Letters to the Editor
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Price In Advance
For me, the big advantage of these clinics is that the prices are clearly stated. For many years, I had a high deductible insurance plan (the only option my employer offered). It wasn't that I minded paying for my medical care, it's that I had no idea what the price would be. I went in for a simple gynocological exam (total time with the doctor: 4 1/2 minutes) and was charged $380. I had no idea if that was a good price, a bad price, an outrageous price, because no one would tell me in advance what the price might be - and I called a lot of doctor's offices. The result was that I was afraid to go to the doctor again, and I just lived with the problem. My fear - the exam might last longer next time, and what might 15 minutes with the doctor cost - $1000? $2000? Insurance companies have set rates for "usual and customary" charges, but consumers don't get to see those.
I couldn't go to a medical clinic for a gynocological exam, but maybe the doctors will learn that patients really appreciate knowing what a doctor's visit costs, instead of just being stuck and having to pay no matter what.
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hm
Sad to say, I worked for Wal-Mart for a summer (they paid better than anyone and were in desperate need of workers). Some of the few things I liked about the company as I read its own self-reported news network thing were its $5 generic prescriptions and its drop-in clinics. Sometimes even big mean corporations have good ideas that help people. Who knew?
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Doctors : Insurance companies : : Airlines : TSA
I am fond of and sympathetic to doctors--they usually get into medicine with the best of intentions, work their asses off, and understandably want to feel valued and earn some money in the end. But the medical insurance system screws them, too. Many medical practices have drastically curtailed the number or kind of insured patients they will accept, not only because of the paperwork, but because 15-minute appointments do not allow ANY doctoring whatsoever! Good for the minority of doctors with the freedom to limit their practice this way and the minority of patients with the right kind of overpriced insurance. Bad for the rest of us.
Retail clinics address two of the major hurts with the current system--cost and waiting time. I would imagine that even for many uninsured poor, the cost of out-of-pocket payment is preferable to the possibly larger cost of spending an entire day in the ER and losing whatever wages might have been made. Not to mention the cost to one's dignity. Want to make someone feel worthless? Make him wait eight hours for a strep test. I would just love the doctors complaining about retail clinics to spend a couple of days and nights in an urban emergency department. What kind of doctoring do they think is happening there?
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Truth in advertising
"Retail health."
Best description ever of American medicine.
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The Quickie-Oil-Change Model Extends Its Tentacles
The approach described in the article seems quite similar to the advent of the "Quickie-Oil Change" phenomenon.
Skim off the easiest, least complex, lowest risk tasks usually performed by service stations, do them quickly with no appointment necessary and use unskilled labor, rather than a well paid mechanic, to do the job.
It has proven to be a brilliant concept in automobile care. The consumer benefits are convenience and perhaps a slight savings on the cost of the service; the oil-change-only shops can make low risk profits. The losers? Traditional repair shops who lose the "easy money" of oil changes.
It's a model that just might be transferable to medical care.
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Back in the Stone Age
When I was growing up, the days when a Selectric was cutting-edge technology, the GP practice my parents frequented (they were friends with one of the docs) was pretty straight forward. 8 to 12 was show up and be seen, and everyone knew it was reserved for people with the flu or who needed stitches checked or something of that sort. 1 to 6 was appointment only and was for checkups and physicals and long-term issues.
The docs in the practice rotated call and would respond to minor emergencies like minor self-inflicted stab wounds (Long story. Unintentional. Lots of blood and panic. Suffice to say the younger me learned to never leave steak knives just lying around.) with a "go the back door of the clinic". And then when you arrived, they were pulling up too. They'd stitch you up/treat the vomiting/administer pain shots/ etc for much less than the cost of an ER visit and without a wait.
It was just what family doctors did in our town.
As for cost, of course you knew what it would cost. What kind of idiot would do something without knowing what it would cost? Visits were a routine amount of money. X amount for the flu, Y amount for check-ups Z amount for yearly physicals etc. It was what it was. The doctors knew that people in the town weren't made of money, nor did they expect to practice only to the wealthy.
But then too, the GPs who served us weren't saddled with obscene debt out of medical school, and the social expectations of the time were completely different than they are today.
Still. The practice, with another generation of doctors, is still there. I wonder if it's still the same. If you wake up sick as a dog, you just stumble in and sign your name to the list along with everyone else. . .
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@Treeple
I am not particularly fond of or sympathetic to doctors, though I agree they work their asses off to become certified MD's. And their work carries with it enormous responsibility and seemingly inhuman effort.
Having said that, there seem to be two essential problems at the core of the medical services delivery apparatus.
1. People, particularly with insurance, seeking out MD-medical care when they don't need it, and,
2. The artificial restriction on the number of doctors in our society. Unquestionably MD's need to possess a high degree of general intelligence, an almost superhuman work ethic, and a natural non-maverick temperament. But they need not be Einsteins; in fact, if they were it might be counterproductive to their medical careers.
If there were more Medical Schools in the United States, graduating, say, two or three times the current number of MD's, the price value of each MD would naturally decline...not something the AMA would be thrilled about. This can be done without obliterating the high standards in place for Medical School admission. [Even now, not every MD has graduated from Harvard or Yale.]
The artificial (monopolistic) restriction on the production of physicians is the root cause of the ludicrous growth of sickness care.
On a final note, the number of licensed physicians per 100,000 population has dramatically decreased over the past 35 years---"you can look it up," as Casey Stengel used to say.