I will never go to a regular doctor for a minor, routine illness again. Sick and wanting an appointment immediately, I went to one of those medical clinics in Wal-Mart. I got in almost immediately, everyone on the staff was extremely friendly, and it only cost $59. Wow. I was pleasantly surprised and impressed.

http://freemanhunt.blogspot.com/2008/01/re...nic-review.html

I read about this elsewhere.

I'm pretty sure this is a very, very good thing. Most of the stuff that folks go to a doc for is trivial stuff.

That type of thing really drove health care costs for my dad's company. Folks think that insurance is somehow a free benefit and that they are obligated to use it as much as possible.

Meanwhile, the missus and I self insure the first $2k, as we have for years, and we actually barter with my doc when we do want to check on things. We do our research and we are careful with our bodies, but we consume very little health care. I would say that most folks should have similar coverage and use WMT for everything trivial.

M

good luck! When doctors formed medical clinics or "groups" the price of medicine rose, as more tests were run, more equipment used, more pressure on doctors from practice managers (read: business managers). There is no incentive to "reassure" (the old "take two aspirin and call me in the morning" approach).

Wal Mart may have figured a way around that, but there is incentive to sell drugs and related medical "stuff". Unless this is purely a marketing scheme to draw folks into the store, offer "discounted" medical care in the hopes that someone picks up a blender and a new TV on the way out the door... Wal Mart isn't just doing this to "be nice"

I smell a rat and the further deterioration of the profession. Who are these "doctors" who are working for Wal Mart?

mm

Sure beats an emergency room visit!
Open weekends, holidays and after hours!
We have two near Tulsa, one in Owasso and one in Broken Arrow.

About RediClinic

RediClinic is high-quality, affordable healthcare that fits how we live today. No appointments, no waiting – and routine treatment and preventive care in about 15 minutes. RediClinic's staff provide convenient and affordable treatment for more than 25 common conditions, such as strep throat and ear infections. They also provide health screening tests, vaccinations, immunizations, and physicals.

RediClinics are staffed by nurse practitioners who provide high-quality primary care and can order appropriate medications. They are registered nurses with advanced degrees and clinical training, often in partnership with doctors from an outstanding local healthcare system.

RediClinics are conveniently located in the stores where you already shop, near the pharmacy of select H-E-B and Wal-Mart locations. They are open extended hours every day of the week, including most holidays.

Home LINK
Partners LINK

They don't work for Walmart.

Bailey Medical Center of Owasso, OK
Bailey Medical Center is associated with RediClinic in Owasso, Oklahoma. It is an acute-care hospital that provides general medicine, general surgery, obstetrics, gynecology, orthopedics, physical rehabilitation, occupational medicine, emergency/urgent care, and internal medicine.

Hillcrest Medical Center of Broken Arrow, OK
Hillcrest Medical Center (HMC) is associated with RediClinic in Broken Arrow, Oklahoma. It offers comprehensive cardiovascular care through the James D. Harvey Center for Cardiovascular Research and the Congestive Heart Failure CARE Center. The hospital also provides services through the Center for Diabetes Management, the Alexander Burn Center, the Helmerich Cancer Center, the Hillcrest Bariatric Institute, and the Hillcrest Sleep Center.

MM,

You "might" get ripped off at one of the WMT clinics, but it GUARANTEED that you will get buggered at an ER if you go there for a trivial problem.

I think what's happening is that there's a market for services that don't subsidize the uninsured and the irresponsible, and WMT is going to exploit it.

M

THe ER system is badly broken for myriad reasons. People you do not know and have no history on or with show up and demand medical care. The ER doctor for medical and LEGAL reasons is forced to run unnecessary, expensive and redundant tests in order to be "thorough" and cover his/her's @ss.

In addition, given the 40 million uninsured, its the place to go to get help, in the hopes you won't get hassled for your bill, since medicine has always promised to provide care in the ER whether you are prepared to pay for it or not.

When you talk about "health care" in a clinic what do YOU think is acceptable? Treating a cold? A cut? More?

And I know no politics are allowed, but have you heard ANY candidate DEFINE what they mean by "health care"? Who is entititled to what?

Does a guy who gets a concussion and 10 broken legs from a silly snowmobile accident get "Universal Health Care" the same as some nerd like me who will never get on a snowmobile and never break a leg? .....

mm

Living in Peru for a while.

Doctor's visit $15.
Meds 80% cheaper and don't require a prescription.
Just tell the pharmacist your symptoms.

Retired Invsestment banker patient. Powerful, egotistical. SHowed up in my office 1 week into a massive heart attack. Was reading on-line about his symptoms, self diagnosed it as "GERD" and was taking Prilosec OTC from Wal Mart. Much damage to his heart by the time he showed up.

A patient from Trinidad thought he had "colitis" and was taking a prescription from his pharmacist. Turned out the pharmacist was giving him 5 Fluoro Uracil, a treatment for colon cancer. Finally flew up to USA where we diagnosed biliary cirrhosis. Liver was shot. We had to look around for a liver transplant.

A patient this weekend was self-medicating with zinc, echinacea and OTC cold remediesfor his "stuffed chest" and shortness of breath. . By the time he got to the emergency room and was found to have atrial fibrillation with congestive heart failure he was 5 days into his symptoms.

As I said before, good luck.

mm

A woman showed up here last week. Self medicating a rash around her vulva/perineum with her pharmacist. Had tried Monistat (thought it might be a yeast infection) then was given hydrocortisone cream, then "lubricating" lotions, and more.

Finally came here. Biopsy shows Lichen Sclerosis et Atrophicus, one sample suspicious for squamous cell carcinoma.

Her pharmacist has NO liability. He only took her word for her symptoms. (I can guarantee you he never looked at her you-know-what).

A nurse practitioner at the nearby Navy Base in the walk in clinic sent a patient with "chest discomfort" to the emergency room. Never really took the patient's history or listened to the patient's story.No labs, no EKG, no examination. Same in the ER. Patient emergently sent for cardiac catheterization by the in-house cardiologists who "assumed" that the clinic doctor and ER doctors had taken proper histories. Patient kept trying to say but... but.. but...

All tests were negative! Patient had indigestion. Too fat, ate too much. Very young, no other risk factors for heart disease. Non smoker, no blood pressure, etc.

Total cost of that "care"? huge. Any liablity in this case? Where do you want to get advice?

mm

My sister-in-law went to her doctor complaining of lower abdominal pain.
Her mother died of ovarian cancer at 43 years old.
My sister-in-law was 43 at the time of the visit.

The busy, dis-interested doctor perscribed birth control pills or something.

It was ovarian cancer and the doctor's lack of diligence prevented her from getting proper treatment for many months.

He doesn't work for Wal-Mart.
They wouldn't have him.
Good luck.

Roger, that is a truly sad story and I am sorry for you. Bad medicine is bad medicine and is sadly a part of life. Doctors are human and prone to mistakes. We have yet to discover some machine like Bones had on Star Trek that scanned the body in a second and told him all he needed to know.

We have a system in place of responsiblity. That doctor should have been sued for negligence if, in fact, the record shows that the give and take betweeen patient and doctor was improper. Let's hope he learned from his mistake and helped others or was so negligent that his license to practice was revoked.

We all have stories like this. I'm not sure it "proves" anything. My father told me one day when I was about 11 years old driving in a car, we were stopped at a red light and he turned to me and said, "Son, what ever you do, do it well".... may have been the most he ever "emoted"... the light turned green and we drove on and never spoke of it again. Wish I had a chance to ask him what was going through his mind that day before he died at age 57 from a heart attack which he thought was indigestion.

As an aside, diagnosing ovarian cancer is tough. Look at Gilda Radner's story, or Madeline Kahn, 2 smart women with a ton of money, both who got misdiagnosed and died.... sad. Should every woman with belly pain have a blood test for ovarian cancer and a CAT Scan and Ultrasound? We don't have the answer for that yet....

mm

BTW, there's nothing wrong with seeing a doc, and an lot right with it.

The every sniffle visit nonsense isn't going to get any complaints from docs, but it sure drives up health insurance costs.

There are a LOT of things that one can't take care of oneself (at least the first time) but probably don't need a doc, either. I've done many of them to myself. Cuts, hooks, sprains and strains, etc. If you're troubled by minor colds, minor viruses, and stuff like that, you probably don't need to even go to WMT, but it's a way to put yourself at ease without blowing your deductible.

M

Mayor Thomas M. Menino embarked on a highly public campaign yesterday to block CVS Corp. and other retailers from opening medical clinics inside their stores, an effort that exposed a rift between Menino and the state's public health commissioner, a longtime ally.

Menino blasted state regulators for paving the way Wednesday for the in-store clinics, which are designed to provide treatment for sore throats, poison ivy, and other minor illnesses.

The decision by the state Public Health Council, "jeopardizes patient safety," Menino said in a written statement. "Limited service medical clinics run by merchants in for-profit corporations will seriously compromise quality of care and hygiene. Allowing retailers to make money off of sick people is wrong."

http://www.boston.com/news/local/massachus...s_in_retailers/

100 years ago (roughly) pharmacists made whatever they felt like in the back room. And sold it for "whatever ails you"... most of the ingredients included morphine, cocaine, pepper, licorice and related stuff. Coca Cola started as a way to draw folks in. It was a mixture of sugar and cocaine. Morphine syrups were widely used. The now famous "Robitussin" came from concoctions designed to loosen up phlegm from "colds" or tuberculosis. Many of those products helped to launch huge corporations, purveyors of useless over the counter products like all the "cold and cough" remedies, to pills for "cramps" and back aches, head aches, etc.

The FDA is still trying to pull some of that crap off the shelf. Only recently did they have the money and guts to remove the stuff for sale to kids, after one dead kid too many.

Granted there are those who argue that we should still be able to walk in and ask for morphine and cocaine from the pharmacist, like in the "good old days".... i'll leave that "discussion" alone for now....

The more I think about it the more I like the idea of these clinics.... you get what you pay for.....

Do you really think an employee of CVS or Wal Mart is going to tell a person with a fever of 101 who just payed 59 bucks she has a "cold" and needs to go home and get some rest and some chicken soup? Or do you think they are going to point them towards some "remedy for what ails you"?

mm

ZZZZZZZZZZZZZZZZZ

I see your point. They may prescribe one of them thar $4 Walmart perscriptions for the big profit margin.
How much do you Docs make on perscriptions?

You may be letting your prejudice show just a bit.
Have you considered that there will be more access to the medical system because of Walmart's clinics?
Many folks who don't have insurance don't have a doctor and may have a difficult time even getting one to accept them as a new patient, and NOT ANY TIME SOON!
Also the ease of a walk in clinic and the certainty of knowing the moderate cost of the "office visit" may get some folks the help they need who otherwise might do without.

Think outside the box and see the potential benefit to the millions of uninsured with such an easy medical option.

And remember, there is a difference between efficacy and effectiveness.

The short answer is I still believe in my "profession"... but that discussion will never fly here because mostly folks bad mouth doctors these days or tell of horrible stories and really have no idea what it is most of us do.

The longer answer is that its not the 4 dollar prescription, but the 20 dollar bottle of RObitussin or Alka Seltzer cold and flu, or Alka Seltzer "Immune Booster" that they are going to sell. Also, the missed serious diseases, etc..

And we do not sell medicine to our patients. It is taboo here. The only ones who do are the chiropractors who sell unregulated Vitamins and "supplements"... The other day a patient brought in a can of "Re-Live" powder the chiropractor sold them for a LOT of money. According to the label it had a few vitamins, and some "secret" formula that included licorice and rhubarb roots. Pure crap.

Another chiropractor was selling VERY expensive "vitamins" that had ground up sheep ovaries and testicles.

Last I heard some docs in Florida were able to sell some penicillin from the office, but I'm not up on all the state regulations.

Look, as you know I think medicine is in bad need of a fix. The CVS and Walmarts aren't going to fix it. They are just going to profit off the problem, not add to the solution.

mm

"Also, the missed serious diseases, etc.. "

My sister-in-law did not go to Walmart for her missed ovarian cancer.

Doctors have a reputation for thinking that they are... Never mind.

You know Roger, I think you're a pretty smart guy. But there is something up with this doctor-racism business I don't understand. Maybe you can enlighten me.



It takes 4 years of college with good to excellent grades in difficult subjects.

Acceptance to medical school is quite hard. A lot of spots go unfilled.

It takes 4 years of medical school, long hours, frequent testing. National Boards are taken not once, not twice, but 3 times over several years.



4 years! We're not talking of 4 years spent lounging around toking joints and doing shots, but ungodly hours in school, classes, study time, hospital wards, clinics, etc. etc.



After those 8 years it takes at least 3 post graduate years to get certified in Family Practice or General Practice. There is NO PLACE in the USA that will offer you a job at that point unless you have passed or are at least signed up to take the NATIONAL boards in Family Practice or Internal Medicine.



If you stay in those fields of medicine you are required to continue taking between 50 and 100 hours of ongoing education ANNUALLY (this is state-dependent). And you are now required to REPEAT the NATIONAL boards. Depending on the specialty this is either every 5 or 10 years.



In addition you have to have your office open to inspection by Private Insurers and Public, like Medicare and Medicaid. They are allowed to examine your procedures and charts. Your prescriptions are followed by national watchdogs, including the DEA for narcotics.



Any error is reported to a NATIONAL database where you can look up and see if your doctor has ever been sued, or found negligent.



In addition, in order to admit a patient to a hospital that hospital will do its own due diligence and monitor your activity there.



If you choose to continue towards advanced degrees this could take an additional 2 to 5 years, depending on Gastroenterology, Cardiology, Pulmonology, Neurology, Oncology, etc. and these are only the MEDICAL fields. Passing those boards and maintaining proficiency there is rigorous, to say the least.



For SURGICAL fields, the MINIMUM is 5 years AFTER 4 years of medical school for basic surgery. More for cardiac, pulmonary, neurosurgery, etc.



There is no other profession that takes so much training, or is required to continue training. There is no other profession that is so open to outsiders looking over our shoulders. We are required to remain knowledgeable, personable, and available.



Most of my colleagues work long, arduous hours. We are in and out of the hospital night and day. We call patients at home. We ask for help from experts in the field. We rarely have lunch. We rarely get home in time for supper. We work hard. We try to help and we are pretty damn good at what we do.



For some time now it has been a "cute" thing to rag on "doctors" as if we were all cut from the same cloth. I think you are smarter than that. Anytime, anywhere there are some who are off...miss diagnoses, prescribe wrong treatments, don't seem to care, etc. We know this. We police ourselves. We pay huge malpractice premiums. We set higher and higher standards. We set tougher and tougher guidelines.



You know, and shame on you if you don't, that on balance the quality of care, knowledge, sincerity, earnestness, and excellence outweighs the occassional screw up a million to one.



I challenge anyone to show that "doctors" suck, that our lives are not better off, that YOUR life is not better off. Show me that kind of integrity in Law, Stock Market analysts, Stock Newsletter writers, Wal Mart executives, Congressman, Priests, Vitamin Corporations, Lead-paint toy makers, cops, truck drivers, etc. etc.



Look, if you don't like "doctors" take care of yourself! DON'T go to doctors. Why put yourself in the hands of us morons? Us dis-interested baboons? Let's all just make fun of all the golf club swinging, country club joining, yacht-owning douche bags who are living the life or riley making money off the stupid public. You know, all those hundreds of millions of stupid people who "let themselves" get sick and then "let themselves" be taken advantage of by us doctors.....



According to much of what I read here the reason people are sick anyway is because they either arent' eating right, or taking the right mix of yeast, grains, proteins and vitamins...right? So, really its the public who are the morons.... we're just taking advantage of them, so kudos to us! Do I have this right?



mm

No disrespect intended, but just what do you think you and your colleagues are doing? Last I heard, you guys aren't charities and in fact, you expect your practice to make a profit.

Profit is what will fix the problem. It's called FREEDOM, and if one believes in it, one allows the market to find solutions.

Mark

No disrespect Mark, but Freedom is not allowed in Medicine. Somehow people believe it is a government ordained "right". Where you have supplemental payment (i.e. "insurance") then people expect the providers (as we are now called) and the Drug Companies to provide "medical care" for free or at reduced prices, while Hospitals and Drug Companies and some doctors who are gaming the system charge MORE because they can get it from the insurers.

Walk into Wal Mart for a TV and you may get a better price, so you'll buy it there. You don't walk into Wal Mart and say, "I don't care what the cost of the TV is, just send the bill to my "Insurance". That's what people do with subsidized, quasi-socialized medicine in this country.

Want to fix the profit abuse and overuse of medicine in this country? Take away insurance for a few months, which will force people to ask what it all costs and then see if they still want to "order every test" or "send me to the "best" specialist for second, third opinion" or "give me that new pill"....

Freedom in medicine? You've got to be kidding. It is supplemented and the closest thing we have to socialism/communism and you know how those experiments turned out. It is intrusive and abusive at multiple levels.

In spite of that, most of us work our asses off to care for people, remain ethical and try to do the right thing. While getting harrassed from Insurers, patients, regulators, and critics.

mm

Basically, I agree.

But what I'm saying is we need more freedom (including you), not less.

And you're dead right, folks need to stop and ask what something costs. They don't. Even smart, responsible folks. Docs may well have some blame in that, but I'd say that gathering authority makes doing their job easier and if it's a problem for others, it's really THEIR responsibility to fix, not Docs.

If you think I don't respect your field, you're quite wrong. I'm just going to get in your (or others') face when you or others say that it's somehow wrong to profit from helping others.

You SHOULD profit from helping others. That's how you know we need help!

Mark

I have several doctors as clients and I love 'em.
They are people. Wonderful people.

Doc, being serious here, you often seem a bit touchy or over-reactive.
You're reactions are often like someone has slapped you personally.
Maybe it's just the problem with this type of bulletin board communication.
I think it causes many misunderstandings between people.

I think you take your profession very seriously, as you should.
No one can do it like you do. I believe that.
You jealously guard your profession. That is a good thing.

So I can understand how it must feel like an insult that some medical treatment is being done at Walmart.
But maybe what they are doing is filling a very real need.

You fear that they will make mistakes and people will suffer.
That will happen.
And I point out that doctors make mistakes, and people suffer.
That will happen.
But it does not put doctors on the same level as as a Walmart clinic.

Do you think it's OK for diabetics to take their own glucose readings and give themselves insulin shots?
Shouldn't doctors be the only ones to perform such medical procedures?
Sometimes the best medical treatment comes down to practicality in the real world.

Diabetics should take their Blood Sugar readings. Particularly Insulin Dependent diabetics. And record them and adjust their insulin according to guidelines. They are encouraged to do so and a lot of time is spent educating them.

Yes, I am touchy and protective, if for no other reason than to fight for some integrity. I dislike the drug companies false tactics. Read today's New York Times regarding LYRICA and FIBROMYALGIA. If that doesn't turn your stomach I don't know what will.

Or read the article about the failure of Zetia to control heart disease in spite of lowering cholesterol. In medicine, we will take that research and completely change our prescribing habits and what we tell our patients.

HOWEVER when that type of research comes out about, say Vitamin A, like a few years ago, did the Heatlh FOod stores take it off their shelves? Did the vitamin companies ADMIT that it had no value in preventing breast cancer (I'm talking about the big breast cancer and Vitamin A/E study)? No, they just kept shilling it. Lying bastages that they are.

So yes, I'm touchy. More on Wal Mart clinics later. Gotta go see a patient.

MM

For those who don't like the idea of Walmart offering "walk in" clinics, consider this real life situation:

Last week my daughter got sick, by Thursday she felt so bad that she called her doctor.
He would try to squeeze her in THE FOLLOWING TUESDAY!
5 DAYS!

So Tuesday she drug herself to the doctors office only to be told that the doctor didn't come in that day but that another doctor could work her in in a few hours.
She eventually was seen and diagnosed with brochititis and given a perscription for an antibiotic.
I betcha Walmart could have done that the previous Thursday.

And don't even think of going to an emergency room for such an illness.
The overworked & overcrowded ER rooms put critical patients first, of course,
Brochititis goes to the back of the line.

Harvard Study News LINK


Just a thought.

This is exactly what the clinic is good for.

Sure, she should check in with her doc when he could be bothered to see her, but in the mean time, she would have gotten treatment and been back in the game by now.

I don't know about your daughter, but I really can't afford to be out of the game for 5 days more than I need to be.

Mark

This did not happen at a Walmat clinic:

This week, my friend's 87 year old mother had stroke symptoms and was told by her doctor to go to the hospital immediately.
But the hospital told her to go back home since they had no beds available.
They promised to call if something came open!!!

So she went home and waited.
Her children eventually called the doctor back and he was able to get her into the hospital, where she is now.

What can I say?

It reminds me of when my uncle was in a head on wreck which shattered his legs.
The hospital examined him and said he looked ok and just needed to go home and get some rest.
He went home as directed but was in so much pain that he returned and spent the next 3 weeks in ICU and nearly died!

A patient goes to the hospital and has a good outcome, therefore hospitals are good?
A patient goes to the hospital and has a bad outcome. Therefore hospitals are bad?

A patient takes Vitamin C and doesn't catch a cold. Therefore vitamin c prevents colds?
A patient takes Vitamin C and catches a cold. Therefore.... um... not enough? Bad karma? Wrong type?

Etc. etc.

None of these anectodal snips are of any logical or useful value and have no meaning.

There are ways to participate in solutions. Become an activist in your community for improving health care. Educate yourself. Serve on the board of the hospital. Add to the solutions.

mm

Dismissive and pejorative.

Go watch the movie Patch Adams and guess who you sound like.

Frankly, this is why I get/got tired of posting here. Its a landscape of complaining with no positive suggestions.

I know Mark says no politics, but its this "politics as usual"...i.e. negative, put downs, complaints, and self-serving interest that is awash here. And Medicine is the whipping boy. When I put up a comprehensive post about my knowledge of medicine, obtained from years of study and two decades of INDEPENDENT SOLO practice of medicine, practiced with integrity, caring and hard work, my 2 cents are ripped to shreds by snippets of manure, frankly. If you recall I posted my thoughts on trading here for years without once mentioning that I was a doctor, but got so sick of the out and out lies that were increasingly posted by some "alternative" lunatics of fake medicine that I finally, albeit unwillingly, jumped in to counter utter LIES that were beginning to appear with the patina of legitmacy.

Whatever.

So, I'm back out on the door to door campaign trail, where I've been for the past months, talking to my colleagues, and key state reps (many of whom are my patients), attending caucus planning meetings, manning phone banks, etc. because I am sick and tired of 47 million uninsured people, I am sick and tired of disproportionate health care, manipulation by drug companies and medical monopolies and, yes, "Wal Mart" phony clinics as well as phony "Health Food" stores and Vitamin lobbies and if we, who know and care, don't do something, it will continue to be business as usual. Suffice it to say, out of respect to Mark's "no politics" guide, I"m not saying who i"m backing but I will say that, "Yes, we can" do a better job for ourselves, our country and our future.

Good luck at Wal Mart. I did see Patch Adams. In fact, when I'm telling a patient they have cancer I usually sing them the news with a banjo and a fake arrow through my head and, if necessary, throw in a few fart jokes. Because that's what "we" doctors are really like....

mm

Guys, can I ask that you give each other a little more love and understanding? Just cut each other a little more slack.

Think a minute about how personally someone might take your comments.

I'm seeing things escalate here and my read is that more is being read into posts than is intended in some cases and otherwise, too broad a brush is being used. Regardless, I'm seeing more emotional and emotional button pushing comments.

That means that from this point, very little real communication is going to take place on this thread. I think we've stopped hearing each other.

Mark

I love the good Doctor, respect his talents, and think I understand where his opinion on this comes from.

Ask any good CPA what they think of Walmart's tax preparation Kiosks set up every year.

You'll hear something very similar.

Good health to all.