AMA AND OTHERS CAUTION “RETAIL CLNICS; BIG BAD WOLF!”

DO WE HAVE YOUR BEST INTERESTS AT HEART?

AMA AND OTHERS CAUTIONS “RETAIL CLNICS; BIG BAD WOLF!”

Let’s start with some of the arguments these groups put forward as reasons for concern in using a Retail Clinic!

• Ø Do not have access to all chart records.
• Ø Causes Fragmentation of care by adding another provider.
• Ø Staffed often by Physician Assistances or Nurse Practitioner
• Ø No patient follow up care.
• Ø Chronically ill are more complicated than clinics usually see.  (Note it doesn’t say can’t handle)
• Ø Question if have patient’s best interests at heart!

I looked in detail at five articles about these warnings.  The first covers the period around 2007.  Titled AMA Goes After Walmart Style Retail Clinics, it warns of the same concerns.  “Our primary focus is patient safety and patient care, and the retail clinics have a different mission of selling products and prescriptions,” said Dr. Rodney Osborn.  The AMA stance at that time was to lobby for increases regulations of these Retail Clinics.  Typically doctors often site regulations and dealing with insurance as an over regulated problem.

The other articles cover and aim at those clinics owned by CVS, Walgreen’s, Target and other groups. On Feb. 23, 2014 (my 52 birthday updated a statement disapproving of the Retail Clinics.  Again the list above covers their reasons for concern.

An article written in Aug. of 2012 shows these statistics.

• Ø Total visits go from 1.5 million (2007) to 6 million (2009)
• Ø The same study notes that there are 557 million visits to Doctors and 177 to ER’s
• Ø One significant change in demographics was that those over 65 were at 7.5% (2000 to 2006) and at 14.7 (2007 to 2009).
• Ø About 40% of the visits from 2007 to 2009 were for immunizations.

I now have a few questions and statements I think need to be considered.

• Ø How often can the people that visited a Retail Clinic did so because of lack of access to an appointment needed now?
• Ø How many ER’s have access to a patient’s health record or chart?
• Ø How many Pediatricians really know a patient and remember that child’s chart when called after hours?
• Ø How many Nurse Practitioners or PA’s are employed by Pediatricians or Doctors?
• Ø Is it really fair to say no access to follow up care?  I say this because many say to follow up with your family practitioner or come back to them if they do not have one!
• Ø If it is still true that most(almost half, 40%) go for immunizations, is this really a big issue?
• Ø What study said this are that?  Compare it to what is actually going on.
• Ø Should Pharmacists really be giving vaccinations when they are bogged down just filling prescriptions?
• Ø How many groups are going to have a formal relationship with your Pediatrician?
• Ø Is some of the disjoint and lack of communication the fault of the AMA for going after the Retail Clinics instead of really working with these groups to shore up the holes? Or, is this just about the bottom line?
• Ø How many people complain about not enough time with their doctor?

I would think again about what the AMA and AAP says about these clinics.  I would think also about getting prescriptions where pharmacists are doing a lot of vaccinations.  I am a pharmacist and will get plenty of feedback for this I am sure.

The bottom line is go to places that you feel comfortable.  I can personally vouch for a Nurse Practitioner owned clinic.   Excellent care is what my husband (also a pharmacist), my son and I get when we go there.  This does not stop me from having a family practice physician.  I have gone to this man since 1987 and will not go elsewhere  besides that NP owned clinic in Yukon, OK.  They do not compete but compliment each other.

Below are the 5 articles used to write this essay; along with my personal knowledge and opinion.

Ollamok AKA Sandra

http://www.amednews.com/article/20120827/business/308279963/7/                                    http://healthland.time.com/2014/02/23/pediatrics-group-advises-against-retail-based-clinics/           http://www.kevinmd.com/blog/2013/08/drug-store-retail-clinics-primary-care-fast.html http://consumerist.com/2007/06/27/american-medical-association-goes-after-walmart-style-retail-clinic /http://virtualmentor.ama-assn.org/2013/11/pdf/vm-1311.pdf

Autism- No Simple Answer Says Sandra “But here goes my try!”

Autism? Simple answers? No! Here is
Sandra’s try at an explanation.

Autism has good graces.
Visit upon us to bless upon.

Doesn’t mean one shouldn’t ask,
“Why? What? When? Where and how?”

God could have intended
You being intentioned in the unhinging of the process.

Vaccination’s that is the key!
Say many with adamation!

I agree for them it could be,
A factor, insult that hit on.

Pharmacist in me says, the study was too small to make it a hallmark.
Flip the coin, drug makers threw around money, plus shouted out!!

Next, a group says environment
Causes problems no doubt.

Environmental insult.
Yep, that is why my child is shut into autism.

Remember here, environmental can be
From chemicals & diseases stalking inside to make their stand.

From, things like maybe Grandpa’s Agent Orange,
To a baby’s hospital stay due to RSV!

May yet wave
The Genetics Flag.

Throw into this mix, I will; smaller families, often an only child
That insists to be totally plugged into away from others.

Oh, how simple it would be
One answer, if could only twas or could be.

Yet, still I want to pose
Older parents, sperms and eggs as a contribution variable.

Not a reason not to conceive!
But to be aware more defects, mutations with age do occur.

Can one really say,
One cause is for autism?

Look at cancer! Common threads
There, still many different scenarios.

Genetics predispose, environmental assaults,
Turns on gene with a society that is ripe in culture and age of parents?

Yet, it matters!
No, it doesn’t matter!

Sound so crazy?
Yes, to help. No because we love and deal with it no matter what!

We learn what can and must be done.
But better realize the blame game must stop.

One answer might be cause in 1% of cases ( just me thinking),
Reality is autism is complex.

Complex, autism really is!
Yet, then is simple too.

Reaching out is what I want to do.
Remember right answers lead to correct therapy n treatments!

Wrong guesses and blame may only
Lead to burying data and wrong wizardly haphazard disasters.

Science, true keeps an open mind!
God is the first and Ultimate Scientist.

Together are we able
To do and can do n be our best.

In some ways the riddle of autism
Is not to be solved!

God means us to be
Who we are as he made us!

Change is something
All of us must do.

Adapting to you and others
Is being kind.

Let us not get behind
Stay in the forefront.

Doing out best to unlock the riddle
As much in prayer; God intends us to do!

I am sure by helping
We learn God’s lessons.

Helping those with autism
I bet could be a society improvement, God intends us to do.

No answer complete do I have;
Except my son is a blessing some may say in disguise!
God we will accept your answers.
Thank you God! Amen!