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Medical Franchising: Good Or Bad For Your Average Medical Doctor?

Urgent care centers and walk-in clinics (collectively referred to as retail health clinics) can be found in almost any city in the United States.  Rather than schedule and wait for an appointment with your primary care physician, you can walk in to a local retail health clinic and be seen the same day; often you can see the physician in less than an hour.

Medical franchising is becoming big business.  The medical profession is undergoing a paradigm shift.  The last major shift saw the creation of health maintenance organizations (HMOs) and preferred provider organizations (PPOs) as well as the rise of the primary care physician.  Now some insurance companies are not only covering medical franchise visits, they are also reducing or waiving the copay.

But it is not just the insurance companies that are causing this increase in retail health clinic use.  Dr. Mark Perry, Professor of Economics and Finance at University of Michigan says:

“Consumers … are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics.  Especially when consumers are spending their own out-of-pocket money for health care and they have a choice, they prefer market-driven, consumer-driven options like affordable, convenient retail clinics over conventional physician offices.”

Is this shift good or bad for your average medical doctor?  Obviously the decrease in office visits is bad for doctors financially, but how else does the shift towards retail health clinics effect medical doctors?

First, it creates a new type of doctor: the retail health clinic physician.  In the past, people usually had a pediatrician and a general practitioner or a family practitioner.  With the advent of HMOs and PPOs came the primary care physician and referrals to specialists. Now retail health clinics are staffed mainly by nurse practitioners and doctors who develop a limited field of experience.  While this may increase competition, it limits the number of people who enter general practice, and that leads to a second area of concern for medical doctors.

The second area of concern is the reduction in the quality of care provided to patients.  When a patient visits a retail health clinic they are usually meeting the care provider for the first time.  The only information that the retail health clinic has is what the patient provides at the time.  In addition, the retail health clinic care provider is only addressing the symptoms presented at the time.  This creates fragmented care.  Knowledge of the patient’s habits and history help the primary care physician treat the whole patient and not just the symptoms.  At a retail health clinic, the care provider is most likely not going to check cholesterol or address issues like smoking. Because of the nature of the retail health clinics, the care providers there don’t have time to access immunization records or medical histories.

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To expand on the difficulty of fragmented care records, HIPPA regulations make sharing of records more time consuming and costly.  Consider the difficulty of compiling an immunization record for a patient who has been to three different retail health clinics in addition to her primary care physician. At the first location the patient received a flu shot.  At the second location she received a Hepatitis B vaccination. At the third location vaccinations for Measles and Mumps were administered.  She needs to provide records for the college she plans on attending in the fall.  This is only a sample of some of the complexities that primary care physicians (and also the patient, who is responsible for proving her immunization record) can face in gathering information.

A third area of concern for doctors (and society as a whole) is the possibility of doctor shopping for medications and diagnoses.  The proliferation of pain management clinics (or ‘pill mills’) has made it much easier for patients seeking to abuse prescription drugs to find what they are looking for.  This doesn’t just apply to prescription drugs.  It is now easier than ever to find the diagnosis you want by going from doctor to doctor.

Finally, the rise of retail health clinics has changed the ownership rights and responsibilities of medical practices.  Initially a doctor would simply put out a shingle and practice.  As the legal landscape developed, some doctors began practicing in groups where each doctor was a partner or shareholder.  Corporations became involved in hospital ownership, but the decision makers and the boards were scientists and medical professionals.  With medical franchising, any individual can buy a retail health clinic franchise regardless of their medical knowledge or ability.  This makes the care providers responsible to a person or persons who may not always have the best interests of the patient in mind.

Medical franchising is rapidly growing in this time of economic downturn.  Patients enjoy the speed and increased choices.  But as doctors have told us over and over, what we want may not always be good for us or for your average medical doctor.

This article was contributed by www.CRTMedical.com.

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