AMA takes on retail clinics

Doctors groups say patients in danger

By Bruce Japsen
Tribune staff reporter
Published June 25, 2007
The American Medical Association should call for a ban on in-store clinics being opened by retail giants like Wal-Mart Stores Inc. and Walgreen Co., several doctors groups urged at the AMA's annual meeting in Chicago on Sunday.

Faced with an onslaught of competition that is forecast to bring several thousand retail health clinics to U.S. consumers, AMA members testified that such clinics are endangering patient care, particularly for children. The doctors say the clinics, largely staffed by advanced-degree nurses and physicians' assistants, are largely unregulated and, therefore, put patients' health at risk.

"There is no more urgent issue than this for the AMA," Dr. Kamran Hashemi, a family physician from South Barrington, said, urging the organization to push for more regulation of retail clinics. "This issue speaks to what all of us do every day in practice." If the AMA does nothing, Hashemi said, "in five years, the chairs [at the AMA] meeting will be filled with representatives from Walgreens, Wal-Mart" and other retail outlets.

The AMA meets through Wednesday to set policy. The committee discussing retail clinics will weigh Sunday's testimony and bring it before the full 555-member House of Delegates in the next two days at the Chicago Hilton and Towers. AMA action on such issues means the group will use its considerable lobbying clout to push for federal laws to increase regulation and slow growth of clinics.

At the very least AMA actions could damage the concept in the court of public opinion as doctors urge their patients to stay away from retail clinics. Given Sunday's broad opposition to retail medical clinics, the doctors group is likely to harden its existing policy toward retail clinics by the end of the meeting.

Retailers such as Walgreens say they do abide by AMA standards, which call for the use of electronic medical records and guidelines for appropriate sanitation and hygiene.

"We would be disappointed if the AMA adopted a policy that is counter to what patients are demanding, which is more accessible and affordable health care that reduces overall costs," Walgreens spokesman Michael Polzin said in a statement. "It would be hard to argue against those principles. The bottom line is, retail clinics are improving health-care access and health outcomes while keeping the patient's doctor informed as the patient desires."

Most clinics are open seven days a week, and no appointment is needed. They treat patients with routine maladies and work under physicians' supervision, although doctors usually are not on site. Most treatments are for ailments such as ear and sinus infections, strep throat and athlete's foot. Retailers such as Walgreens do not treat patients under 18 months. One doctor said pediatric care is too complex for nurse practitioners and retailers should increase the age limit to 3 years or even older.