Menino in the wrong

by Beacon Staff • January 30, 2008

On Jan. 9, the Massachusetts Public Health Council approved a plan that will allow some retailers and nonprofit organizations to operate medical clinics for the treatment of minor health ailments like poison ivy and earaches.,Boston residents sick of clogged emergency rooms and busy primary-care physicians will soon have a new place to receive walk-in health care. That is, if Mayor Menino and the Boston Public Health Commission consider the public's best interest.

On Jan. 9, the Massachusetts Public Health Council approved a plan that will allow some retailers and nonprofit organizations to operate medical clinics for the treatment of minor health ailments like poison ivy and earaches.

Upon this announcement, MinuteClinic, a subsidiary of CVS Corp., announced it will open 100 to 120 clinics in Massachusetts CVS stores over the next three to five years. MinuteClinic already operates 466 clinics in 25 states, and has been praised for the quality and expedience of its services. Retailers Walgreens and Wal-Mart also announced intentions to open similar clinics, but have not gone into specifics.

Recent reforms have made health insurance mandatory for all Massachusetts residents and has resulted in 300,000 newly-insured citizens, exacerbating current problems in care availability. Walk-in clinics would spread this burden across multiple fronts, easing the pressure on primary-care physicians and helping to preserve our emergency rooms for the gravest injuries.

Inexplicably, Mayor Menino opposes the plan.

"Limited service medical clinics run by merchants in for-profit corporations will seriously compromise quality of care and hygiene," he argued in a written statement released Jan. 11. "Allowing retailers to make money off of sick people is wrong."

Granted, MinuteClinics will suggest patients purchase CVS items to follow through on treatment, but this decision is ultimately left up to the consumer. Nobody's forcing anyone. Anyway, this is a mild instance of collusion when we consider how pharmaceutical representatives schmooze physicians to prescribe their company's medications.

CVS is a for-profit enterprise, this is true, but so is much of the American health care apparatus. But that isn't really relevant. Those who visit MinuteClinics would do so of their own accord, and the trip would be at least partially reimbursed by the majority of insurance providers (treatment at Connecticut MinuteClinics currently ranges from $59-$69).

Hygiene is an important concern, but it must be understood that MinuteClinics will be separated from the rest of the store, and that certified nurse practitioners, not blue-shirted CVS clerks, will be providing the actual care. When a patient is seriously ill, nurses can and will refer him elsewhere.

If Menino is concerned about quality, he should consider how diverting patients into retailer-run clinics would ease emergency room congestion and appointment backlogs.

A Harvard study found that the median wait time in Massachusetts emergency rooms rose from 22 minutes in 1997 to 30 minutes in 2004. Compounding this is a severe shortage of family physicians. In 2006, 53 percent of patients were able to see a doctor within a week of making an appointment. Last year, that share fell to 42 percent.

Menino fears MinuteClinics will siphon experienced nurses away from hospitals into this new niche. This fear is legitimate, yet it is not reason enough to derail an otherwise workable health-care solution.

The subtext here is that the mayor fears competition. This mentality simply does not jive with our free market system. Massachusetts citizens should be thrilled by the proliferation of health care enterprises. MinuteClinics will provide increased care quality at diminished its price.

MinuteClinics are not meant to replace health coverage, but to act as a supplement for improving existing modes of care. It's a supplement Bostonians should, for their own good, not go without.