Walgreens Plays Doctor- Family Physicians Bristle

Bruce Japsen, Contributor, Forbes, April 6,2013

Walgreen’s latest push into primary care has one major doctor group taking issue with the retailer’s expansion into “management for chronic conditions” such as high cholesterol, diabetes and hypertension.

The nation’s largest drugstore chain earlier this week announced that its more than 330 Take Care clinics staffed by advanced degree nurses known as nurse practitioners were expanding the scope of the health care services beyond routine maladies like treating strep throat or pink eye.

Walgreen is now providing new services that include “assessment, treatment and management for chronic conditions such as hypertension, diabetes, high cholesterol, asthma and others, as well as additional preventive health services.” Walgreen said it was moving further along than clinics run by rivals like CVS/Caremark (CVS) or Wal-Mart Stores (WMT).

But some physicians are upset by the expansion, saying it will further splinter an already fragmented health care system and therefore harm quality and patient safety.

“It is more difficult to comprehensively manage a patient’s care if they are treated in multiple settings,” said Dr. Jeffrey Cain, president of the American Academy of Family Physicians in a statement to Forbes. Here’s a link to the academy’s policy statement in regard to retail clinics.

“Our health care system is already fragmented, and our concern is that the expansion of retail clinics into chronic care will lower quality, increase costs, and pose a risk to patients’ long-term health outcomes,” Cain added. “Retail clinics may not have some specialty services needed to treat those with complex diseases. In addition, family physicians establish relationships and get to know their patients, which better enables them to help someone with diabetes learn how to eat better, start exercising and stick with their treatment plan.”

But Walgreen says the services offered at its Take Care clinics meet the company’s “objective to help address the need for greater access to care by working collaboratively with physicians to support and complement their care plans for chronic patients.”

Walgreen, for example, has formed various affiliations with large hospital systems and doctor-led clinics across the country to create patient-care protocols and other programs. Walgreen has also formed and is joining with larger providers to create accountable care organizations, which organize a collection of medical-care providers to care for a group of patients.

ACOs work to keep patients healthy and out of the more expensive hospital setting. If ACOs are successful and reduce costs, the providers in the organization divvy up the savings with the health plans that are paying them.

“With this service expansion, Take Care Clinics now provide the most comprehensive service offering within the retail clinic industry, and can play an even more valuable role in helping patients get, stay and live well,” said Dr. Jeffrey Kang, senior vice president of health and wellness services and solutions, Walgreens.

Yet Walgreen may still have some physician groups to win over as it forges ahead in its effort to be a larger provider of health care services.

The American Medical Association, for example, and the retailer have discussed the new service expansions but the nation’s largest group said it had no comment on the retailer’s latest move. A source close to the AMA said the doctor group was evaluating the expansion into chronic care services.

READ FULL ARTICLE -For Key aspects of AMA Policy

CMJ-Walgreens move to provide more healthcare services in stores puts more pressure from big corporations on primary care doctors. It is likely that this will persuade more top private doctors to convert to alternative practice models like concierge medicine and direct primary care. Patients looking for the convenience that an in-store clinic provides may also choose to find a concierge doctor and compare the benefits. A concierge doctor provides even more access to health care and in some cases even house calls.

About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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