AMA calls for investigations to protect the patient?

By Richard E. Walrath and Patricia L Johnson

American Medical Association (AMA) announced on June 25, 2007 it is calling for investigations into conflicts of interest between store-based health clinics and pharmacy chains.  You know the places - CVS/Caremark stores, Wal-Mart stores, Krogers and Walgreen Co.

AMA Board Member Peter Carmel, MD states AMA physicians feel incentives may compromise the quality of care provided to patients:

"There are clear incentives for retailers to participate in the implementation and operation of store-based health clinics, said AMA Board Member Peter Carmel, MD. "The nation's physicians want the AMA to ensure these incentives do not compromise the basic obligation of store-based health clinics to provide patients with quality care."

The nation's physician leaders meeting at the AMA Annual Meeting voted to adopt the following directive instructing the AMA to:

1. ask the appropriate state and federal agencies to investigate ventures between retail clinics and pharmacy chains with an emphasis on inherent conflicts of interest in such relationships, patients' welfare and risk, and professional liability concerns.
2. continue to work with interested state and specialty medical societies in developing guidelines for model legislation that regulates the operation of store-based health clinics.
3. oppose waiving any state and/or federal regulations for store-based health clinics that do not comply with existing standards of medical practice facilities.

AMA and doctors are off on the wrong foot--again.  They made the big mistake of opposing national health care when Hillary Clinton tried and failed to get it passed, thanks to Big Bidness with their Harry and Louise ads and the efforts of the AMA and doctors who opposed it.

So what happened?  Doctors ended up working for HMO's that make all the money while doctors' incomes have gone steadily downward as their patient loads have been steadily increased.  They might as well be punching a time clock.

Now the opposition is against clinics in stores like CVS, Wal-mart, and Krogers all of which have pharmacies standing by waiting to serve you after you have seen the doctor on duty without having to wait a half hour or more to see him/her.  And how convenient it is to pick up while you'rethere whatever else it is that you may want to buy?

In separate action, physicians updated principles for the promotion of quality and safety at store-based health clinics adopted last year at the AMA policy-making meeting. Physicians today approved an additional principle that seeks equal treatment for physicians regarding health insurers' co-payment policies. These financial incentives may inappropriately steer patients to these clinics on the basis of cost rather than quality of care.

"Health insurers are allowing store-based health clinics to waive or lower patient co-payments, while forcing physicians to collect these fees, said Dr. Carmel. The AMA believes health insurers should be prohibited from waiving or lowering co-payments only for patients that receive services at store-based health clinics."

Hasn't anyone bothered to tell AMA members there are a minimum 45 million Americans that do not have health insurance?  If a person is not receiving health care due to the fact they do not have medical insurance and cannot afford to pay the full price for an office visit, but can afford to pay the fee charged at store-based health clinics shouldn't the quality of health care they receive be considered a step up from no health care?

What doctors and the AMA should be doing is joining this new medical marketing effort in supporting national health care.  People are going to use these clinics because they fill a need.  If you get sick and need to see a doctor, what you want is not an appointment.  You want to see a doctor. 

If you need a prescription, the pharmacy is right there if you go to one of clinics and in many instances the fees charged for generic equivalent prescription drugs make it possible for patients to receive medications they would otherwise not be able to afford.