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Fast, cheap, happy health care

Scott Jagow Dec 23, 2009

So, I’ve had this nagging cough the past couple of weeks. After a while, I realized it wasn’t going away on its own. I called up my doctor, and his assistant said:

Assistant: He can’t see you until after the New Year.

Me: But I have this cough. It won’t go away. I just need some antibiotics. Cough. Wheeze.

Assistant: After the New Year.

Me: But… hack, cough, phlegm.

Assistant: After the New Year.

So, I scoured the Internet looking for an alternative and stumbled across the Minute Clinic. You’ll find it over behind the potato chips at the CVS. The website said most visits take about 15 minutes. No appointment necessary. Most insurance taken. It even listed the prices. $62 for a minor illness exam. $62? Heck, that’s not much more than my co-pay.

But does my insurance approve of this? Who will I be seeing? Is it good care?

I discovered that my insurance would indeed work and that I’d be seeing a physician’s assistant or a nurse practitioner. As for the care, here’s what happened:

I arrived at 2:45pm and made my way through the throngs of holiday shoppers to the Minute Clinic at the back of the drug store. I expected the clinic to look like an emergency room, with people splayed out across chairs, sleeping on each other, kids playing with plastic cars on the floor, the take-a-number sign flashing 1,091.

Nope. There wasn’t a soul waiting. A friendly staffer told me to use the touch screen and enter my information. Literally 30 seconds after I was done, she called me in. She asked some questions, did a few tests and seemed as capable as any medical professional I’ve encountered elsewhere. Plus, the equipment she used was the most modern, unlike the Flintstone devices my doctor often takes out of the drawer. The Minute nurse diagnosed acute bronchitis, suggested an antibiotic regimen and told me I could get the prescription filled there or at another pharmacy. I left the clinic at 2:57 pm. Twelve minutes.

Wow. Time Magazine recently looked at these “Drive-Thru Medical” places. The article pointed out the low fees, the short waits, the fact that both uninsured and insured patients are treated. What’s not to like?

Plenty, say physicians associations, whose members warn that clinics — which are typically staffed by nurse practitioners and are positioned in stores that also sell prescriptions — will be inclined to misdiagnose and overprescribe. Worse, they are not built to provide long-term care for chronic conditions such as hypertension, and they threaten the ideal of a lasting doctor-patient relationship, denying consumers a so-called “medical home.”

Well, my nurse practitioner asked me if I wanted an extra prescription for the cough or would the cough medicine I had at home be enough. She wasn’t pushing drugs. And yes, I wouldn’t recommend going to the Minute Clinic if your arm is dangling from its socket or you have a serious, ongoing condition. As for my medical home, the doctor wasn’t going to let me in it until January, no matter what was wrong with me.

He doesn’t need to waste his time on my nagging cough anyway. I’ve seen the other patients in his office.

As for the quality issue, Time also reported on a recent study by the Rand Corp. in Minnesota. It looked at the care of quickie retail clinics versus urgent care centers, doctor’s offices and emergency rooms. The findings:

If the results are any indication, the next time you have a routine medical need, you should probably make haste to a clinic. On a quality scale of 0% to 100%, the clinics finished first with a 63.6% while urgent-care centers and doctor’s offices followed within a couple of points. Habitually overcrowded emergency rooms came in last at a distant 55.1%. When it came to fees, the results were even more dramatic. For the various kinds of services studied, the average visit to a retail clinic cost $110, versus $156 for urgent care and $166 for a family doc. As for ERs? A cool $570.

As I said, the Minute Clinic visit is $62. And with the extra time I saved, I also got some shopping done. I mean, I was right there in the drug store anyway.

You been to one of these? What do you think?

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