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TUESDAY, June 26 (HealthDay News) -- The American Medical Association is calling upon federal and state agencies to investigate possible conflicts of interest posed by store-based health clinics operated by pharmacy chains.
The AMA said the request, made Monday at its annual meeting in Chicago, was spurred by reports that retailers say the store-based clinics help increase store traffic, which can increase sales of prescription drugs and non-health related items.
"It seemed to many [AMA] members that there was an inherent conflict of interest in a relationship between a health clinic and a pharmacy chain in terms of writing prescriptions and getting them filled in that pharmacy," said Dr. Peter Carmel, a member of the AMA board of trustees, and chairman of the Department of Neurological Surgery at New Jersey Medical School.
Carmel said that, before the vote, there were "allusions to reports" of potential conflicts, in which clinic operators earn more money or get promotions based on the amount of prescriptions written.
Specifically, the AMA voted to:
- Ask state and federal agencies to investigate the clinics and pharmacies for potential conflicts of interest as they relate to patient welfare and risk, and professional liability concerns.
- Work with state and specialty medical societies in developing guidelines for legislation that regulates store-based health clinics.
- Oppose any state and/or federal regulations for store-based health clinics that waive existing standards for medical care facilities.
A spokesman for Walgreens, the large drugstore chain that operates Take Care Health clinics staffed by nurse practitioners in some of its stores, defended the company's record and denied any conflict of interest.
"If the AMA pushes this agenda, its members may find out that legislators and their constituents have been demanding accessible, affordable and high-quality health care for years," Michael Polzin said. "And that's exactly what retail clinics are delivering.
"Any attempt to push back retail clinics will result in higher health-care costs and prevent some patients from receiving the care they're seeking," Polzin said. "Also, Take Care Health nurse practitioners are meeting or exceeding national guidelines for prescribing, so they're doing a proper job of prescribing medications like antibiotics."
A statement issued by the Convenient Care Association, which lobbies for in-store health clinics, noted that the number of in-store clinics has grown "due to a widespread lack of access to high-quality, affordable health care in America.
"We are surprised that the AMA would take the position that it has, because so many physicians and other health-care professionals have accepted this new model and see it as part of the solution to our broken health-care system," the association statement said. "While the AMA convened its annual meeting this week to discuss ways to prevent patient access to convenient health care, the Convenient Care Association held an annual retreat to promote accessible, affordable, price-transparent health care to all Americans."
The AMA's Carmel believes that in-store clinics have a role to play in a consumer-driven health care system. "But it is necessary to be vigilant to make sure that the same high-quality standards that doctors meet in their offices are met in these clinics," he said.
In a related vote, the AMA also passed a resolution that seeks equal insurance co-payments for in-store clinics and doctors' offices. A difference is co-payments could steer patients to the clinics on the basis of cost rather than quality of care, the AMA said.
"There have been examples of insurance companies waiving or lowering the co-pay for patients who go to retail store clinics, but not offering that same waiving or lowering to patients who are seen in a physician's office," Carmel said. "We feel by doing that, insurance companies are steering patients to retail clinics and, in a sense of equity, it should be a level field between the retail clinic and the physician's office."
The AMA took several other votes during its annual meeting. They included:
A vote to lobby for laws allowing severely allergic children to bring lifesaving medicine to school. The recommendation refers to medicines such as epinephrine and other injectable drugs that treat severe allergic reactions called anaphylaxis, which can cause swelling, difficulty breathing, loss of consciousness and death, the Associated Press reported.
Currently, many school districts prohibit children from bringing medicine to school and 18 states have similar bans, according to Dr. Duane Cady, a member of the AMA's Board of Trustees.
A vote to adopt a policy endorsing the use of radio frequency identification tags (RFIDs), which store essential medical information under the skin of patients. The devices, the size of a grain of rice, are implanted with a needle and could give emergency room doctors quick access to the records of chronically ill patients, the AP reported.
The main concern surrounding the devices is protecting the privacy of the stored information.
SOURCES: Peter Carmel, M.D., member board of trustees, American Medical Association, chairman, Department of Neurological Surgery, New Jersey Medical School, Newark; Michael Polzin, spokesman, Walgreens; June 26, 2007, statement, Convenient Care Association, Philadelphia; Associated Press
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