Thursday, October 29, 2015

The 'Mall-ification' of Medical Care - The New York Times

Last week I was dashing through O'Hare International Airport in Chicago to catch a flight back to New York. Fifty feet before my gate I noticed a stand offering flu shots. I'd been considering getting a coffee before the flight, but maybe I should get a flu shot instead?

It sure looked tempting. I'd been meaning to get my flu shot at work, but whenever I had a moment the nurse was busy with patients, and whenever she was available I was locked in mortal combat with the electronic medical record system. The pleasant young woman at the airport clinic offered to check my insurance plan to see if it would be covered, and I was about to pull out my insurance card when the paperwork logistics gave me pause.

Because I'm a doctor and am required to get vaccinated, I'd have to get documentation from the airport kiosk, remember to bring it to my hospital, and figure out how to get it incorporated into my official medical record. And who was this white-coated person anyway, I wondered. Was she a nurse, a pharmacist, an airport employee? Who was certifying this kiosk? Were they storing the vaccine in the proper manner? Did they have equipment available to handle allergic reactions?

When retail health clinics started springing up in the early 2000's, many thought it was a passing fad. But these clinics have exploded over the last 10 years, and now it seems like every other big-box store, supermarket and shopping mall has its own clinic. Apparently airports are now getting in on the action.

Between 2007 and 2009, the number of visits to retail clinics quadrupled. Almost half the visits were after hours — on evenings and weekends when doctors' offices are usually closed. Most were for minor acute conditions like flu symptoms, ear infections and back pain, or for simple preventive care like vaccinations and sports physicals.

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