In Store Clinics

LETTER TO THE EDITOR:


RE: Drugstore Diagnosis: No appointment necessary; by Maureen Glabman, Florida Medical Business, June 13-June 26,06:

The AMA House of Delegates emphasized during the Association's Annual Meeting that the in-store clinics are no substitute for a long-term relationship with a trained and board-certified medical doctor. These clinics may provide invaluable medical services for the insured, uninsured and underinsured who value the convenience and flexibility of getting treatment on a walk-in basis instead of having to schedule an appointment to see their physician. Even though the operators of those clinics claim that they do not substitute but complement the existing medical services at doctors offices, the delegates at the AMA Annual Meeting expressed concern about the clinics' impact on quality care, leading the house to adopt nine guidelines and direct the AMA to monitor the effects of the clinics on the health care marketplace.
These guidelines can be sumarized as follows:

* Encourage patients to establish a relationship with a primary care physician to
ensure continuity of care.
* Have a well-defined and limited scope of clinical services consistent with
state scope-of-practice laws.
* Use standardized medical protocols derived from evidence-based practice
guidelines to ensure patient safety and quality of care.
* Establish protocols for ensuring continuity of care with practicing physicians
within a local community.
* Set up a referral system with physician practices or other facilities for
appropriate treatment if the patient's conditions or symptoms are beyond the
scope of services provided by the clinic.
* Clearly inform patients in advance of the qualifications of their health care
practitioners as well as limitations in the types of illnesses that they can
diagnose and treat.
* Establish appropriate sanitation and hygienic guidelines and facilities to
ensure the safety of patients.

As a practicing family physician I cautiously support the establishment of in-store clinics as long as they abide by the above guidelines.
All in-store clinics should develop a working relationship with a local primary care physician to provide continuous medical care for patients diagnosed with chronic diseases requiring longitudinal medical care.
In store medical clinic may cater to consumers seeking quick and focused medical attention, but may also create a "quick-fix" mentality for the treatment of medical problems that require the attention of an experienced medical doctor.

Bernd Wollschlaeger, MD, FAAFp
Vice-President Dade County Medical Association
AMA Delegate