Patient Care and Retail Based Clinics

patient_careThe American Academy of Pediatrics (AAP) recently released a strongly worded policy declaration re-enforcing its place that retail-based treatment centers (RBCs) are unsuitable locations for pediatric patient care. Many workers in pediatrics are also up-in-arms over the increase of RBCs as many practices feel they are taking valuable sufferers. The fact is that RBCs are an excellent supplement to the micro practice design that our practice is depending on. For us, the advantage of RBCs is that they do what we do not want to do. Namely, they open on evenings, Saturdays, Sundays and vacations. But one major adverse is that they cannot staff as many hours as the bigger, multi-provider practice.

A recent cover story at The Harvard Business Review said to forget about work-life balance and it described that life is about hard choices; this is a fact. Employees want to be home for supper with their family and invest their time in their children’s days off from school having fun. We like knowing that the RBCs are there to fill in for the bigger practices when they are closed. It should be said that RBCs offer a convenience; medically, there is usually no reason why someone with symptoms cannot get some over-the-phone patient care from the health professional or physician on call and then wait for their office to open at 9 a.m. the next morning. But for those who choose not to wait and in some situations are willing to pay a premium for the comfort, why should not they go see an experienced and certified health professional specialist at an RBC? Whether the strep test is run by bigger practices or RBCs, provided that there is interaction, there shouldn’t be an issue with RBCs offering mid-level triage for us.

They key is, as with most issues affecting personal and community health, has to do with RBC rules. How much can a patient really value the guidance of a company who works for an organization that makes money when you buy over-priced over-the-counter snake oil? Government departments have a responsibility to make sure that RBCs are not favoring client care over quality clinical judgment. Think about it: Patients looking for needless medications are more likely to buy over-priced products when they have gladly obtained the medication they desired but probably did not need. As a primary patient care provider, one of the greatest values of RBCs is the ability to diagnose illness as early as possible in order to treat the patient for the best possible outcome.

Attitude Toward Patient Care

PatientCare“American physicians need to be totally able to do what they have been trained to do, succeed at practicing medicine. American patients need to be totally able to choose the family health insurance coverage and medications that suit their needs, not something forced by a central power. This simply cannot occur under the imprisoning pressure of the Affordable Care Act.” – Richard A. Armstrong, M.D. “Under the Affordable Care Act, physicians who effectively work together with other suppliers to improve patient care results, the value of healthcare services and patient experiences will flourish and be the leaders of the healthcare care program.” – Robert Kocher, M.D.; Ezekiel J. Emanuel, M.D.; Nancy-Ann DeParle

Physicians have been caught in the middle of the transformation of the American healthcare care distribution program brought on by the Affordable Care Act. Doctors who battle the regulation and those who support it are trying to adjust to a fast changing healthcare environment. A Deloitte Center for Health Solutions survey of American physicians found 44 % thought the ACA was “a good start” and 44% reacted that “it is a step in the wrong direction.” Obviously, older physicians were more likely to be in the second group of participants than younger physicians.

The ACA overhauls the healthcare care distribution program in the following ways:

  • It improves accessibility healthcare for more Americans
  • It creates incentives to promote better patient care synchronization and quality
  • It provides feedback to physicians on cost and quality of their patient care
  • It changes the payment program from fee for service to value based
  • It focuses on patient-centered care
  • It depends on increased use of electronic medical records
  • It attempts to increase access to primary care and allied health providers