More on ERs and primary care

DB, there is one thing that I would support Wal-Mart to do well if they did go into care. I think they have the skill-set and man-power to actually make a decent, manageable EMR system.

Unfortunately, that’s the only thing I would expect from them that is high quality. Otherwise, Wal-Mart is still of the pile-it-high and sell-it-cheap mindset, which I don’t like with regards to medical care.

How long before McDonald’s sees the value of adding sniffles treatment to its menu and offers drive-through McMedicine?

I agree with DB: diluting primary medical care by broader distribution of inferior quality care is most assuredly not the solution to the primary care crisis. Indeed, we have to fix the broken payment system.

–TNT

Having any sort of drop-in clinics will help reduce the ER crunch; it certainly has in my area. Even so, those clinics at Wal-Mart, etc, by definition don’t address those in the most need: those without the means to be in a store like that in the first place. So ERs will always have to provide that safety net, until universal coverage is available (we can only hope.) And when that happens, it’ll be more imperitive than ever to get at the real costs of health care, which happen in hospitals. It’ll require solutions much more difficult and controversial than just ratcheting down reimbursement, which has pretty much reached its end-point.

CJD,
I practiced in an urgent care center. It is easy to make a mistake, especially if you are less experienced and don’t know the “customer” from before. You can’t apply the studies done regarding malpractice and patient-physician relationship to the Wal-Mart clinics, because it is a different situation. I shop at Wal-Mart quite often but I don’t have any “attachment” for the store. The same will happen to these clinics. If the store would be at fault, i would sanction them promptly. You can’t avoid making a medical mistake just by good management. And these clinics, the way they are created, will be more prone to mistakes. I am sure the store has an army of lawyers. But it also has big pockets. And in the US, that enough is a guarantee of a lawsuit.

Something’s got to be done! It’s so expensive to visit the doctor if you don’t have a good health plan. As a self-employed person, the only way I can afford health insurance is to take a $5,000 – $7,000 deductible. The fact that this country doesn’t have universal healthcare or some sort of affordable plan for the uninsured is a very sad commentary on America.