States Consider Regulating In-Store Health Clinics Amid Safety Concerns

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More states are looking into the quality of care offered by clinics in retail locations in response to a campaign by the American Medical Association and physician groups that asked states to investigate in-store clinics, the Wall Street Journalreports. Despite arguments from retail clinics that AMA's criticisms"are overblown and motivated by financial concerns," some states thatonce gave the clinics "extensive waivers from hygiene and safetyrestrictions" are beginning to crack down as the facilities grow innumber nationwide, according to the Journal.

There are more than 730 retail clinics throughout the U.S., and CVS Caremark, Wal-Mart Stores, Walgreen and Targetall have plans to expand their number of clinics this year. Some haveestablished new restrictions on in-store clinics, while others ban themaltogether.

Rhode Island has refused to let CVS Caremark openclinics in the state; Florida requires clinics to post a sign statingwhether a physician is present and disclose staffers' credentials topatients; and California has mandated that retail clinics be owned by aphysician. Meanwhile, some states, such as Texas and Wyoming, havereduced restrictions on the treatments that nurse practitioners canadminister in the clinics, the Journal reports.

Inthe debate over regulations, CVS Caremark has been working todemonstrate that its clinics adequately administer the appropriatetreatments within the scope of services provided. Company officialscite a study to be released later this year in the American Journal of Medical Qualityfinding that for sore throats -- the most common condition treated atin-store clinics -- the facilities gave proper treatment 99.15% of thetime, according to the Journal.

Forrester Researchfound that patients at retail clinics use them because of convenience,not quality, with 7% of respondents to a survey saying they thought thecare they received was better than that at a typical visit to aphysician office, the Journal reports.

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Massachusetts Retail Clinic Hearing

After reviewing a CVS Caremark proposal to open its MinuteClinics asthe state's first retail clinics, health regulators in Massachusetts onWednesday proposed regulations that now are under consideration by thestate's Public Health Council, the Journal reports (Seward, Wall Street Journal, 8/9).

Duringa hearing, council members expressed concerns that patients would notreceive adequate care if they go to retail clinics and that patientsmay use the clinics to obtain prescription drugs that their regularphysicians would not prescribe, the Boston Globe reports. Paul Dreyer, director of the Massachusetts Division of Health Care Quality, said that such abuse would not be a problem because the clinics will not "be prescribing drugs of interest to drug abusers."

Physiciangroups, hospitals and community health centers also expressed concernsabout how patient safety and infection control would be monitored atthe clinics, according to the Globe. The Massachusetts Department of Public Healthwill hold a public hearing Sept. 5. If Massachusetts allows retailclinics, CVS Caremark's clinics each would need individual states'approval to operate, the Globe reports (Smith/Kowalczyk, Boston Globe, 8/9).

Bruce Auerbach, president-elect of the Massachusetts Medical Society and chief of emergency medicine at Sturdy Memorial Hospital, said, "You're crowding people who may be sick, not to mention potentially exposing someone who's just trying to buy Doritos" (Wall Street Journal, 8/9).

MichaelHowe, CEO of CVS Caremark's MinuteClinic, in an e-mail said,"MinuteClinic can serve a critical health care need by providingconvenient, affordable access to quality health care for common medicalconditions. As Massachusetts expands access to health insurance tohundreds of thousands of people, we know that demand for basic healthcare services will increase" (Boston Globe, 8/9).

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Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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