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

The New York SAFE Law offends the spirit and word of the US Constitution.  The Bill of Rights will cease to exist if we permit it to be rewritten by knee jerk reactionaries and political opportunist seeking to centralize power in a government of the few.

The US Constitution will be relegated to a museum artifact memorialized as a quaint idea of self governed people.

It is a falsehood of the thinnest pretense, that free people are incapable of keeping their own safety to the point where State Managers criminalize it. Along with the crime of imbibing a soft drink, a hired City Manager concludes we must be protected from.  The dishonest cries of we must give up these freedoms to save lives are an insult to our human dignity.

The contagion of this hysteria driven, prefabricated crisis have infected willing accomplices, throughout New York and among members of County Legislatures, in lock step with the notion of Lords and Masters over you and I.

Some feigned they had no technical knowledge of firearms, when all they were elected to do was have a reasonable working knowledge of the Bill of Rights.

Instead, we bear witness to a willing acceptance of a capricious and arbitrary law passed in the dark of night that created over 5 million criminals in that instance.  Not to mention, the entire law enforcement community along with them.

There were over 5 million legal firearms owners in the State of New York.  The SAFE Law overnight created criminals in all of them, because among other things, a seven round magazine does not exist.

The use of the word ‘commonsense’ in a debate absent reality is useless.  It is a propaganda ploy to color anyone who disagrees with them as lacking it.

Every elected official swore an oath upon their honor to preserve, protect and defend the US Constitution and the New York Constitution from all enemies, foreign and domestic.

New York State’s Constitution clearly states that all Bills must be seasoned, or rest on the desk for an excess of 72 hours. Governor Cuomo wantonly violated it, under a falsehood of urgency.  The Governor and his accomplices should face impeachment for this attempt at perpetrating a fraud on the honest people of New York.

All elected employees who voted to pass resolutions and support the SAFE Law expressed contempt for the Constitution and violated their oath.  They have dishonored themselves and abdicate the customary title of “honorable”, which of tradition precedes their name.

There is no intellectually honest argument yet presented, that can bear the scrutiny of inspection, fact or cross examination, which remotely can begin to abrogate or infringe upon the Second Amendment.

History will bear witness that in our day, these misguided usurpers made a blatant attempt at displacing our founding documents incrementally, harboring an insidious agenda of disarming us.

There be none in the People’s legislative body, from the White House to the State House, who can begin to improve upon the majesty enshrined in the Bill of Rights.

The Bill of Rights guarantees your freedom of speech, religion and worship because it limits the power of government to disarm you.  We will never need it, until they try to take it.

The SAFE Law strips you of that inviolable right; anyone who voted for it, committed treason against every soldier who fell defending it.

In this article, Freedom of the Press is now the last line of intellectual defense by drawing upon all the powers of persuasion that can be mustered in an appeal to nothing more than the commonsense you own.

To you few, who shame your elected office, your days are numbered and your honor is stained, for history will bear this out.

If a day should come, where one drop of blood is spilled or one hour of liberty is denied to one honest American, in an attempt to enforce it, that curse be upon your head.

To any, who seek to restore their honor, find courage in the redemption of renouncing this contemptible attempt at supplanting the idea of self government with the stench of the Oligarch.  Repeal the SAFE Law and oppose everyone who voted for it, by word and deed.

Anthony Mele, MA, Diplomacy, International Conflict Management
President, AMI GLOBAL SECURITY, LLC   www.amiglobalsecurity.com

I grew up poor and I thought it was unfair for me to be held back simply because of the mistakes of my parents. It drove me nuts, for example, to think that kids less intelligent, hard-working, and moral than me enjoyed vacations in Europe while I lived in a home with raw sewage in the backyard. I thought Marxist socialism would give young people in similar situations a more equal opportunity to enjoy the good things in life.

In retrospect, however, I didn't have anyone in my life to explain compound interest, or how to write a business plan, or how to apply computer technology to the most interesting questions. I think if my family had been part of a contemporary Christian church, then I would have had my questions answered and I would have made better decisions.

I got a track scholarship to attend Occidental College in Los Angeles. All the folks around me at Oxy seemed to think the best thing on earth that you could do with your life was to become a college professor. So I went with the program. I got a scholarship to attend graduate school where I got to study with the some of the best professors in the nation in American government and public policy.

My commitment to Marxist socialist thought, however, gradually came to an end by the summer of 1982 when I began to notice that there was a larger spiritual world which did not fit the materialistic atheist models of modern social science. It was a world of intuition, coincidence, and syncronicity which Marxism saw as only an illusion used to lubricate the workings of capitalist exploitation. I also figured out that my empathy for others was not a weakness...it was an extremely useful tool for generating guesses about how the world really worked.

As I became more spiritual I also started to have an unusual amount of success intellectually and academically. My thinking, writing, and observations knit together and I started to attract positive attention with my research on the causes and timing of welfare programs in the U.S.

In my case, I remember where I was the exact moment I realized I no longer believed in the ideals of Communism: I was walking through the basement of McGraw Hall at Cornell University in September 1983. I had just finished an argument with my radical thesis advisor. As I recall I began to believe that the problems associated with child abuse and neglect might be easily first through the use of European-style visiting nurse program. As best I can recall my thesis advisor, however, saw child abuse as a larger problem caused by the necessity to invest in the reproduction of social capital under conditions in which children were mistakenly seen as elements of private property as part of the larger cultural and legal structure which maintain the reproduction of oppressive class conflict. The solution to child abuse would involve paying attention to much greater issues involving the distribution of power and wealth in a modern industrialized society. (Or something like that...) Whatever the details of that argument, I remember the encounter left me  me thinking he was ideologically blinded and alarmingly out-of-touch with reality.

I inadvertantly discovered a bizarre failing in modern political science. I was able to show that much of what we consider our modern America - schools, parks, Boy Scout and Girl Scout programs, and aid for families with dependent children - were largely a consequence of the earlier effort to enforce child labor laws. I know this sounds completely obvious...but the social science development literature of the 1960s and 1970s had been written without any reference to the role of child labor law enforcement as a key step in the modernization process.

Based on my historical research, I disconfirmed the Marxist hypothesis that welfare programs arose out of class struggle. My research showed they arose as an unintended consequence of the completely independent prior decision to stop child labor.

I ended up teaching at Williams College in MA, the nation's top rated liberal arts college. I won an award from the American Political Science Association for my thesis. It is now published in book form.

Today, I'm married. I'm proud that I attend a Baptist Church that overlooks the Pacific Ocean. I have my own management consulting business. Right at this moment, I'm struggling to get up to speed on this new social networking technology...and I'm excited that it provides a way to get around the mainstream media. For a brief overview of my Life of John compared to the more famous Life of Julia, please click here.
 
John C. Drew, Ph.D. is an award-winning political scientist.

Author: Brian D. Hill

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