Medical Comedy: The Ointment Spoofs Wal-Mart Clinics
Barbara Lock, MDMay 05, 2009
This fake news piece from The Ointment spoofs the Wal-Mart clinics, with an actress pretending that she is taking care of patients without any special training, having been promoted from the Photo Lab. She also pretends that she is getting medical support from a 12 year old boy in India.
It's reasonably good comedy, but how true is it?
What are the qualifications of providers who work in retail health clinics?
According to its website, Wal-Mart.com, Wal-mart does not provide the medical services in its clinics. Instead, it contracts these services out to companies, such as Quick Health (California) and RediClinic (Texas), which supply the medical staff. This model is common around the country, with companies such as ExpressCare supplying the staff to clinics located in ShopRite stores in New Jersey, and MinuteClinic supplying the staff to clinics in CVS stores throughout the country.
Who really provides services at these so-called retail health centers? Although some companies advertise that care is provided by physicians, it is likely that at prices charged, almost all care is being delivered by mid-level providers such as Nurse Practitioners and Physician Assistants. Is this good enough for coughs, colds, immunizations, and allergies? Can mid-level providers substitute for general practitioners, for physicians who went to medical school?
It turns out that it they probably can. A group in the Netherlands led by Dierick-van Daele randomized 1501 patients in 15 general practices to be seen by either a general practitioner (physician) or a nurse practitioner for their general medical care. By randomly assigning the patients to the two groups, the investigators were able to increase the likelihood that the patients in each group were similar to each other, and increased the validity of the study.
In both groups, patients appreciated the quality of care. Health status, resources used, and compliance with care guidelines was just as good in the nurse practitioner group as it was in the physician group. But, get this: patients spent more time with the nurse practitioners than they did with the general practitioners.
There are boutique retail health practices that are exclusively staffed by highly trained physicians, and these practices are usually equiped, and priced, to handle sicker patients. A company called SwiftMD provides telephone consultation with Emergency Physicians for patients with minor medical complaints, with pricing similar to that of mid-level staffed retail health clinics. No 12-year-olds there.
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