 11:58 PM

At least WM can keep the lines short...

You talk about pulling one out of left field. What is there in anyone’s experience to indicate that Wal-Mart can keep lines short?

Ken V in Texas
Tuesday, May 08 at 03:27 AM

The AMA is afraid to death of Wal-Mart. The banking industry is afraid to death of Wal-Mart. The UFCW is afraid to death of Wal-Mart.

What do all these groups have in common, besides fear of Wal-Mart? Well, they control the Social Democrat party and they have, thus far, been able to bribe and manipulate certain politicians to protect themselves from competition.

They do not want a free market because a consumer with choice is a difficult and inconvenient proposition. Why should the AMA have to compete for patients? Why should the banks have any competition? Why should workers get the right to vote on whether or not they want to join the UFCW? Shouldn’t government just protect these groups from Wal-Mart? The next thing you know, they might have to change their ways and, God forbid, COMPETE with quality service and COMPETITIVE prices.

That’s just not FAIR!

Nick in
Tuesday, May 08 at 04:42 AM

Ken V,

“What is there in anyone’s experience to indicate that Wal-Mart can keep lines short?”

Guess you have never had to wait to see a doctor at an ER or clinic, have you?

Bob in
Tuesday, May 08 at 09:04 AM

Wal-Mart is losing its FOCUS here. K-Mart lost its focus some years ago and look what happened to them. They owned a few other companies, (I don’t remember which ones), AND it took their focus off of their department store. They eventually had to sell them all and CONCENTRATE on
K-Mart. And now look at them. K-Mart is a shell of what it used to be.
Wal-Mart lost its FOCUS a while ago and it bombed. They tried to sell upscale clothing, etc. They tried to go after Target’s market and IT DIDN’T WORK! While I am not a fan of Sam Walton, he at least kept the store focused. He was only concerned with running his department store. Sam NEVER would have put clinics in his stores. Clinics would have taken the focus off of the department store. Sam KNEW WHO HIS CUSTOMERS WERE.
The Wal-Mart of today is trying to be everything to everybody. When are they FINALLY going to learn that it will never work?

Jane in N.Y. in
Tuesday, May 08 at 09:35 AM

You all are assuming that the price will be low,Wal-Mart is only doing this to help increase foot traffic they do not have medical license therefore they will have nothing to do with it Drs. will run them and charge the same as your regular Drs. do at least that is the way it is here.

I can not see Wal-Mart paying our giving a deduction on the bill unless they leave you use discount card which on and average would be $10.00

guest in
Tuesday, May 08 at 09:40 AM

Affordable, Accessible and pt focused care is what people need and want.  Nurse Practitioners can do that and do it well.  Nurse practitioner are highly trained and very educated.  Nurse practitioner are an excellent health care providers.

MS in
Tuesday, May 08 at 12:04 PM

Affordable, Accessible and pt focused care is what people need and want.  Nurse Practitioners can do that and do it well.  Nurse practitioner are highly trained and very educated.  Nurse practitioner are an excellent health care providers.

MS in
Tuesday, May 08 at 12:04 PM

At the moment I am not sure if this is good or bad for WM.

However Nick is correct relative to AMA and others in regards to licensing professions.  The unions control most counties, try and get an electrical license or plumbing license in those counties if you are not union.  The same as the Bar Association controls the lawyers-- that is why I have to always becareful of my activities.

Back to the AMA—doctors do not look to alternative ways of healing, nor do the medial schools teach as such.  For years I have followed the results of Essiac Tea and its success, but do you hear of it from Doctors?  No!

Thus I started a Christian Ministry to help those with primarily cancer get started on the Essiac Tea and the results prove it works.  I charge nothing for the start up, after that one can buy from the supplier.  One man with prostrate cancer started feeling better in three days.
It will give you the “runs” for a day or so.

I have to add:  perhaps some on here should take, and it might clean out their system and they wouldn’t be so full of it.

The Sage in
Tuesday, May 08 at 01:08 PM

Sage,

“Back to the AMA—doctors do not look to alternative ways of healing, nor do the medial schools teach as such.”

Sure, they don’t want alternative ways of healing, how much can they make if you treat yourself at home?  I believe that doctors keep people just on the edge of healthy, so you have to keep returning.  I am 63 years old and haven’t been to a doctor in about 40 years, because I take care of my self, but, I have known many people who go to doctors and they are sick ten times more than I am, (I hardly ever get sick).  And, it seems every time someone goes to the doctor, they come out with a prescription in hand, why is that?  And, now, they even tell people on TV, to ask their doctor about this medicine or that one, so that you can get even more prescriptions!!

Think about this, why is ‘Natural Childbirth’ at home, not considered ‘Natural’ anymore?  For a period of time, ‘C Section’ was the new ‘Natural Childbirth’, because it fit better into the doctors schedule!!

Bob in
Tuesday, May 08 at 01:31 PM

Jane,

Let’s get the record straight—WM is not actively “running” these clinics—they are simply leasing-out the space within their stores (much as they do for Subway or McDonald’s).

That said, what “focus” is there to lose?

JB

Jim Bunch in
Tuesday, May 08 at 02:03 PM

Clinics may be alright, but the bottom line is, if you go to one run by Wal mart you will go into the store and spend money.  Thats the bottom line.  Otherwise, their insurance for the employees is a farce.  That will never change, and as for some of the conditions, yes, they need a union.  Since Sam died, Wal mart has gone to the dogs.  The jury is still out on the clinics, if anything bad does happen, you can bet the blame will be on someone else.

B in whosville
Tuesday, May 08 at 02:53 PM

WalMart is already operating an insanity clinic for their own PR efforts subcontracted as the Edelman blogger fraud group in the Bentonville ‘war room’ to treat themselves for sick culture fraud creations. We can only hope they keep the door locked to keep these mentally deranged blogger frauds from wandering out into the parking lot/vomit garden.

Reports indicate that WalMart pays Edelman $10,000,000 per year to keep these loons at the ‘war room’ clinic. Mental health expects note that WalMart admits to the existence of the insanity ward and the cost but won’t allow patients to openly identify themselves as part of their treatment.

The insane blogger frauds insist that WalMart is not actively “running” the clinic and that nobody there actually gets paid. Apparently smoking is allowed inside the facility and the patients proclaim that smoking does not cause any known health problems according to facility adminisrator Bob McAdam formerly of Altria (Philip Morris) fame.

Since the patients are there on a hobbyist volunteer basis they are either silently funded by other groups in a corporate propaganda welfare scheme or live in abject poverty as trolls would underground similar to the new Bruce Gabbard residential arrangement.

It would also seem that the only food allowed into the clinic are imported Guatemalan insanity peppers and Cheetos for patients to throw at each other. Additionally, the only productivity output from the facilty is fraud, insanity and delusional claims about “associate” benefits and their unsurpassed happiness levels.

WalMart- Mental health is spying paranoia on our “associates”. Wait until Mona Williams opens a new mental health clinic minute branch for former “associates” over in public relations.

SanDiegoView in
Tuesday, May 08 at 11:57 PM

Sage is dead on target here. The AMA runs the medical industry in this country. Forget all the talk about insurance companies, etc. It is the doctors who control health care technologies, access, cost, quality and education. The AMA runs all the med schools and they teach Allopathic medicine, which is medicine that treats the symptom only. There are also Osteopathic med schools but they have a poor reputation, get the students rejected from allopathic med schools and can’t get their students into decent clinical rotations. There are the natural healers, who seem like kooks at first glance but are actually on to something. Our bodies react badly to medicine. Once you start down the prescription drug path, forever will it dominate your destiny! We need more natural healing. Giving people drugs to stop one sympton creates side effects that sometimes do more damage than the affliction the drugs were supposed to stop. Doctors mix up dosages, give out the wrong medications, kill tens of thousands of people per year through poor treatment, etc.

As Sage said, Natural treatments are best for your body but you will never hear of them because the AMA wants to protect its monopoly. Imagine the entire Oncology business disappearing because of some tea! I don’t put too much faith in modern medicine. They can’t keep you alive and once they get you on one medication, you never stop with some type of medicine in your life.

Nick in
Wednesday, May 09 at 05:34 AM

“If smoking caused cancer, wouldn’t every single person who ever smoked get cancer?”
Nick in
Monday, May 07 at 07:39 PM

http://walmartwatch.com/blog/archives/wal_mart_considers_sourcing_yet_more_products_from_overseas/#comments

“Forget all the talk about insurance companies, etc.”

This illustrates why some of WalMart’s public relations and propaganda problems are self-induced.
Nick is an imbecile with pretentious medical and economic drivel disorder. A boresome mental miget twiddler with vapor lock and internet access.

WalMart- Well...we pay him just like we did EllisW.

SanDiegoView in
Wednesday, May 09 at 06:04 AM

Nick,

You and Sage are so right.

“which is medicine that treats the symptom only”

As the symptom is usually the body reacting to a real problem, to mask that symptom is to ignore the problem and actually work against the bodies defense mechanisms!!  Example: A runny nose, is the body ejecting waste material from the battle of the immune system fighting a cold, to prevent that, is to work against the body trying to cure you.

“Our bodies react badly to medicine.”

As our bodies have a ‘Natural’ immune system, medication can counteract that system, causing side effects, which require a doctor to prescribe another or additional medication.

“Once you start down the prescription drug path, forever will it dominate your destiny”

SDV is an example of what can happen when someone over uses drugs, they can cause you to hallucinate or drive you to paranoia!!

Bob in
Wednesday, May 09 at 10:46 AM

Golly I am so delighted that SDV got in his usual imbecilic exhortation.  But what a sec, SDV can’t be an imbecile as that belongs to Bob, Nick, I, etal.

Nick and Bob at times I take exception to what you post and have so written—however to give credit where credit is due, you are both right on the bulls-eye.  I the same as Bob has written, have not seen a Doctor in close to 40 years.

I have books and so many papers on natural healings, but the “associations ??” won’t let it get out.  However I intend on enjoying good health until the Lord has my harp and cloud ready and calls me to my eternal home.

The Sage in
Wednesday, May 09 at 01:07 PM

Sage,

Thanks for the credit, but it is not me, it is all just ‘common sense’!!  It doesn’t make much sense, to put something in your body, that is not natural.  I take no drugs of any kind, except an asprin occasionally, but very occasionally.

I know you don’t always agree with everything I say, but it usually comes from ‘common sense’ and while I seem harsh at times, I believe in the fact that everyone has to EARN their way through life.  I know that everyone is not equal, but it is the trying that is important!!  If you at least TRY, most people will respect and reward you for it.  But, if you sit around and whine, you won’t get much respect at all!!  Take for example, those who complain about the ‘company cheer’ or the smocks, those things are meant to bring people together as a team, so, if you complain about them, it shows that you don’t want to be part of the team and why should you be rewarded for complaining?

Common sense, says you will get better results from positive feedback, than negative feedback, that’s why I like your ‘In house’ idea, if a group of people representing the other employees were to approach management with positive ideas which benefit both the employees and the company, I think they would start to listen, but, if you approach management in a manner where you tell them, “We want a say in what goes on here”, that negative approach will be shot down on the spot.  What’s the old saying, “You can catch more flies with honey, than vinegar”!!

Bob in
Wednesday, May 09 at 10:07 PM

“If smoking caused cancer, wouldn’t every single person who ever smoked get cancer?”
Nick in
Monday, May 07 at 07:39 PM

“If smoking causes cancer...”
Bob in
Monday, May 07 at 09:33 PM

“Nick and Bob at times I take exception to what you post…
...you are both right on the bulls-eye.  I the same as Bob has written, have not seen a Doctor in close to 40 years.”
The Sage in
Wednesday, May 09 at 02:07 PM

“Though I agree that cigarettes, in my opinion are BAD for health, I still believe in the free enterprise system.”
The Sage in
Friday, March 23 at 11:26 AM

You are double minded - 1 Cor. 6: 19-20
19 What! know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own?
20 For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God’s.

Glorify Jesus with a cigarette? Or 1 Tim. 6: 10 -

“For the love of money is the root of all evil: which while some coveted after, they have erred from the faith, and pierced themselves through with many sorrows.”

Free enterprise including murder by a ‘product’ that has but one purpose-

I repeat this background material from you health experts
on smoking since you now make proclamations about iatrogenic medical practices in the United States.

Why don’t you three quacks open a Mexican minute clinic for cancer treatment in Tijuana? Then you could worship WalMart in Spanish with a picture of Steve McQueen on the wall. Sell cuban cigars in the front office with Rush on the radio and corpse disposal out back in the alley.

WalMart- Now providing medical PR guano from our ‘war room’ specialists. Our parking lots will become vomit gardens in our new medical coverage program for our “associates”. They don’t need actual health insurance or any of that genuine medical school stuff.

SanDiegoView in
Thursday, May 10 at 06:38 AM

Hey, with these new Walmart walk-in clinics are they going to provide abortion services at always low prices?
Just curious,

http://www.amptoons.com/blog/images/walmart_morality.jpg

Rudy G in NY
Thursday, May 10 at 08:51 AM

SDV,

Nice job of pontificating and bible quotes, but where is your answer to the question: “If smoking caused cancer, wouldn’t every single person who ever smoked get cancer?”!!

We all agree that smoking is ‘bad for your health’, but disagree with the fact that smoking CAUSES cancer!!  The fact that not all smokers get cancer and that non smokers also get cancer makes us take pause at pointing the finger totally at smoking!!

“You are double minded - 1 Cor. 6: 19-20
19 What! know ye not that your body is the temple of the Holy Ghost which is in you, which ye have of God, and ye are not your own?
20 For ye are bought with a price: therefore glorify God in your body, and in your spirit, which are God’s.”

But, smoking and injecting dope are not defiling the body, right?  And, pushing prescription pills in your mouth isn’t either, right?  How about eating food that has a shelf life of 50 years?  And, in California, what is that ‘smog’ anyway, is it safe to breath that stuff?  Talk about being double minded!!

Bob in
Thursday, May 10 at 11:17 AM

Hey, with these new Walmart walk-in clinics are they going to provide abortion services at always low prices?
Just curious,

http://www.amptoons.com/blog/images/walmart_morality.jpg

Rudy G in NY

Excellent question Rudy G.  I wonder if we shoud direct your question to Someone.
I believe that is was suggested by Someone that abortion is a preferable choice to a single mother vs. expecting Walmart [and other employers] to pay higher wages.
Wouldn’t this be handy for ‘Someone’s business model’?

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Alex in Ontario, Canada
Thursday, May 10 at 11:56 AM

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