Give retail clinics a break

Your special report on healthcare providers opening retail clinics was a timely message for healthcare executives across the country who are experiencing the onslaught of retail and convenient-care clinics by national and regional retailers and pharmacy chains (“Look who’s buying retail,” Nov. 19, p. 26). The experience of the early clinic providers has shown that people are drawn to consumer-friendly environments where they can be seen quickly for minor medical ailments. Patients do not want to wait long or rearrange their schedules to see healthcare providers for simple treatments. Retail and convenient-care clinics supplement existing medical practices by providing convenient hours that are welcome to walk-ins and have quick service and easy-to-understand charges—all consumer-friendly qualities that will continue to attract new patients. The most amazing quality of these clinics is that they require a minimal capital investment compared with facility and equipment investments traditionally made by hospitals, health systems and physicians; they are not facility- or equipment-intensive. For traditional healthcare organizations and providers, these clinics are a low-cost, low-risk alternative for testing market expansion and new locations. Mayo Clinic’s strategy to operate a convenience clinic in a stand-alone storefront in a strip mall is a new approach that is sure to be effective. With a stand-alone retail location convenient to the public, the sponsoring healthcare organization can maintain maximum control of their branding, hours of operation, scope of services, quality oversight and referrals—without choosing sides by aligning with a single retailer.

James Killian

Executive director, business development Medcor McHenry, Ill.

The commentary by Rudy Giuliani marks a 180-degree turn from his stands as mayor of New York (“Let the consumer rule,” Nov. 12, p. 36). In 2000, in his second term, he proposed to “enroll as many as 1 million more city residents in government health programs (and) to enroll as many children as possible.” He added that “in a city like ours, if we can do this, it becomes a model for the rest of the country.” His current stance on “consumer rule and empowerment” seems to be a convenient new person particularly in light of his heavy-handed, socially insensitive and often legally challenged mayoral actions. The reforms he proposes are almost all encompassed in the very successful and well-received Medicare program. We hear minimum criticisms from senior beneficiaries. Medicare empowers consumers, is portable, is not state-regulated, is price- and quality-transparent, manages chronic care and is reasonable in costs. While prescription pricing should be addressed in line with the Veterans Affairs Department healthcare program, this does not seem likely under the Giuliani plan. While Giuliani is entitled to his personal views, we should look toward universal coverage under a government-run, all-payer plan.

Norman Rosenfeld

Consulting principal, health sciences group Stonehill & Taylor New York

Every time I read about excluding bad debt from community benefit reporting or Internal Revenue Service mandates, I think to myself, “There is no way most hospitals will meet a 5% goal for charity care” (“Caution: More scrutiny ahead,” Nov. 12, p. 46). I have worked in hospitals for 20 years, and as the person who currently approves accounts for further collection activity, I know that a large majority of patients who are given the chance to apply for charity care simply do not take the opportunity. They generally ignore our phone calls and applications, and even slip out the back door when we attempt to speak to them in the hospital. It sounds as if I am “blaming the victim,” but I assure you we do everything we can to help people understand our process and help them work through it. We could give a lot more charity if we didn’t have to document patient need, but I don’t think that would meet standards either. Perhaps the various government organizations should be in charge of the charity application process. I will be watching with great interest as this all plays out.

Liz Baptist

Business office director Perry Memorial Hospital Princeton, Ill.

Regarding the Federal Communications Commission’s plan to provide grants for rural information technology (“FCC has IT dreams in rural setting,” Nov. 19, p. 8): I think this is a tremendous move on the FCC’s part to provide funding for local hospitals. In trying to compete with metropolitan-sized healthcare facilities, the rural system continues to struggle to provide state-of-the-art healthcare. Having grant money available to link a rural hospital to physician offices, clinics, etc., would allow for a more modern approach to rural healthcare and even provide an opportunity for digital radiology and other online services.

Gregory White

Director of public relations Washington County Memorial Hospital Salem, Ind.

Regarding your Nov. 14 Health IT Strategist item, “AHIC wants to mandate e-prescribing”: While cutting through physicians on the way to the proposed “slam dunk,” one cannot ignore the 7-footers crowding the paint. Physician offices already e-prescribing cannot use the technology with several national pharmacy benefit managers. Furthermore, regulations forbid e-prescription transmittal for certain prescriptions. Not including the reticent PBMs, state boards of pharmacy and federal regulatory agencies in this “play for pay” scenario curtails the efficiency and safety gains sought by such a mandate. While I can accept that we, as physicians, must step up efforts to utilize IT resources, making physicians out to be the only impediment to a more efficient system is wearing thin.

Jon Seager

Family physician Hartville, Ohio

What do you think?

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